Burnham House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Peoples needs were assessed regularly to ensure they received personalised care. Care plans were person centred and people received personalised care and support. People had access to healthcare services and were supported to live healthier lives. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The care home worked in partnership with health and social professionals to ensure people were in the best of health.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager and staff told us that peoples needs were assessed regularly to ensure they always received personalised care. A staff member told us, "We review people’s care plans on a regular basis and when needed. We also hold key worker sessions where we support people to look at goals and things they would like to achieve." The registered manager commented, "Reviews are completed with family and staff. Might need health professionals. Peoples goals, aspirations and dreams are in the support plan. Evaluations are done and action plans are put in place. Key worker monthly summaries are done by key workers."

Systems were in place to carry out pre-admission assessment to identify people’s backgrounds, health conditions and support needs to determine if the service was able to support them. One to one reviews were carried out with people regularly to ensure people received support in accordance with their current circumstances. The reviews discussed people’s preferences and allowed them to make choices on their daily routines. This meant that people’s needs, and choices were being assessed comprehensively to achieve effective outcomes for their care. Reviews of care plans were also carried out. Where people did not have capacity to make decisions, then best interest processes were followed and their next of kin were involved as part of assessing needs.

People and relatives told us people received personalised care according to their needs. A relative told us when asked if persons needs were being met, "Yes, as far as I can see they do."

The registered manager and staff told us people care was based around what is important to them and according to their preferences. A staff member told us, "To ensure that care is given in the way the person chooses. Everyone has a different way they would like to be supported so therefore care should be different for each person."

Care plans included the support people required with care and treatment. This included monitoring people with fluid and nutrition. Records showed that people had been supported to access a number of health services to ensure they were in the best of health. Quality improvement systems were in place, which included regular audits and feedback from people and staff to ensure people received safe and effective support at all times.

People and relatives were positive about the care provided.

Feedback from professional were positive. Comments included, "Overall there were no concerns regarding the support being provided and the [person] appeared to have some autonomy around [person] day to day life."

The care home worked in partnership with other agencies such as health and social professionals if people were not well, to ensure people were in the best of health. Staff handovers were completed during shift change, which included tasks completed, tasks outstanding and wellbeing of people.

People and relatives were positive about staff and going to different services. A person told us, "They help me to make appointments if I need to." A relative told us, "Yes, [person] had a condition that required [person] to see a specialist with regards to a condition. [Person] needed to go see a Consultant and [person] went there."

Staff told us they worked well with eachother and external services and were supported by management. A staff member told us, "We have a handover system in place, which means that we would verbally handover to staff that are taking over the shift. We would record any concerns in the handover book that we may have that we feel that staff need to know about" and "We support people by making appointments for people if we identify somebody is not feeling well."

People were supported to live healthier lives. We saw that people were encouraged to drink and eat a balanced diet and were encouraged with activities.

Care records included the contact details of people’s GP, so staff could contact them if they had concerns about a person’s health. Annual reviews of their health were carried out. A health action plan and hospital plan was in place that recorded how people should be supported with upcoming health appointments. People also had access to dental services and oral health care plans were in place. We observed that people had access to dental care products to ensure they were in the best of oral health. Staff had also been trained in oral healthcare. People were supported with activities. People’s preferences with activities were recorded and activities were planned weekly. We observed that people participated in activities at the home. Records showed that people participated in a number of activities, which included accessing the community and indoor activities such as baking, dancing and playing games. People were able to maintain relationships with family and friends.

The registered manager and staff told us that people were always supported to live healthier lives. This included encouraging a balanced diet, participating in activities and promoting independence. A staff member told us, "We support people to be a part of the community, this includes going shopping, also having meals out and also booking holidays. We also do various activities inside the home and outside for example we do puzzles board games." The registered manager told us, "Each person has a weekly timetable. Two people go to college, three days a week. There is a plan and the actual activity. What is on the weekly plan will be reflected in the daily records."

The registered manager and staff told us peoples outcomes were always monitored through daily observations and reviews such as key worker meetings. During reviews, care needs were discussed to improve outcomes. The registered manager told us that regular audits were carried out also to monitor and improve outcomes.

People and relatives had no concerns about the care people received.

Systems were in place to monitor and improve outcomes. Care plans were personalised to ensure outcomes can be met in ensuring people received safe and effective support. Reviews were carried out regularly to ensure peoples support and outcomes were monitored. Audits were being carried out and action plan was in place to ensure people received personalised care according to their needs to ensure there was a cycle of improvement and improving outcomes for people.

We observed that staff requested peoples consent prior to supporting them and around daily activities.

The registered manager and staff were aware of the principles of the Mental Capacity Act (MCA) and the need to ask for consent. A staff member told us, "We have received training regarding the Mental Capacity Act as well as Deprivation of Liberty training. This means if somebody is unable to communicate or have the ability to make decisions then we should follow the Mental Capacity Act and arrange a meeting to discuss different options on how to support the person. However, this also means we need to try different ways of explaining the task such as using pictures objects a reference."

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. Systems were in place to obtain consent from people to provide care and support. Consent forms had been completed to ensure people consented to receive care and support from the service. MCA policy was in place and staff had been trained on the MCA. The registered manager and staff were aware of the principles of the MCA. Staff told us that they would always request people’s consent before doing any tasks. People were able to make day to day decisions about their lives. For example, they were able to chose how they wanted to be supported. Where people did not have capacity to consent to care and treatment, then MCA assessments had been carried out and best interest decision process was followed. DoLS applications had been made in a timely manner to deprive peoples of their liberty lawfully for their own safety.