Inspection on 25/11/09 for Birchwood Grove

This is the latest available inspection report for this service, carried out on 25th November 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Birchwood Grove 09/10/07

Birchwood Grove 12/04/07

Birchwood Grove 21/08/06

Birchwood Grove 15/11/05

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Birchwood Grove 64 Sydney Road Haywards Heath West Sussex RH16 1QA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: David Bannier     Date: 2 5 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Birchwood Grove 64 Sydney Road Haywards Heath West Sussex RH16 1QA 01444458271 01444441792 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Name of registered manager (if applicable) Miss Rachel Bridget Bekaert Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 24 The registered person may provide the following category/ies of service only: Care home with nursing - N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia DE Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Birchwood Grove is a care home providing personal care and nursing for elderly persons with dementia and other mental disorders. The home admits residents from the age of 50 years upwards provided they are assessed as requiring care for mental health problems. The registered providers are Ashbourne (Eaton) Limited. Birchwood Grove is a large detached house in a residential area of Haywards Heath; 5 Care Homes for Older People Page 4 of 31 Over 65 0 0 24 24 1 2 1 0 2 0 0 8 Brief description of the care home minutes walk from the local railway station and town centre. The residents accommodation is situated on the ground and first floor accessed by a passenger lift. There are 20 single bedrooms and 2 double bedrooms, 14 of which offer en-suite facilities. There are two lounge and dining areas and a garden at the rear, which is accessible to the residents and limited parking space to the front of the property. The responsible individual on behalf of the company is Mrs Sarah OMara. A manager has been appointed and is the process of regsitering with the Commission. The current fees are from £550.00 to £750.00. Additional charges are made for dry cleaning, toiletries, hairdressing and newspapers. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. The inspection has followed the Inspecting for Better Lives methodology. It is called a key inspection as it assesses those standards determined by the Commission as key standards. The quality rating awarded at this inspection will determine the frequency of inspections hereafter. The provider completed and returned to us their Annual Quality Assurance Assessment, referred to as the AQAA. Some residents and staff were sent surveys by the Commission entitled Have Your Say. These are designed to enable residents and staff to give their opinions about how the care home is being run. The information received from these documents will be referred to in the report. We made a visit to the care home on Tuesday 25th November 2009. As this was an unannounced inspection we gave the provider and the manager no notice of our Care Homes for Older People Page 6 of 31 intention to visit. We spoke to three of the 14 residents who were being accommodated and observed care practices. We also spoke with three relatives who were visiting at the same time. This helped us to form an opinion of what it is like to live in this care home. We also spoke to some staff on duty in order to gain a sense of how it is like to work at the care home. We also viewed some of the accommodation and examined some records. The visit started at 10am and was completed by approximately 6.30pm. The manager was present and provided us with information about the service. We gave feedback to the manager at the end of our visit. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 31 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care needs of all prospective residents are assessed before moving into this care home. Birchwood Grove does not provide intermediate care. Evidence: During this visit we examined the care records of four residents, two of whom had been admitted since our last inspection. We found evidence that the needs of each resident had been assessed prior to admission as required. Areas of need assessed included personal care, physical wellbeing, mental state and cognition, mobility and dexterity, sight, hearing and communication, oral health and foot care, continence, social interests, hobbies, religious and cultural needs. We spoke to three care staff who were on duty. They were able to explain clearly their understanding of the needs of recently admitted residents. Care Homes for Older People Page 11 of 31 Evidence: We also spoke to two relatives and a close friend of a resident during our visit. They confirmed that residents care needs had been assessed and discussed with them before admission. One relative told us, We visited several homes looking for a place for our mother. We liked the homely atmosphere we found at Birchwood Grove. The manager went to the hospital to assess my mothers needs before she was admitted. The AQAA stated that Each client will have a personalised pre assessment to assess their needs. We could find no evidence that Birchwood Grove provides intermediate care. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents health, personal and social care needs and wishes have been set out in an individual plan of care. Residents health care needs have been fully met. Residents have been are protected by the homes policies and procedures for dealing with medicines. Residents feel they are treated with respect and their right to privacy is upheld Evidence: From evidence found during our last inspection we formed a judgement that care planning systems needed to reflect the current needs of people living in the home. We also formed a judgement that improvements needed to be made to the risk assessments. We sampled a selection of care records during this visit and found that improvements Care Homes for Older People Page 13 of 31 Evidence: had been made as required. Residents care records include care plans which have been drawn up from the information gathered at the pre admission assessment. Care plans include details of residents identified needs together with clear information for staff to follow so they know the action they are expected to take to ensure they have been met. There was evidence that confirmed care plans have also been routinely reviewed. This means that information about residents care needs is kept up to date. Care records also include details of appointments with residents doctors or other health care professionals including details of any treatment prescribed and provided. We were informed that one resident tended to refuse solid foods. As a result fortified vegetable and fruit drinks or smoothies are provided to ensure their nutrition intake is sufficient. We discussed this with the manager in terms of the capacity of the resident to understand and to make informed choices or if this practice is deceptive. We recommended that the manager makes a referral to the local authority under the Deprivation of Liberty Standards (DOLS) in order to make an assessment and to determine if the appointment of an advocate would be beneficial for the resident. The manager agreed to take appropriate steps to make such a referral. Two completed surveys confirmed that residents always receive the care and support they need, whilst one survey confirmed this is usually the case. One relative informed us, We are very happy with the the home. Mum is happy in her own way. She is happy being able just walk about as and when she wants to. She goes off on her own and sits. Another relative we spoke to told us, My aunt has improved since she first moved in. She looks a lot better and her physical state has improved. Two surveys completed on behalf of residents confirmed the home always makes sure they get the medical care they need, whilst one survey confirmed this is usually the case. We spoke to care staff who were on duty. They were able to demonstrate they were familiar with the needs of identified residents and the actions they should take to ensure they have been met. Surveys returned by staff confirmed that they are always given up to date information about the needs of people they support and care for. The AQAA confirmed that, Each service user has an individual plan of care that is regularly updated and revised. We observed care practices and noted that care staff are respectful when speaking to residents and ensure residents are treated with dignity when personal care is being provided. Staff were seen to address residents politely and in a professional manner. Care Homes for Older People Page 14 of 31 Evidence: One survey returned to us confirmed that staff always listen to residents and relatives and act on what they say, whilst two surveys confirmed this is usually the case. A survey returned by a visiting social worker confirmed that the care home usually respects the privacy and dignity of residents. Information provided in the AQAA confirmed that, Dignity and Privacy are consistently put into practice. From evidence found during our last inspection we formed a judgement that improvements needed to be made to the process of handling, recording and administration of medication. We looked at care records and medication records. We were satisfied that medication records had been well maintained and were up to date. We also noted that a secure facility had been provided to store all medication.We noted that staff who handle medication had been provided with up to date and appropriate training. We noted that some residents have been prescribed medication, such as pain and constipation relief on an as required basis. However, care plans we examined did not include any directions to staff with regard to the circumstances when such medication should be administered and the dosage to be administered. We brought this to the attention of the manager who agreed to take the necessary steps to amend care plans where necessary. We observed the trained nurse on duty administering medication over lunch. We noted that this person wore a red tabard which warned other staff not to distract them whilst they carried out this task. Medication was administered from a trolley which was locked when the nurse was not in attendance. Medication was taken to each resident, whether they were in the dining room or in their own room. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with a range of activities and entertainments. Residents maintain contact with family, friends, representatives and the local community as they wish. Where appropriate residents have been helped to exercise choice and control over their lives. Residents have received a wholesome appealing balanced diet which meets individual residents nutritional needs. Evidence: From evidence found during our last visit we formed a judgement that people living in the home needed to be given the opportunity to experience a lifestyle that matched their expectations, choice and preferences in respect of leisure activities and meals. During this visit we noted that care records included details of each residents interests and hobbies. We were informed that an activities coordinator has been appointed who is responsible for organising activities for residents to enjoy. On the day of our visit this person was attending a meeting with the manager about providing Care Homes for Older People Page 16 of 31 Evidence: appropriate activities for residents. We did not observe any activities taking place, but did note the interactions between residents and staff over morning coffee. We saw staff speaking to residents with respect, using the name and title of the resident. One member of staff knelt down beside a resident to ensure they were at the same eye level whilst talking to them. As the resident was agitated the member of staff spoke gently and quietly to them to find out if the resident required assistance with something. We were informed that there is programme of activities which are arranged on a daily basis. We were shown a copy of previous weeks activities programmes and noted they included a gardening club, puzzles, music sessions, arts and crafts, ball games and reminiscence sessions. The programme is also on display on a notice in the front hallway of the care home so that residents and their relatives can see what has been organised. One survey completed by a relative on behalf of a resident confirmed that there are usually activities provided that they can take part in if they want. One relative was unable to answer this as they did not know, A third resident stated there a never activities arranged. This person commented, It could organise some trips out. At present I only go out if my grandson comes. Most of the other residents have much more severe mental and physical health problems and there is no one of my age I can really talk to. Information provided in the AQAA stated that, Residents are generally happy and responsive. They participate when possible in social interactions and activities, relative to their individual skills and likes and their dependency levels. During this visit we noted that care records include details of residents families and next of kin, including telephone numbers, so that they may be contacted. We looked through the visitors book and noted that residents do receive visitors every day of the week. Visitors we spoke to confirmed that they are able to keep in touch with family and friends. One relative told us, We visit weekly. We are made welcome by the staff and are offered a cup of tea. We spoke to the cook during this visit who told us about the main meal of the day that was being prepared. This consisted of a choice of chicken curry, rice and a mixed vegetable or sausage roll with vegetables followed by a choice of pineapple with custard or fresh fruit. Alternatives such as jacket potatoes and omelettes were also available for those residents who required a lighter meal. The cook also informed us of Care Homes for Older People Page 17 of 31 Evidence: the special diets that were currently being catered for. This included diets for residents who are diabetic and also those who required liquidised meals. We were given copies of recent menus to look through. They demonstrated that a varied, wholesome and nutritious diet has been provided. We observed the main meal of the day being served. We noted that tables in the dining room had been attractively presented with tablecloths and napkins, condiments, a choice of cold drinks and individual place settings. Menus were on display in the dining room and position so that residents are able to view them. We were informed that some residents have chosen to taken their meal in their rooms. The meal was served out by the cook and was attractively presented to encourage residents appetite. Residents we spoke to during the meal confirmed the meal was tasty and nicely cooked. We noted that the majority of residents had chosen curry. Two surveys confirmed that residents usually like the meals provided. The third survey was not completed in this section. The person completing the form commented, I cannot answer for my mother. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Residents have been protected from abuse. Evidence: We noted that the homes complaint procedure was on display in the front hallway of the care home. Relatives we spoke to during our visit confirmed they knew who to speak to if they wished to make a complaint. They also confirmed they were confident their concerns would be listened to and taken seriously. One resident commented, If I needed to make a complaint I would speak to the manager. I would comfortable in speaking to her as she is quite approachable. All three surveys completed and returned by relatives on behalf of residents confirmed they knew how to make a formal complaint. Information in the AQAA confirmed that, We have a clear and precise complaints procedure in place and any complaint is dealt with in a timely nature. The AQAA also confirmed four complaints have been received over the past 12 months. It was also confirmed they have all been resolved to the satisfaction of the person making the Care Homes for Older People Page 19 of 31 Evidence: complaint within agreed timescales. During this visit we spoke to some staff who were on duty. They confirmed they have received training with regard to identifying different types of abuse. Following discussion the staff were able to demonstrate they knew the different categories of abuse that they might encounter. They were also able to explain who they should notify if they witnessed an incident where a resident had been abused. We also examined records of staff training which confirmed they had received training in this area. Relatives of residents we spoke to confirmed they were satisfied with the quality of care provided. They also confirmed they felt residents were in safe hands. The AQAA also confirmed, All staff receive training in adult protection and whistle blowing and have access to all guidance, policies and procedures. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are living in a safe, well-maintained environment. The home is clean, pleasant and hygienic. Some work is required to ensure the laundry area can maintain good standards of hygiene. Evidence: During our last visit we judged that most parts of the home were maintained providing a homely and comfortable environment for people living in the home. Improvements needed to be made in respect of on-going maintenance, refurbishment and cleanliness to ensure all areas of the home are pleasing and safe. During this visit We looked at the private accommodation of several residents along with the communal areas, including the dining room and the lounges. These areas were well maintained, clean, decorated and furnished in a comfortable manner that met the needs of the residents accommodated. Residents have been encouraged to bring personal effects and small items of furniture in order to make bedrooms as individual as possible. Relatives of residents we spoke to told us they were satisfied with their accommodation. One person told us, The home is always clean and tidy when we visit. There are never any unpleasant smells. One survey confirmed the home is Care Homes for Older People Page 21 of 31 Evidence: always fresh and clean, whilst two surveys confirmed this is usually the case. We also visited the kitchen area, and several bathrooms. We noted that these areas have been maintained to a good standard of cleanliness. We also visited the laundry, which is the basement. We were informed that this area is always cleaned and tidied at the end of the working day. However, there were some areas of the laundry which cannot be maintained to the necessary standards of cleanliness to prevent the risk of infection. The floor covering does not cover the whole floor, leaving a concrete floor exposed. Some wall tiling had been removed when detergent dispensers were installed but have not been replaced and made good. We discussed this with the manager and advised that floor and wall coverings must be of an impervious material to ensure they are easily cleaned. This will ensure protection against the risk of cross infection occurring. The manager agreed to take the necessary steps to ensure these areas are repaired and made good. Information within the AQAA confirmed, The home has recently undergone a total redecoration and refurbishment programme. Communal areas and bedrooms have been decorated in consultation with residents and staff in relation to colour schemes, etc. The home retains the homely atmosphere where residents can relax and be with friends and family. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skill mix of staff provided meet residents needs. Residents are in safe hands at all times. Residents are supported and protected by the homes recruitment policy and practices. Staff are trained and are competent to do their jobs. Evidence: During our last visit we formed a judgement that improvements need to be made to staffing levels, staff training and recruitment practice to ensure care needs are met in full by a competent staff team who have undergone a robust recruitment procedure. During this visit we examined a selection of staff rotas. They showed that there is a trained nurse on duty 24 hours a day. From 8am to 2pm the trained nurse is supported by at least two care assistants; some mornings there are three care assistants. From 2pm to 8pm the trained nurse is supported by two care assistants. From 8pm to 8am each night care is provided to residents by a trained nurse and a care assistant who are awake and on duty. In addition to the care staff there are housekeeping staffing, including chefs and Care Homes for Older People Page 23 of 31 Evidence: domestic staff who are responsible for the providing meals to residents and for keeping the premises clean. We noted that completed forms designed to assess residents dependency levels were present in each of the care records seen. We were advised us they are used to work out the staffing levels required to ensure all residents needs are met. Relatives of residents we spoke to confirmed they are very satisfied with the care provided. One resident told us, We have noticed improvements in Mum since she arrived at Birchwood Grove. She is always clean and tidy in appearance. Another resident commented, My aunt looks a lot better in her physical state since she has been here. All three surveys returned to us on behalf of residents confirmed there are always staff available when they are needed. Information provided in the AQAA confirmed, Four weekly rotas are in place and staffing levels are monitored regularly. We also looked at staff training records. They demonstrated that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents rights, independence, choice and dignity. Training records also provided evidence that confirmed staff have been provided with mandatory training including fire safety, health and safety, moving and handling and food hygiene. The AQAA confirmed that this care home has a staff development programme that meets National Minimum Standards (NMS) for this service. It also confirmed that, of the nine permanent care workers employed, six have obtained the National Vocational Qualification (NVQ) in Care or Health and Social care at Level 2 or above. We spoke a group of staff who were on duty. Following discussion, they told us about their role in the care home, the training they have undertaken, their understanding of the needs of identified residents and the action they are expected to take to ensure residents needs have been met. We looked through the recruitment records of two staff who have been appointed since our last visit. These records demonstrated that the registered providers have obtained the following information about staff, criminal records checks, written references and proof of each persons identity. Care Homes for Older People Page 24 of 31 Evidence: Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home which has been well run and well managed The home has been run in the best interests of residents. Staff working at the care home have been well supported by the manager. Appropriate steps have been taken to maintain the health and safety of residents and staff. Evidence: During our last inspection we judged that staff need to be provided with sustained leadership and direction and systems need to be put in place to ensure all aspects of service users health, welfare and safety are protected and promoted. During this visit we met with the manager. We had been informed she was appointed in August 2009. We were also informed she has submitted an application to register Care Homes for Older People Page 26 of 31 Evidence: with us. We were shown copies of minutes and an agenda of a relatives meetings. We were informed that residents are also invited but they do not have the capacity to attend. This We noted this took place soon after the manager was appointed. The new manager was introduced to relatives and also included discussions about the homes complaint procedure and plans for Birchwood Grove. There was also an opportunity for relatives to raise issues regarding the day to day running of the home. We noted that it was intended to hold such meetings on a regular basis. The next one was planned for December 2009. We spoke to relatives who confirmed that such meetings are held regularly. They also informed us that, whilst the management uses such meetings to communicate with them, there is also ample opportunity for residents and their families to share ideas, opinions and concerns with the manager. One relative was very complimentary about the manager, She has a real passion for the job! We were also shown minutes of staff meetings. They demonstrated they are held regularly and that the manager uses them as a means of communicating with the staff of the care home. Staff on duty who we spoke to confirmed they receive supervision every two months and attend staff meetings regularly. They also confirmed they felt well supported by the management. The manager showed us recent records of supervision sessions together with a record of sessions planned to take place in the future. Information provided in the AQAA confirmed that, Staff meetings are held in the home, staff supervisions are undertaken. Training is sourced and scheduled and posted on staff notice boards. The registered provider has set up a quality assurance system to be used throughout their care homes. We saw evidence that this was in use at Birchwood Grove. The manager is expected to carry out monthly audits on various areas about the the day to day management of the care home. We were shown audit reports which have occurred over the past few months. The manager informed us that she is expected to review records and assess practices against national minimum standards and award a score. We were informed, when the manager assess accidents and incidents, she is expected to look for trends and reasons why they have occurred. This information is then used to review policies and practices to determine if improvements are needed. Representatives of the registered provider also visit the home on a monthly basis to monitor and evaluate how well the home is being managed. We examined copies of Care Homes for Older People Page 27 of 31 Evidence: the reports of such visits. They confirmed that they had been undertaken regularly and had been used to monitor the service provided. Information supplied in the AQAA confirmed the registered provider has taken appropriate steps to ensure the premises and equipment within the care home is safe for use. For example, gas and electrical appliances have been checked and maintained regularly. We found evidence that a programme of training provided to all staff includes health and safety issues, fire prevention, manual handling and first aid. Care Homes for Older People Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 26 13 Wall and floor coverings in the laundry area must be repaired and made good. This will ensure good standards of hygiene are maintained to prevent the risk of cross infection 28/02/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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