Inspection on 13/01/06 for Birch Heath Lodge Nursing Home

This inspection was carried out on 13th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Birch Heath Lodge Nursing Home 17/04/07

Birch Heath Lodge Nursing Home 11/07/06

Birch Heath Lodge Nursing Home 14/06/05

Birch Heath Lodge Nursing Home 18/01/05

Birch Heath Lodge Nursing Home 03/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Birch Heath Lodge Nursing Home Birch Heath Lodge Birch Heath Lane Christleton Chester Cheshire CH3 7AP Lead Inspector Wendy Smith Unannounced Inspection 11:30 13 January 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Birch Heath Lodge Nursing Home Address Birch Heath Lodge Birch Heath Lane Christleton Chester Cheshire CH3 7AP 01244 335503 01244 335503 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Birch Heath Lodge Limited Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of 38 service users in the category of OP (Old age, not falling within any other category) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection 14th June 2005 3. Date of last inspection Brief Description of the Service: Birch Heath Lodge is a listed building that has been converted and extended into a nursing home for older people. The home consists of the main house and the Greenwood unit, which is a separate building in the same grounds. It is situated in a conservation area in the centre of the village of Christleton, approximately four miles from Chester. The home enjoys close links with the local community and some amenities are provided in the village. There is a bus service to Chester. The home can accommodate up to 38 residents in bedrooms on two floors. A passenger lift provides access to most, but not all, levels of the building. There are also two stair lifts. Part of the first floor in the main part of the building is used for office and staff facilities. There are two lounges, a conservatory, a dining room and other communal areas. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was on 13th January 2006. 34 residents were living at the home and a new resident was to be admitted later that day. Two rooms that were formerly shared by two residents were now singly occupied. A tour of the building, including communal areas and some bedrooms, was completed. Time was spent talking with the home owner, who purchased Birch Heath Limited in April 2005, and the home manger, who took up post in December 2005. Some of the staff on duty and a number of residents were also spoken with. Arrangements for handling residents’ personal spending money were reviewed. Some of the key national minimum standards were inspected and found to be met in full at the inspection carried out on 14th June 2005 and were not inspected again at this visit. What the service does well: What has improved since the last inspection? Requirements and recommendations made at the last inspection have been acted on. The manager has introduced new documents to the care plans to ensure that they are comprehensive. Improvements have been made to the care plan format. Residents’ personal information is now stored in a more private area and staff handovers are held in the office area to protect the confidentiality of residents. Arrangements for the handling of medicines have been modernised. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 6 Work has continued to improve the standard of décor throughout the building. A new nurse call system has been installed and more equipment is provided for the care of residents. Increased staffing levels have been maintained. A staff training programme is being developed and implementation of this had commenced. A number of care staff are working towards an NVQ in care. A system of staff supervision and appraisal is being introduced and a named nurse and key worker system has been introduced. The home has a new manager. Staff morale has improved and there is an open atmosphere in the home. A visitors book in the main entrance area contains a record of all visitors to the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. EVIDENCE: Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Each resident has a care plan and improvements to the standard of care planning was ongoing. The health needs of residents are met. Arrangements for the handling of medicines have been modernised. EVIDENCE: The home uses the Standex format of care plans. These have been transferred to individual folders for each resident and are kept in trolleys in the main office and the Greenwood office. The home manager has identified that further improvements are needed to the care plans and has added a falls risk assessment document. A named nurse system has been introduced and this means that each of the nurses will take responsibility for a number of care plans relating to the residents who are allocated to them. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 10 A nurse assessor, employed by the Primary Care Trust, was in the home carrying out resident reviews. She told the inspector that said that she was very satisfied with the direction the home is moving in and considered that the new management team had ‘made a tremendous difference’ to the care being provided to the residents. The manager has audited accident records and identified those residents who are at high risk. Additional safeguards have been put in place for the health and safety of these residents. New moving and handling equipment has been provided and five more pressure mattresses have been bought. Bedrails have been risk assessed and all bedrails in use were protected with good quality covers. Arrangements for the ordering and storage of medicines have been changed, and previous poor practices have been discontinued. Each unit has a new medicine trolley. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 The social needs of residents are provided for. Residents are able to exercise choice in daily living. EVIDENCE: The home has an activities organiser and the hours allocated for activities have been increased. The activities organiser has worked at the home for several years and knows the residents well. Social activities are provided for small groups of residents and on a one to one basis. A weekly activities programme was displayed but the manager said that this is under review. On the afternoon of the inspection a number of residents were enjoying gentle exercises in the lounge. A choice of sitting areas is provided for residents and some choose to spend their time in their own room. Most bedrooms had been personalised by the resident with furniture, pictures and other personal belongings. Mealtimes can be flexible to meet the needs and preferences of individuals. An increase in staffing levels has allowed residents to have greater choice of when they are assisted to get up and go to bed. Each resident has a key worker who is responsible for ensuring that each resident’s personal needs and preferences are met. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a complaints procedure that meets the required standard. The home’s policies and procedures for adult protection need to be developed and accompanied with staff training. EVIDENCE: The home has a complaints procedure that meets the required standard. A copy of the complaints procedure is provided for each new resident and their relatives. At present the complaints procedure is not displayed in the home, but the responsible individual for the home said that he would give consideration to doing this. There is a complaints book, but no complaints had been recorded since 2004, and the responsible individual said that none had been received since he acquired the home in April 2005. There is an up to date copy of ‘No Secrets’ in the home. The manager said that internal adult protection policies and procedures need to be developed. Staff training regarding abuse was provided in 2004 by the previous manager, however this will need to be updated and should ensure that staff are fully aware of the home’s policies and procedures. Recommendation 1 Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home is clean and well maintained and there is a programme of continuing improvement of the environment. EVIDENCE: Greenwood unit has new carpets and soft furnishings and is being decorated. The main lounge and entrance are to be refurbished during 2006. Bedrooms are being decorated as they come vacant. A new nurse call system has been installed and this has been a great improvement. All parts of the home were clean and there were no unpleasant odours in any areas. Laundry and sluicing facilities are provided to meet the required standard. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Staff are provided in sufficient numbers to meet the needs of residents. The home has not yet met the standard for care staff achieving a qualification in care. A staff training programme is being developed. EVIDENCE: At the time of the inspection the home had a full team of staff and only one shift had been covered by an agency worker during December. One of the home’s nurses is due to retire soon and a nurse has been recruited to cover the post. During the day there are two nurses and six care staff on duty; in an evening one nurse and four care staff; and at night a nurse and three care staff. The manager and the responsible individual were devising a training plan for 2006 that will include all staff. A training file with an individual record for each staff member had been set up, and a fire safety training had been held. The manager was setting up a staff supervision and appraisal system Four staff were going to attend a wound care update the following week. Three care staff are working towards NVQ level 2 and one to NVQ level 3. One carer has an NVQ in care. Recommendation 2 and 3 Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 and 35 The home has a new manager who has been previously registered with the Commission for Social Care Inspection. A quality assurance system needs to be developed. Residents’ personal money is handled appropriately. EVIDENCE: A new manager commenced working in the home in December 2005. She is a registered nurse who has previously been registered with Commission for Social Care Inspection as manager of a similar type of establishment. She does not have a management qualification and is aware that this will be required. The responsible individual must make an application to the Commission for Social Care Inspection for registration of the manager. Requirement 1 Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 16 The manager has held three staff meetings to introduce herself to the staff. At the time of the inspection the manager and the home owner were working closely on plans for the development of the service. The manager works alongside the staff three days a week. The home owner has been working full time in the home since April 2005. A staff member told the inspector ‘its a much nicer place to work’. Birch Heath Lodge has a new management team. The previous manager carried out an audit of the home in early 2005, and the registered person expressed his intention of carrying out a further audit in 2006. An auditing and monitoring system needs to be developed to ensure that the home continues to move forward, and that residents and other stakeholders are satisfied with the service provided. Requirement 2 There is a visitors book in the entrance area and this records all visitors to the home. Some residents have small amounts of personal spending money in safekeeping at the home. This is kept in individual envelopes and used for items such as hairdressing, chiropody and newspapers. The home’s staff do not act as agent or appointee for any residents. Two residents have a solicitor to look after their financial affairs and three are able to look after their own money. All others have a relative or close friend to assist them. The home’s administrator keeps very good records of all transactions and receipts for all purchases. As a protection for this member of staff, it is recommended that these records are audited regularly by a second person. Receipts are given for some amounts paid in. This is good practice and should be extended to include all monies received. Recommendation 4 Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 X X X Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP31 Regulation 8 and 9 Requirement The registered person must make an application to register a manager for the home. A quality assurance system must be developed. Timescale for action 28/02/06 2 OP33 24 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP18 Good Practice Recommendations The home’s adult protection procedures should be developed and should be communicated to all staff working in the home. The home should continue working towards 50 of care staff having a qualification in care. The proposed training programme should be implemented for all staff. 2. 3. OP28 OP30 Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 19 4. OP35 It is recommended that residents’ personal money accounts are audited regularly. Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Birch Heath Lodge Nursing Home DS0000018712.V259930.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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