Inspection on 14/06/05 for Birch Heath Lodge Nursing Home

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 13/01/06

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 Birth Heath Lane Christleton Chester CH3 7AP Lead Inspector Wendy Smith Announced Inspection 14th June 2005 09:30 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 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 F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Birch Heath Lodge Address Birch Heath Lane Christleton Chester CH3 7AP 01244-335503 Telephone number Fax number Email 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 Limited Care Home 38 Category(ies) of OP (Old Age) registration, with number of places BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 38 service users in the category of OP (Old age, not falling within any other category) 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 18th January 2005 Brief Description of the Service: Birch Heath Lodge is a listed building which has been converted and extended into a nursing home for older people. It is situated in a conservation area in the centre of the village of Christleton, which is approximately four miles from Chester. The home enjoys close links with the local community and amenities provided in the village. There is a convenient bus service to Chester.Bedrooms are 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 as office and administration accommodation and staff room. There are two lounges, a conservatory, a dining room and other communal areas. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by two inspectors on 14th June 2005 over a period of seven hours. 36 residents were living at the home. The inspection was carried out using a process of cross referencing the documentation of identified residents following discussion with them, and following the delivery of care and support to them. Staff records were inspected. A tour of the building, including communal areas and bedrooms, was completed. Information was also taken from the pre-inspection questionnaire completed by the provider. Time was spent in conversation with the home owner, who had purchased Birch Heath Limited in April 2005, and most of the staff on duty were also spoken with. Comments cards were received from four residents and from six relatives/visitors. Residents were positive about the care they received at the home. Relatives/visitors also made mostly positive responses, however one relative commented that her mother would like a bath or shower more often, two people were of the opinion that there were not always enough staff on duty, and two were not aware of the home’s complaints procedure. What the service does well: Birch Heath Lodge is situated in the centre of the village of Christleton and has strong links with the local church and the local community. A programme of activities is provided which has been planned to suit the interests and abilities of the residents. A high standard of catering is provided with individual needs and preferences accommodated. The building has been well maintained and was found to be clean throughout. The home provides a variety of different bedrooms and residents have been encouraged to personalise their own rooms. The home has a mature and experienced staff team. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 1 and 3, standard 6 is not applicable. Prospective residents and their relatives are provided with information about the home. All residents have a contract of terms and conditions. Prospective residents are assessed by a nurse from the home to ensure that their needs can be met. EVIDENCE: The statement of purpose has been reviewed to reflect the change in ownership of the company, and contracts of terms and conditions have been provided for all residents. Senior nurses now go out to assess all prospective residents prior to admission to determine whether the home can meet their needs. An assessment proforma is in use. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7, 9 and 10. Each resident has a care plan but care plans were not completed to a satisfactory standard. Arrangements for handling medicines needs to be reviewed. Residents’ privacy and dignity are upheld. EVIDENCE: Residents’ care plans did not contain all the information needed by staff to deliver effective care to residents. Examples included a resident’s care plan and risk assessment that were contradictory in relation to whether she could weight-bear or whether a hoist was needed for transfers; another resident had lost four kilograms in weight in one month but the evaluation of the care plan said that her weight was stable. In general, the care plans were not consistent with the standard expected in a nursing home and the inspectors considered that staff would benefit from training to improve their care planning skills. See requirement. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 11 The acting manager confirmed that there was a historical practice in the home of medicines being ‘potted up’ to be administered later in the day and sometimes by a different member of staff. This was discussed with the proprietor who confirmed that he would ensure that this practice was discontinued immediately to prevent the possibility of any medication errors occurring. He also confirmed that the current system for ordering and administration of medicines was under review. See requirement. Residents spoken with, and those who returned comments cards, confirmed that the staff helped them to maintain their privacy and dignity. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12, 13 and 15. A programme of social activities is provided and residents are supported to pursue their interests. Families and friends are made welcome at any reasonable time. Residents expressed their satisfaction with their meals. EVIDENCE: One of the more able residents said that the staff were very good and accommodating and that she could choose how she spent her time. On the morning of the inspection she had been into Chester on the bus. Another resident who was not mobile said that staff were very good but she was bored of sitting in her room with only the radio and television for entertainment. When this was brought to the attention of the staff it was said that previously she had preferred to stay in her room. Activities are provided twice a week and the registered provider indicated that he intended to increase this. Activities for June included an antiques fayre, a visit from the mobile library, three sessions of exercise to music, board games, bingo and a talk on ‘Shopping and Food in your Era.’ Holy Communion was also being provided in June and some residents were planning to visit a local coffee morning. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 13 All of the relatives/visitors who completed comments cards considered that they were made welcome at the home and confirmed that they were able to see the resident in privacy. It was noticed that the Visitors Book was not used by all visitors to the home. All visitors should be asked to sign in the book in order to comply with schedule 4 of the Care Homes Regulations. See requirement. All residents spoken with were very complimentary about the food. One said she was a very fussy eater but the chef always provided her with what she wanted. Another said the food was ‘really, really good’. The pureed meals did not look appetising as all the ingredients had been blended together, making it impossible to tell what the food was. This was discussed with the chef who said that he would be able to improve the presentation of pureed meals. See recommendation. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 14 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 standard(s) These standards were not inspected on this occasion. EVIDENCE: BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19 and 26. The environment is safe, clean and well-maintained. EVIDENCE: The home was clean, well-maintained and free from odour. Some bedrooms had been redecorated since the last inspection and the two vacant bedrooms were in the process of being decorated. A new hoist had been purchased and the provider said that he intended to replace the nurse call system and improve the laundry facilities. There is no lock recommendation. on the bathroom door in Greenwood unit. See BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29. Staff, including registered nurses, are provided in sufficient numbers to meet the needs of the residents. Recruitment practices ensure that new staff have the appropriate checks carried out before working with vulnerable people. EVIDENCE: 15 registered nurses and 26 care assistants are employed at the home. The registered provider indicated that he had increased the staffing in the evening and at night and was recruiting more staff to provide five staff every evening and four every night. Any shortfalls had been covered by agency staff. Five staff were undertaking an NVQ Level 2 in Care. An inspection of a sample of staff files showed that appropriate recruitment practices were being followed. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 38 The home has a new proprietor who demonstrates an open and inclusive approach. The health and safety of staff and residents is promoted, with the exception of three specific matters that have been identified. EVIDENCE: Birch Heath Limited changed ownership in April 2005 and the previous manager retired. The new owner has been working at the home in a full-time capacity for the last six weeks. The appointment of a new manager has not yet been confirmed with the Commission for Social Care Inspection. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 18 Four residents spoken with said that they had felt apprehensive about the change but were happy with the new proprietor and were pleased that he ‘came out and talked’ with them. Staff spoken with also confirmed that they found the new proprietor very approachable. He had also written to residents’ relatives to introduce himself to them. Two beds had bedrails fitted that were not high enough to prevent the resident rolling out of bed because there was a pressure relieving mattress fitted on top of the ordinary mattress. In one case the gap between the mattress and the bedrail was wide enough for the resident to become entrapped. Risk assessments for bedrails did not take account of the risks associated when a pressure relieving mattress was fitted. See recommendation. The new hoist was being charged in the corridor. This could present a fire risk. The registered provider was advised to ask the fire safety officer for advice on the safest place to charge it. See recommendation. A laundry assistant and the chef were asked where the hazard data sheets were for the cleaning products. Neither knew the meaning of the term. The chef found them in the cleaning cupboard in the laundry, but there were no data sheets for several of the products that were being used. Staff should all receive training in the control of substances hazardous to health and know where to obtain information on the potential hazards of the products used and what action to take to protect themselves. See recommendation. Magnetic door closers have been fitted to all rooms since the last inspection. The pre-inspection questionnaire provided evidence that plant and equipment had been serviced and maintained. BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 3 x x x x x 2 BIRCH HEATH LODGE F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? 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 OP7 Regulation 15 Requirement Care plans must be improved to ensure that they contain accurate and up to date information about the residents needs and how they are met. The arrangements for handling medicines must be reviewed. A record must be kept of all visitors to the home. Timescale for action 30/9/05 2. 3. OP9 OP13 13(2) 17(2) schedule 4 30/9/05 30/6/05 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. 2. 3. 4. 5. Refer to Standard OP15 OP19 OP38 OP38 OP38 Good Practice Recommendations Pureed meals should be presented in a more appetising form. The registered person should provide a lock on the bathroom door on Greenwood unit. The registered person should consult the fire officer to clarify safe arrangements for charging the hoist. Staff should have access to information regarding any hazardous substances they are using. The registered person should ensure that whenever bedrails are used they are fitted in a safe manner. F51 F01 S18712 Birch Heath Lodge V223308 140605 Stage 4.doc Version 1.30 Page 21 BIRCH HEATH LODGE Commission for Social Care Inspection Unid 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. 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