Inspection on 17/04/07 for Birch Heath Lodge Nursing Home

This inspection was carried out on 17th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 11/07/06

Birch Heath Lodge Nursing Home 13/01/06

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 17th April 2007 9:30 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.V332781.R01.S.doc Version 5.2 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.V332781.R01.S.doc Version 5.2 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 F/P 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 Mrs Ann Evans 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.V332781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: This home is registered for a maximum of 38 service users in the category of OP (Old age, not falling within any other category). Date of last inspection 11th July 2006 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 the centre of the village of Christleton, approximately four miles from Chester. The current weekly fees are from £483 to £610. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 17th April 2007 and took four hours. The home had 36 residents, all of whom are older people. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with the proprietor, the home manager, residents, staff and a visitor. Some of the information contained in this report is taken from the preinspection questionnaire that was completed by the manager. Comments cards were provided for residents, visitors and visiting professionals and six were returned. What the service does well: What has improved since the last inspection? Arrangements for the ordering, storage, administration and recording of medicines have been made more robust to ensure that residents always get their prescribed medicines. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 6 Improvements to the environment have continued including the refurbishment of two bathrooms to a very high standard, new corridor carpets and new bedroom furniture. Requirements and recommendations made at the last inspection have all been addressed. 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. The summary of this inspection report can be made available in other formats on request. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 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.V332781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are interested in going to live at the home have a full assessment to determine whether their needs can be met in full. EVIDENCE: At the time of the visit 36 residents were living at the home. The average age was 91 years, with only one person under 80. Information provided by the manager indicated that four residents have a dementing illness. None of these people were presenting any difficulty in managing their condition, and the home manager said that the home receives good support, when needed, from mental health professionals. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 9 Two new residents were admitted in February 2007 and two in March 2007. Three of these people were assessed by the home manager prior to admission and the other person was admitted for a short stay in an emergency at the request of a relative but has now decided to make it her home. A relative spoken with said that his sister chose the home after visiting several establishments and all the family were very pleased with Birch Heath Lodge. The proprietor confirmed that all residents have a contract with the home. Most are privately funded. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are met and residents are treated with courtesy and respect. EVIDENCE: Each resident has a care plan that details their needs, any risks identified and the care that they require. A sample of the care plans was looked at. The care plans were detailed and were clearly written. When residents’ needs had changed, the care plans had been revised to reflect this. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 11 At the time of the visit two people were poorly and being cared for in bed. Appropriate pain relief had been prescribed and was given regularly to ensure their comfort. Two residents had pressure sores, one due to long term skin problems. Advice had been sought from the tissue viability nurse specialist and appropriate equipment was used to relieve pressure. One of the nurses employed at the home has lead responsibility for wound care. A number of new nursing beds have been bought and more are ordered. Pressure relieving mattresses and cushions are available for all residents who need them. A carer takes lead responsibility for the ordering and distribution of continence products. She keeps records for all residents and has a good rapport with the continence advisor. She said that she distributes products weekly and ensures that all residents receive the correct items. A local medical practice will provide a GP service for any new residents who need to have a new doctor due to re-location, or for any who wish to change doctor. A comments card received from a GP described Birch Heath Lodge as ‘A well run home, communicates well with GP practice to aid patient management’. A private physiotherapist is available for any residents who wish to have this service. Since the last inspection the deputy manager has completed a medicines management training course. Good systems are now in place to ensure that medicines are handled and stored correctly and that residents receive their medicines as prescribed. The home manager has been carrying our regular audits of the medicines and the dispensing pharmacy has revised the medicine administration record sheets. From observation during the visit to the home, and from speaking with management, staff and residents, it was evident that the ethos of the home is to regard residents and their families with courtesy and respect. Everyone working in the home is made aware of the individual needs and preferences of the residents. A relative commented that ‘we appreciate the high quality of support mother and all of us receive’. One very large bedroom is occupied by two residents. A portable screen is used to ensure privacy when care is being given. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice in daily living and enjoy a high standard of catering. EVIDENCE: The home has a social activities organiser who arranges a group activity for residents twice a week. A monthly programme is displayed. This includes gentle exercises and visiting speakers. A resident commented that ‘A carer is responsible for arranging a programme of various interests which are always enjoyable and held twice a week’. During the visit to the home most residents were occupied doing knitting, reading a newspaper, or watching TV. The home is within very close proximity to the local church and a number of residents enjoy going to church. Last week a number of residents enjoyed watching a wedding at the church. A mobile library visits regularly. Several residents go out regularly with friends and family. The home owners bought Easter Eggs for all the staff and residents and one resident said that it was the first she had ever had. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 13 Most residents have taken the opportunity to personalise their bedroom with their own belongings including pictures and small items of furniture. A lot of thought has been put into the dining arrangements. A member of staff sits with any resident who needs assistance and makes sure that they are able to enjoy their meal with others and without embarrassment. Most residents use the main dining room or the smaller dining area in the Greenwood Unit. Residents may also choose to have their meals in their own room. The home owner is planning to buy new dining furniture. The manager thinks that round tables will be better for the residents and the new chairs will enable residents to be able to transfer out of wheelchairs for their meals. There is a new hot cabinet in the kitchen that meals are served from. Residents can have a cooked breakfast. The chef starts work at 8 am. A new chef has recently been appointed. A meeting has been arranged to discuss possible changes to the menus and residents have been consulted about what dishes they would like to see on the menus. One resident commented on the ‘very good standard of food’ and a relative described the food as ‘excellent’. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to ensure the protection of residents. Any issues raised by residents or relatives are addressed. EVIDENCE: The home has a complaints procedure and a copy of this is provided for all residents in the handbook. Since the last inspection, no complaints have been recorded at the home and none have been received by the Commission for Social Care Inspection. A relative commented that ‘Any issues raised by mother/family have been dealt with promptly’. The home owner visits three days a week and is available for residents or visitors who wish to raise any issues with him. Most staff have attended training regarding the protection of vulnerable adults. New staff who have not yet had the opportunity to attend this course have watched a training video as part of their induction. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and well-appointed environment that is kept clean and safe for them. EVIDENCE: The entrance area is very attractive and welcoming. Some residents choose to sit in the conservatory at the front of the building from where they can watch village life. The main lounge is comfortably and tastefully decorated and furnished, and has a large screen television that can be watched from all parts of the room. Corridors have all been decorated and re-carpeted. Two bathrooms have been refurbished to a very high standard with bathing aids to suit all residents. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 16 Some bedrooms have been fitted with new furniture including beds, chests of drawers, wardrobes, bed tables and commodes. New bedding has also been provided. All parts of the home were clean and there were no unpleasant smells in any areas. Outdoor areas are tidy and well-maintained. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides enough skilled and qualified staff to meet the needs of residents. EVIDENCE: The home employs eleven nurses, 24 carers and nine ancillary staff. Fifteen of the care staff have a national vocational qualification in care and a further three are working towards a qualification. The staff rotas were available until the end of June 2007 and showed that there are enough staff to meet the needs of the residents. The manager said that all staff work in both the main building and the Greenwood Unit. The manager organises a monthly social event for staff and said that this has helped greatly with team building. There is a low staff turnover, with no new carers employed since November 2006 giving a good continuity of care for residents. Recruitment records were looked at for the four most recently recruited staff. These were a chef, a care assistant and two bank nurses. Records were complete for the chef and the care assistant including two good references and Criminal Records Bureau disclosures. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 18 The two nurses both had application forms and good references but did not have a Criminal Records Bureau disclosure relating to their employment at Birch Heath Lodge. They both have full-time employment elsewhere and work only occasionally at the home. They both had copies of Criminal Records Bureau disclosures from their main employment. The home owner said that he was not aware that they required a further check but would now apply without delay. The home is a member of the Cheshire Consortium for training and takes every opportunity to send members of staff to training provided by the Primary Care Trust. It is disappointing that a number of these events are cancelled. There is a training record sheet for each member of staff. These showed that all staff had recent fire safety training. There are four in-house moving and handling trainers who are able to provide training for new staff and updates for other staff. One of these people is the home’s administrator and she said that the training covers theory in the morning and practice in the afternoon. Names and dates for forthcoming sessions were displayed on the staff notice-board. Hoist training has also been provided by the supplier of new equipment. Care staff have all been given a copy of a book entitled ‘How to be a great care assistant’. The book is used in staff training and supervision, and supervision meetings are used to discuss individual staff’s training needs and interests. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of the residents and has continued to move forward with continuous improvement in all areas. EVIDENCE: The manager has been in post for sixteen months and over this time has been able to put her own personality into the service. She is a registered nurse with considerable previous experience as a home manager, and has recently completed the Registered Manager Award. She said that she loves her job and feels happy to come to work in a morning. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 20 The registered person bought the home two years ago. He has given a great deal of commitment to the service and has made significant improvements to all areas. Investment has been made in the building and facilities to make them pleasant and comfortable for residents and to ensure that staff and residents have whatever equipment they need. Staffing levels were increased and staff are consulted and empowered which has given them pride in their achievements. There is a commitment to staff training and development. The administrator and the deputy manager are also important people in the management team. Residents are also consulted and the registered person has taken the time to get to know each resident and their families. In a survey form a resident wrote ‘A resident forum is held every month; one is free to talk and air grievances or bring forth suggestions’. A group of residents is involved in updating the resident handbook. They have made suggestions about information they would like included in it and how it should be laid out. The home does not look after the finances of any residents but small amounts of personal spending money (not exceeding £100) can be put in safekeeping and full records are kept. Information received from the manager showed that all plant and equipment is tested, serviced and maintenance in good condition. Within the last seven months the home has been visited by an Environmental Health Officer, a Health and Safety Executive inspector and a Fire Officer. Some new heat detectors have been installed. Insect screening has been fitted in the kitchen. Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 X X 3 Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 22 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 OP29 Regulation 19 Schedule 2 Requirement Timescale for action 18/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Birch Heath Lodge Nursing Home DS0000018712.V332781.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V332781.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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