Inspection on 15/12/08 for Birch Hill

This inspection was carried out on 15th December 2008.

CSCI 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

Birch Hill 29/01/07

Birch Hill 07/12/05

Birch Hill 12/05/05

Birch Hill 04/11/04

Birch Hill 13/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Birch Hill Birch Hill Norham Berwick Upon Tweed Northumberland TD15 2JZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne UrwinBrown     Date: 1 5 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Birch Hill Birch Hill Norham Berwick Upon Tweed Northumberland TD15 2JZ 01289-382216 01289382087 denise.turnbull@ben.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): BEN - Motor & Allied Trades Benevolent Fund Name of registered manager (if applicable) Denise Turnbull Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Birch Hill is situated on the edge of Norham village, which is approximately eight miles from Berwick upon Tweed. There are local bus services to Berwick where there is a main line railway station. Birch Hill is a detached house situated in its own attractive gardens with views of the village and the river Tweed. The Home is owned by BEN Motor and Allied Trades Benevolent Fund and is registered as a charity. Birch Hill provides comfortable, homely accommodation for up to twenty-six elderly people two of whom suffer some degree of dementia. All service users have access to information about the home including inspection reports. Fees for the home range from £419.08 to £475.00. Care Homes for Older People Page 4 of 27 care home 26 Over 65 2 24 0 0 Care Homes for Older People Page 5 of 27 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 star rating for this service is two stars. This means that people who use the service experience good quality outcomes. Summary: This is an overview of what the the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: Information we have received since the last visit on 29 January 2008. Care Homes for Older People Page 6 of 27 How the service dealt with any complaints & concerns since the last visit. Any changes to how the home is run. The provider’s view of how well they care for people. The Visit: An unannounced visit was made on 15 December 2008. This vist lasted seven hours. During the visit we: Talked with people who use the service, relatives, staff, the deputy manager. Looked at information about the people who use the service & how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe & comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? All staff receive accredited medication training so that people living in the home are protected. The Statement of Purpose and Service User guide have been updated. People living in the home are involved in preparing their care plans. Work to improve the decor in sitting and dining areas of the home have been completed. Over ninety per cent of staff have completed National Vocational Qualifications in care at Level 2 and fifty per cent have completed Level 3. The gardens now produce more vegetables used in the homes kitchen. Raised beds and hard surface paths have been completed so that people are able to make better use the gardens. Care Homes for Older People Page 8 of 27 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before people move into the home they have enough information about the service to make an informed choice about living there. Sometimes the pre admission assessments do not provide enough information to ensure that staff can effectively meet peoples needs. Evidence: The Statement of Purpose and Service User guide have been updated since the last inspection. These contain relevant information about the service as identified in the National Minimum Standards and lets people know what they can expect at Birch Hill. The manager understands the importance of having good information available when choosing a care home that will meet peoples needs and preferences. Each person has a contract that is agreed prior to admission and this includes appropriate information about the terms and conditions of residence and charges Care Homes for Older People Page 11 of 27 Evidence: made. Pre-admission assessments are carried out before people are admitted to the home. Four peoples records were seen at this inspection. In the case of two people more information about their background and health care was needed and this was supplied by them and their family at the time of admission. The manager said that the current assessment tool is being reviewed and updated to ensure that all relevant information is collected prior to admission so that staff are sure that individuals needs can effectively be met. Intermediate care is not provided at Birch Hill. Care Homes for Older People Page 12 of 27 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. People living in the home receive good quality care that is organised to suit their individual needs in a way that respects their privacy and dignity. Evidence: Each person has a care plan in place detailing their needs. There was evidence that people receive personal and health care support using a person centred approach that takes account of their rights to dignity, equality, fairness, autonomy and respect. Peoples care needs including specialist health care are generally recorded to a good standard, however two records showed that some problems have not been properly addressed within their individual care plans. In addition there was evidence that some risk assessments are not being updated regularly and in one case was not updated after problems were identified. There was evidence from talking to people living in the home and to staff that people receive the support they need, but records do not always show that this is being done. Monthly evaluations have been introduced since the last inspection and provide an overview of peoples care. There was good evidence that people living in the home have been involved in contributing to their care plans. Care Homes for Older People Page 13 of 27 Evidence: The manager said that there are plans to review care planning systems, introduce monthly audits and to provide more staff training to encourage best practice. Systems for assessments relating to Moving and Handling, Nutrition, Tissue Viability and falls are in place, but are sometimes not updated regularly. Health care needs are identified and met, but some records do not contain enough information about how needs are met. People using the service have access to other professionals, including dentistry, chiropody and opticians. Good records were in place for interventions by health care professionals. The home has an appropriate medication policy in place that is supported by procedures and practice guidance for staff. Medication records were in good order and corresponded with stocks held. All staff giving out medicines have completed appropriate training. Staff induction training includes references to the need to respect peoples dignity and independence. Staff respect privacy and dignity and are sensitive to peoples individual needs. This was evidenced in discussion with people living in the home, from questionnaires and from talking to staff. Care Homes for Older People Page 14 of 27 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. People are encouraged and supported to make choices about their routines and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits individuals. Evidence: The homes philosophy is to encourage and promote peoples individual rights to live an ordinary and meaningful life. Evidence was available from records that people are encouraged to make choices about their lifestyle and routines that are individualised and personal to them. People are consulted about the daily routines in the home through regular resident meetings and from the use of questionnaires. Results of the information collected from questionnaires is made available on the notice board in the home. Records show evidence of peoples social needs, however sometimes this information is limited. An activity co-ordinator organises activities and supports people where they need it to take part in arranged events. One to one work is also undertaken to suit individual needs. Activity records were available to show that there are daily events and people are supported to take part in these. There are weekly trips out of the home Care Homes for Older People Page 15 of 27 Evidence: to places of interest chosen by those going out. Good arrangements are in place to support people to keep in touch with relatives and friends in the community. Visitors are supplied with information about the home when their relative/friend is admitted. The menus show that a varied diet is provided with alternatives available at each meal time. People living in the home report that the food is excellent, with good portions and choice always available. They said that they were very satisfied with the food and had never had any cause to complaint about it. The kitchen is well organised with good stocks of food available. The kitchen staff have completed Food Hygiene and other appropriate training. The food served during the inspection was well cooked and presented. Care Homes for Older People Page 16 of 27 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. People are protected by the good systems in place at Birch Hill for dealing with complaints and safeguarding. Evidence: The home is receptive to comments being made about the service. There is a clear complaints procedure and people are supplied with information about making a complaint when they come to live at the home and are reminded regularly about how to do this. Appropriate records are kept of any complaints, giving details of the investigation and outcome. People living in the home said that they knew how to make a complaint and felt able to raise any concerns or issues they had about the service. They said the manager and her staff are very approachable and they are happy with the service provided. One person said she could speak to the manager if she had any concerns and that she felt safe and secure at Birch Hill. Staff are wonderful and I am very well cared for here. Staff were clear about how to assist someone who wanted to make a complaint. Complaint records are kept in an appropriate form. No complaints have been made since the last inspection. Policies and procedures are in place for safeguarding adults and these give clear specific guidance for those using them. Staff working in the home were able to describe the appropriate procedure for making a safeguarding referral. One matter has been referred to the Safeguarding Adults team, but no further action was taken. There Care Homes for Older People Page 17 of 27 Evidence: have been no other referrals. There is a whistleblowing policy in place for staff. Staff training have been provided in safeguarding and the Mental Capacity Act. Training is provided for new staff to cover these areas. Care Homes for Older People Page 18 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Birch Hill provides a comfortable, well maintained and safe environment that suits the needs of the people living there. Evidence: Birch Hill provides a comfortable, well decorated and furnished home that suits the needs of the people living there. The grounds are very attractive and well kept. Produce from the garden is used in the kitchen. Since the last inspection work has been completed on hard surface pathways and raised beds in the garden to the front of the building. A shaft lift is fitted for access to the first floor. The sitting and dining areas are comfortable, spacious, homely and very well decorated. There is an ongoing programme of redecoration and upgrading so that it is a pleasant, safe place to live. The environment promotes the privacy, dignity and autonomy of people living in the home. Bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people living in the home. There are seven rooms with en-suite accommodation. Three of these en-suites are wet rooms and people said that they find these facilities very good. Care Homes for Older People Page 19 of 27 Evidence: People living in the home said that there was plenty of hot water and the temperature of rooms can be adjusted to suit their individual needs. The home is well lit, clean and tidy and smells fresh. There are good infection control systems in place and staff training is provided. The laundry is well organised and was clean and tidy. Care Homes for Older People Page 20 of 27 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. There are sufficient appropriately skilled and trained staff to meet the needs of the people living in the home. Evidence: The home maintains good staffing levels that support the needs, activities and aspirations of people in an individualised and person centred way. People living in the home spoke highly of the manager and her staff and said that they received good support that suited their needs. Good communication is fostered and staff are clear about their roles and responsibilities. All staff have appropriate job descriptions. Good training opportunities are provided and there is a training matrix that shows the training provided in the past year. Staff receive relevant training that is targeted and focused on improving outcomes for the people living in the home. Over ninety per cent of staff have achieved national qualifications in care. Birch Hill has retained its Investors in People award. The content of Induction training is robust and records showed it is detailed and specific to the home. Staff recruitment policies are in place that take account of equality and diversity principles. All elements of the recruitment process are well recorded and individual records showed that appropriate checks are carried out before staff start working in Care Homes for Older People Page 21 of 27 Evidence: the home. There are regular staff meetings and staff said that they feel well supported by the senior staff and manager. Staff have regular supervision and annual appraisals. Care Homes for Older People Page 22 of 27 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. People benefit from living in a well managed home and are encouraged to put forward their views. Evidence: The manager is a registered nurse who has completed appropriate management training and is experienced in the care of older people. She is highly competent and has a sound knowledge of the organisations management and operational policies. She is able to describe a clear vision for the home and communicates a clear sense of direction that evidences continuous improvement and customer satisfaction. She has a good understanding of equality and diversity and person centred practice and is able to communicate these to staff. Residents said that they felt well supported by the manager and her staff and that they were able to speak to her at any time with any concerns or issues about the service. Three people said that she always took their concerns seriously. There is a strong ethos of being open and transparent in all areas of the running of the home. Care Homes for Older People Page 23 of 27 Evidence: There is a quality assurance system in place that includes audits of records and systems as well as asking for the views of those using the service and their representatives. There was evidence that changes in practice have been made to take account of the findings of the quality assurance systems. Good systems are in place for recording money held on behalf of people living in the home. Good records are in place to show that health and safety requirements and legislation are met. Accident records were clear and there was evidence of appropriate monitoring of any issues arising from these. Staff receive mandatory training at regular intervals and systems are in place for recording this. Maintenance contracts are in place for regular servicing and repair of equipment. Records inspection were in good order showing appropriate testing and checks of equipment. Care Homes for Older People Page 24 of 27 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 25 of 27 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 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 1 3 Each persons pre admission assessment should cover the areas identified within this standard so that enough information is available to inform the care planning process. Individual plans and assessments must be regularly updated to show peoples changing needs and how these are met by staff. 2 8 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!