Inspection on 26/09/05 for Birch House

This inspection was carried out on 26th September 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Birch House 31/12/08

Birch House 03/01/07

Birch House 06/06/05

Birch House 26/11/04

Birch House 02/08/04

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Insight - Eastchurch

Southfields

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Dovedale Court

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

CARE HOME ADULTS 18-65 Birch House Birch House The Street Appledore Kent TN26 2AF Lead Inspector Lois Tozer Unannounced Inspection 26th September 2005 13:50 Birch House DS0000023198.V253905.R01.S.doc Version 5.0 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 House DS0000023198.V253905.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 Adults 18-65. 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 House DS0000023198.V253905.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Birch House Address Birch House The Street Appledore Kent TN26 2AF 01233 758527 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) Nexus Direct Limited Ms Sharon Anne Gedling Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration conditional on Manager completing NVQ4 in management. Date of last inspection 6th June 2005 Brief Description of the Service: Birch House is a large, detached property situated in the village of Appledore, on the edge of Romney Marsh. It is owned by the company Nexus Direct and is managed on a day-to-day basis by registered manager, Ms Sharon Gedling. Set in its own spacious grounds, access to local facilities such as the village shop and post office, pub and recreation ground are minutes walk away. There is a train station situated a brisk 20 minutes walk from the home and an infrequent public bus service is available. The home has access to a dedicated vehicle and is able to have access to a second company vehicle if required. The home offers accommodation to a maximum of 3 people who have learning disabilities and fall between the age ranges of 18 to 65. The house offers a large communal lounge / diner, kitchen, laundry, WC and spacious lobby on the ground floor. All bedrooms and the office are situated on the first floor, with easy access to an additional WC and large bathroom. The garden is managed by the residents with staff support, and the development of a conservation area at the back encourages wildlife to use this habitat. A spacious gravelled area allows residents to air-dry clothes without getting muddy. The large front garden is currently being landscaped. Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place on 26th September 2005 between 13.50 and 15.30. There are currently three people living at the home, but all were out during this inspection. A senior staff member was on duty, and assisted the short inspection process. All core standards were inspected in June, and the outcomes for all residents was generally very positive. Therefore, the focus of this inspection was to see how work was progressing on requirements made previously. A care plan, several risk assessments, medication records and policies were seen. A brief tour of the home took place, noting the recent improvements. What the service does well: What has improved since the last inspection? The recruitment process has been amended making the process of employing new staff safer for the people living at the home. Training for medication management and administration has been given, staff said that it was ‘eye opening’ and that gaps in knowledge (not previously realised), were now closed. Medication records were in very good order and accurately reflected the medication prescribed to each individual. Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 6 The house has been fitted with full UPVC double-glazing, which looks very attractive. Security to the rear of the premises has been improved, as side gates have been fitted. The majority of recommendations had been met, and those that had not were in progress. 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 House DS0000023198.V253905.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 Individual needs, aspirations and goals are reflected in the service user plan. Risks are managed in a way that does not limit individual development, and ensures each individual has the right level of support. EVIDENCE: Each resident has a care plan that is highly descriptive of individual need and gives practical advice to provide a consistent approach by staff. Risk management strategies were in place and were specific to the individual. Staff have received training to enable full support of individual needs that may pose a risk to individual welfare. Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 20 Access to all healthcare professionals is well supported. The staff manage the residents medication, there has been improvements in this area, although security of storage requires attention. EVIDENCE: Records show that access to healthcare professionals is obtained without delay and staff follow up any action required. Individual health needs are well supported by an adequately trained staff team. Lots of improvements in medication management has taken place, through training and the increased knowledge base of staff. All records seen were in very good order and accurate. The previous medication storage facility had been bolted to the wall, but a new (and more appropriate) facility, recently purchased, had not. Supported self administration of medication was discussed. Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30 The home is comfortable and safe with a homely atmosphere. Bedrooms meet individual needs and lifestyles and promote independence. There are sufficient toilets and bathrooms. Sufficient shared space freely is available. Specialist adaptations have been fitted per needs assessment. The home is clean and hygienic. EVIDENCE: The maintenance and improvement programme has resulted in the front garden benefiting from landscaping and full replacement of windows and frames to the entire the house. Side gates have been fitted to improve security to the rear of the property. Communal areas are decorated and furnished to a good standard. The house is bright and airy throughout. The kitchen is spacious and leads to a dedicated utility room. An infection control procedure limits the spread of infection from laundry. Residents are encouraged to furnish their rooms with items of their choosing, one resident has moved bedroom and has had full input in its decoration (it looks lovely). Rooms are decorated as each individual wishes. Flooring is appropriate to individual needs and is of high quality. Staff benefit from a dedicated office that is also sufficiently large for a ‘sleep in’ room. Alarms and adaptations are in place to meet individual assessed needs. Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 14 Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40, Work is underway to improve service user accessibility to the quality assurance process. Practice in recruitment and medication management has improved, but the policies and procedures do not appear to have been revised. EVIDENCE: A large piece of work is underway to improve quality assurance questions and where needed into symbol format. The current system of service user consultation is effective and draws out day to day needs and aspirations. The policies made available to staff relating to medication and recruitment had not been revised, although the manager may very well be working on them. The practice however had improved and the outcome to the people living at the home is positive. Birch House DS0000023198.V253905.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 Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Birch House Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score X X 3 2 X X X DS0000023198.V253905.R01.S.doc Version 5.0 Page 18 Yes 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 2 3 Standard YA1 YA20 YA40 Regulation 5 13 (2) 13 (2), 18, 19. Requirement Simplify service user guide to enable greater accessibility to residents. Bolt medication cabinet securely to wall. Review medication & recruitment policy and procedure to reflect current legislation and good practice (previous requirement timescale 01/08/05, extended) Timescale for action 01/07/06 26/10/05 01/01/06 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 YA20 Good Practice Recommendations Where possible, develop greater levels of involvement in the administration of medication for each service user. Birch House DS0000023198.V253905.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 House DS0000023198.V253905.R01.S.doc Version 5.0 Page 20 - 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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