Inspection on 18/02/09 for Birchlands

This inspection was carried out on 18th February 2009.

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

Birchlands 01/11/06

Birchlands 11/05/06

Birchlands 17/10/05

Birchlands 21/04/05

Birchlands 26/11/04

Birchlands 11/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Birchlands Birchlands Barley Mow Road Englefield Green Surrey TW20 0NP     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: Sally Hall     Date: 1 8 0 2 2 0 0 9 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 26 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 26 Information about the care home Name of care home: Address: Birchlands Barley Mow Road Birchlands Englefield Green Surrey TW20 0NP 01784435153 N/A lucy.ncube@anchor.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Anchor Trust Name of registered manager (if applicable) Ms Lucy Ncube 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: The maximum number of service users ot be accommodated is 51 The registered person may provide the following categories of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Birchlands is a residential care home in a substantial detached property that has been purpose built to provide accommodation for fifty one service users. The home is owned by the Anchor Trust Group and is located in Englefield Green, near Egham. A selection of facilities and services including shops, church, public transport and G.P. surgeries are available locally. The home is a two storey building served by a passenger lift to Care Homes for Older People Page 4 of 26 care home 51 Over 65 0 51 51 0 Brief description of the care home both floors. A wheelchair lift provides access from the first floor to one of the seven residential units which the home is divided into. Each unit accommodates between 6 and 8 service users and has its own communal lounge and dining room with a kitchenette. Units on the ground floor have access to the garden via french doors from the lounge. All bedrooms are for single occupancy and have wash basins. Toilets and bathrooms, most with easy access baths or with a hoist facility, are provided on each of the units. The home has recently undergone a major renovation and refurbishment to improve facilities for residents and staff, and particularly for those residents with dementia. There is a large communal lounge, equipped with a television, music centre, piano and selection of books. This room is used for activities and has access to an enclosed garden area. A further area with comfortable seating and a music centre is situated centrally on the first floor. The fees at Birchlands range from 501.87 to 699.05 pounds per week depending on the level of care needs. Care Homes for Older People Page 5 of 26 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 quality rating for this service is 2 star. This means the people who use this service experience good, quality outcomes. The Inspector agreed and explained the inspection process with the Registered Manager and the Deputy Manager at the start of the inspection. The focus of the inspection was to assess Birchlands in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Care Homes for Older People Page 6 of 26 The Inspector used a varied method of gathering evidence to complete this inspection, pre-inspection information such as the previous report and discussion and correspondence with the registered provider was used in the planning process to support the inspector to explore any issues of concern and verify practice and service provision. The home had completed an AQAA an annual quality assurance assessment questionnaire, which was received prior the site visit to the home. This provided the Inspector with information relating to what the home considers it does well, what they could do better, what has improved within the last 12 months and plans for improvement. Survey questionnaires were sent to the home prior to the inspection and a number were received from both service users and health care professionals who visit the home. Information from these have been used in the inspection process. Documentation and records were read. Time was spent reading of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, staff rota, training records and recruitment records. The Inspector identified six people who use the service for case tracking, speaking with one of them whilst assessing the available information held in the home pertaining to the care provision for them. In addition the Inspector met with the other People who use the service and their family, which gave her a good opportunity to observe the quality of care being provided by the home and understand the impact the care provision has on their quality of life. What the care home does well: What has improved since the last inspection? 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 8 of 26 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 9 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can be confident that if they are offered a place at the home then their assessed needs can be met. Evidence: Evidence was seen in the service user files sampled, that admissions are not made to the home until a full needs assessment has been undertaken. The manager and staff who have the necessary experience and skills undertake an assessment. The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. The assessment often takes place at the home with prospective service users being invited there for the day. The assessments seen are comprehensive and form a good initial base for person centred care plans. It was apparent form the information collected that the service users had been part of the assessment process and their views, wishes and expectations have been taken into account. Care Homes for Older People Page 10 of 26 Evidence: Where the service users had been referred by the local social services and/or the health authority the manager insists on receiving the assessment and a copy of the care plan they have written before admission, these were seen on service users files. The manager confirmed admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective service user. Care Homes for Older People Page 11 of 26 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. Service users benefit from detailed care plans and are supported by staff who treat them with dignity and respect. Service users benefit from their health care and social needs being met. The homes procedures with regard to the handling and administration of medication ensure that service users receive the medication as prescribed. Evidence: Evidence was seen during the inspection process that many service users receive personal and healthcare support using a person centred approach with support provided based upon the rights of the individual. Personal support was responsive to the varied and individual needs and preferences of the service user. Unfortunately currently not all care plans reflect the same level of person centred approach, with inconsistency in the way the plans are written depending on who has written them. The manager is making arrangements to review all of the plans and organise further training for staff. Care Homes for Older People Page 12 of 26 Evidence: The persons needs have been identified by the use of a number of detailed assessments used by the home, giving a comprehensive overview of their care and health needs. Monthly reviews being carried out act as an indicator of change in requirements, which are then used to adjust the care provision, however this is not always then reflected in the plan it self. Staff observed respected service users privacy and dignity and were sensitive to service users personal needs. The staff listened to service users and responded to individuals choices and decisions regarding their personal care. Evidence was seen that service users are supported and helped to be independent. Service users spoken with confirmed that they are encouraged to take responsibility for their personal care needs when they are able. There social care needs are also recognised by staff and interaction is encouraged to suit the needs of the service user. Evidence was seen that service users have access to healthcare and remedial services. Staff make sure that those who are able are encouraged to attend appointments and visit local health care services. The health care needs of service users unable to leave the home are managed by visits from local health care services, which includes chiropody for example. Service users were seen to have the aids and equipment they need to remain mobile and as independent as possible. The home has a medication policy supported by procedures which staff follow. Medication records were seen completed, containing required entries, and are signed by appropriate staff. However during a sample audit it was found that current stock is not always carried forward on to the new MAR sheet making monitoring difficult. No other discrepancies were found. Staff have to complete and pass an appropriate medication training and then an assessment is carried out to ensure each member of staff is competent to handle, record and administer medication properly before being considered competent to administer medication to service users. The home respects and understands the rights of service users in the area of health care and medication. Current service users at the home do not manage their own medication and the care staff manages medication on their behalf with their agreement. The manager stated that the only risk assessments for medication would be completed for service user who wish to self medicate. There were no protocols for the use of PRN medication in place. Care Homes for Older People Page 13 of 26 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. Current service users enjoy a good lifestyle and range of activities, which can enhance their quality of life. Relatives are actively encouraged to maintain contact with their relatives and service users are encouraged to maintain choice and control over their lives. The service users benefit on the whole from appetising meals and balanced diet offered at the home. Evidence: Service users visitors spoken to said they feel welcome and know they can visit the home at any time. They said that staff always make time to talk to visitors and share information and give support. The design of the home means that there are a number of individual units each accommodating six to eight service users, each provides seating areas dining and a lounge area. Visitors can chose to sit here or service users can entertain their visitors if they wish, in the privacy of their own room. Service users are given choices over meals, activities and the pattern of daily life. The Care Homes for Older People Page 14 of 26 Evidence: menu and the activity programme are displayed, however they have not been designed to include picture formats which could afford an easy recognition for service users suffering from dementia. There is an activity co-ordinator available 40 hours per week. Staff do arrange some activities within the unit as well. The activity coordinator explained that he arranges both group and individual activities. Some of the activities include bingo, ball games, craft, sing alongs. He has also arranged for two service users to have a bus pass and he is able to take them shopping in the local towns. The local schools also provide entertainment through the year, service users have been invited to a play the senior school is putting on in March for example. Around the home were many photographs showing the local area years ago, several of the service users were able to talk about their memories. The coordinator had a large number of photos showing examples of the activities and outings that had taken place recently, these can be used for reminiscence. The menu for the day was seen displayed in the dining areas and there was a menu on every table. The menu showed there are choices on a daily basis. The staff confirmed other food is offered if the service users are not happy with what is available. The meals are cooked fresh in the home. The cook explained that she has meetings with the service users to get ideas for the menu which she changes with the seasons. During the inspection drinks were often offered and service users were encouraged to drink plenty. Snacks were also seen offered, and if service users said they wanted a biscuit for example this was facilitated. Service users spoken to said that the meals were good and the surveys received also made very positive comments about the food. Care Homes for Older People Page 15 of 26 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. Service users can be confident that complaints will be taken seriously, they aware of their rights with regard to making a complaint and to whom to complain. Service users are fully protected from the risk of abuse by the homes Safeguarding Adults policy and procedures. Evidence: A copy of the complaints procedures was seen and several service users surveys confirmed that they would know how to complain. The service users spoken to and surveyed said that they were confident that they would be listened to and concerns would be taken seriously. Copies of the service users guide which contains the complaints procedure was seen in service users bedrooms. No complaints had been received by the home since the last inspection. The Commission for Social Care Inspection has received notification/complaint of one incident which occurred at the home and is being investigated by the health and safety executive, the home has been open in it dealings with the multi-agencies involved and has followed procedures. The homes Policy for the safeguarding adults and the local authority protocols were seen. These include procedures for the reporting of suspicion or evidence of abuse or any allegations with the action to be taken in such an event happening. All staff have Care Homes for Older People Page 16 of 26 Evidence: had adult safeguarding training the manager confirmed. Evidence was provided that staff have been checked with the Criminal Records bureau and the homes recruitment procedures were found to be robust. Care Homes for Older People Page 17 of 26 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. Service users benefit from living in a well maintained environment which provides a homely warm atmosphere with safe access to comfortable indoor and outdoor communal areas. Evidence: A partial tour of the building was undertaken, the parts of the building seen were extremely clean with no offensive odors noticeable. There was a slight odor in two bedrooms, the carpets in these rooms are cleaned on a daily basis and staff said that the home was looking to replace the existing cleaning machine in the hope that this would improve the situation . The bedrooms are well furnished and service users are certainly encouraged to bring in their own furniture if they wish. The rooms entered had been personalised. The quality of the decoration and furnishings is good and thought had been given to the aesthetics of the communal areas within each of the eight separate units. Each unit has a lounge/ dinning area, bedrooms and a kitchenette were drinks and snacks are served from. The home has its own laundry facilities and all laundry is undertaken in house. Care Homes for Older People Page 18 of 26 Evidence: There are small gardens that can be seen and accessed from each unit on the ground floor. Staff said that these are well used in the summer and service users also help with planting and keeping the gardens looking nice. Care Homes for Older People Page 19 of 26 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. Service users care, social and emotional needs are promoted by well trained care staff in sufficient numbers to meet their needs. They are also protected by the recruitment procedures within the home. Evidence: The manager confirmed that all new staff undertake the induction programme with in the home, this covers awareness of the homes policies and procedures. The induction also covers topics such as health and safety, infection control, safeguarding adults and gives them certificates in moving and handling, basic food hygiene, and first aid for example. The home employs ancillary staff who work as cleaners, cooks, gardener/ maintenance staff. Thus allowing care staff the time to meet the care needs of the service users. From documentary evidence seen the standard of staff training was good overall with the majority of staff completing basic courses. The homes staff have exceeded 50 achieving a NVQ (National Vocational Qualification) Level 2 or above care qualification. With the staff currently undertaking the award and those who have been put forward for the award starting in March 2009 the home will far exceed this percentage. Many staff are going on to do level 3 once they have completed level 2. Care Homes for Older People Page 20 of 26 Evidence: The home showed that it undertakes sound recruitment practice including submission of an application form detailing all previous work history, requests proof of identity, seeks two written references, and confirms work status. The homes recruitment files viewed were seen to include all the information as required under schedule 2 of the Care Home Regulations 2001. Contracts have been issued to staff they have been signed and returned by staff. Care Homes for Older People Page 21 of 26 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. Service users benefit from an overall well run home that is operated in their best interests, where their views and opinions are important. Being cared for by staff that are appropriately supervised. Service users and their families can feel confidant that at all times their health and safety is protected as far is practically possible. Evidence: The registered manager has experience working in residential care since 2002 and archived the RMA, Registered Managers award and is awaiting her certificate. She has worked hard to increase the standards within the home. The service is planned to be user focused, and generally works in partnership with service users, their families and health professionals. Service users surveyed confirmed that the staff and manager respond to their requests and are approachable. Care Homes for Older People Page 22 of 26 Evidence: Observation of interactions during the day of inspection evidenced an open and friendly atmosphere through out the home. Throughout the inspection the staff were open and honest and assisted in the inspection process. Quality assurance was discussed and the views and opinions of many of the service users have been sought. Service users spoken with confirmed a great deal of satisfaction in living within the home and felt confident that the staff and management valued their views and opinions. An annual questionnaire has been given out to service users and service users surveyed with confirmed this. The home has regular service user meeting where topics such as the menus are discussed. The home has policies and procedures in place to deal with service users personal monies held their behalf. All monies are documented and service users and staff sign for each transaction. The manager and another person from the organisation then audits the accounts at least two monthly. Although records were not seen the homes manager confirmed that staff are supervised formally at least six times per year, it is undertaken by the team leaders currently every two months. The supervision is increased if it felt the staff member needs support or there is a problem with performance. All staff also have an annual appraisal and development meeting. The inspector viewed records relating to Health and Safety Procedures, maintenance and servicing, and risk assessments. Evidence was available in the completed AQAA, Annual Quality Assurance Assessment received prior to the inspection with regard to the servicing of gas boilers, servicing of the lift and electrical tests etc. The home has in place all the required policies and procedures which currently it needs to review to ensure they meet any changes in legislation etc. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!