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Inspection on 10/08/05 for Birchville Court Nursing Home

Also see our care home review for Birchville Court Nursing Home for more information

This inspection was carried out on 10th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Registered Manager conducts assessments identifying the needs of service users prior to admission. On the day of the inspection a room was being held for an assessed service users awaiting supply of a piece of specialist equipment. The care plans drawn up from the assessment and on going knowledge of the service users needs are excellent. They are clear, informative and give an excellent around picture of the needs of the service users and how those needs are to be met.

What has improved since the last inspection?

The home has now started to conduct regular supervision with its staff. The Registered Manager and her staff continue to explore ways of enhancing the lives of its service users.

What the care home could do better:

Given the very frail nature of the service users the home admits it is recommended that they review their registration and seek to change it to include care for those who have a terminal illness.

CARE HOMES FOR OLDER PEOPLE Birchville Court Nursing Home Heathbourne Road Bushey Heath Hertfordshire WD23 1PB Lead Inspector Marian Byrne Unannounced 10 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Birchville Court Nursing Home Address Heathbourne Road, Bushey Heath, Hertfordshire, WD23 1PB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 4219110 0208 4219117 Peach Glen Limited Mrs Christine Kelly Care Home with Nursing 39 Category(ies) of OP Old Age 39 registration, with number of places Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate 39 older people who require nursing care. Date of last inspection 28th October 2004 Brief Description of the Service: Birchville Court is situated on the outskirts of Bushey Heath. The two storey period building with a modern ground floor extension to the rear is set back from the road in extensive grounds. Visitor’s parking is provided to the side of the main building. The home has been extensively modernised in the last eighteen months providing accommodation in 39 single rooms many of which have en-suite toilets and wash hand basins. A feature of the home is the overhead tracking hoists which have been provided in the bathrooms, shower room and toilets.There is a large lounge, sunroom, conservatory and dining room on the ground floor. The rooms in the older part of the house and the entrance hall are decorated in period style. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a positive inspection. The home was clean and fresh on the day of the inspection. The inspector observed good interaction between staff and service users. The inspection took place on the 10th August 2005 and was carried out by one inspector. The inspection lasted five hours. Service users were appropriately dresses and were well presented. The home caters for very frail service users and provides ‘kirton’ for service users who would otherwise be unable to sit in the sitting room. Kirton chairs provide full support to enable a very frail person to sit comfortably and safely. Risk assessments have been completed to ensure the chairs are being used appropriately. Some very frail service users admitted to the home are in the last stages of their lives. The home is not registered to care for people with a terminal illness. It is recommended that the registration is reviewed to include a number of places to provide care for service users to have a terminal illness. What the service does well: What has improved since the last inspection? The home has now started to conduct regular supervision with its staff. The Registered Manager and her staff continue to explore ways of enhancing the lives of its service users. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 6 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. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 The home offers good information on the services it provides and the assessments carried out prior to admission are very good. EVIDENCE: The home has updated its Statement of Purpose to reflect the changes to the floor covering in the home. A very thorough, assessment of needs is carried out by the Registered Manager, prior to admission. If a potential service user’s needs cannot be met, a place is not offered. At the time of the inspection the home was waiting for a specialised piece of equipment to be supplied prior to admitting a service user. The home operates in a very open and transparent way families and representatives are welcome at all reasonable times. All service users are admitted for a trial period following which their needs will be assessed. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The home provides very detailed, clear care plans that reflect the care carried out. The home meets service users health care needs in a manner that upholds their dignity. EVIDENCE: The care plans are excellent containing good detail written in a very clear easily accessible manner. They give details that include records of bruising, mental health status, falls prevention and body maps. All visits by health professionals are recorded. The home admits very frail service users and is keenly aware of the need for fully detailed care plans. The inspector read the care plan of a recently admitted service user. This contained all the appropriate and required information to ensure all identified needs can be met. The inspector observed service users being treated with respect and dignity and service users spoken with confirmed this. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 The home provides a caring atmosphere where service users have their needs met. There are no restrictions on visitors to the home. EVIDENCE: A high number of service users are very frail. The home makes every effort to ensure they are not isolated in their rooms. Kirton chairs are provided to ensure they can be got up and spend some time in the sitting rooms. These chairs enclose the service users and ensure they are fully supported. Without these the service users would experience difficulty in spending time out of bed. The appropriate risk assessments have been carried out on all service uers who use kirton chairs. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected. EVIDENCE: Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26. With the exception of some of the ‘kirton’ chairs the home was clean and fresh. The grounds were well tended and safe to use by service users. The home meets the standards on size and the provision of bathing and lavatory facilities. EVIDENCE: On the day of the inspection the home was clean, fresh and odour free. The new floor coving in the dining room and sitting room is showing premature signs of wear and tear. The Registered Provider is aware of this and is pursuing the matter with the manufacturers. Some of the chairs in the dining room are also showing signs of wear and tear. When the inspector enquired, the Registered Manager informed her of the high needs of the service users mean they are in constant use. Additional chaiars must be provided to allow for deep cleaning. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected. EVIDENCE: Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected EVIDENCE: Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 16 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 26 Regulation 23(2)(c ) Requirement The Registered Manager must ensure that additional kirton chairs are provided to facilitate the chairs in use being deep cleaned. Timescale for action 30/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations It is recommended that the home reviews its registration a view to the inclusion of a number of places to provide care for those with a terminal illness. Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire, AL7 3BQ 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 Birchville Court Nursing Home I52 S19293 Birchville Court V243379 100805 Stage 4.doc Version 1.40 Page 18 - 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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