Inspection on 28/02/06 for Birchwood

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Birchwood 18/06/07

Birchwood 19/10/05

Birchwood 16/03/05

Birchwood 14/09/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Birchwood Fullers Close Chesham Bucks HP5 1DP Lead Inspector Chris Schwarz 28 th Unannounced Inspection February 2006 10:25 Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 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 Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 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. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Birchwood Address Fullers Close Chesham Bucks HP5 1DP 01494 794112 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) SCOPE Mr Jon Inker Care Home 15 Category(ies) of Learning disability (2), Physical disability (13) registration, with number of places Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: Birchwood is situated on the outskirts of Chesham, a small Buckinghamshire town containing a variety of shops, a theatre, various restaurants, and other local amenities. The town is served by local bus routes, and is connected to national rail links via a Metropolitan line tube station. The home is run by the organisation SCOPE, and has been built to provide accommodation for 15 service users. In its construction the home has been purpose built, and is fitted with the latest in disability aids and house design. All service users rooms are on the ground floor, and staff accommodation, office and storage space is situated on the first floor. Thirteen service users are accommodated in single rooms with en-suite shower and/or bath, and extensive tracking hoist systems are present in all rooms. Two service users share an individual apartment, which is part of the main building. This apartment comprises a bedroom, kitchen, storage, bathroom and lounge. A covered car parking space is adjacent to this apartment. The homes staff team includes care staff, physiotherapists, activities organisers and speech and language therapists. Access to allied healthcare professionals is possible through direct contact or referral by the service users general practitioner. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted on a week day, from 10.25 am until 2.00 pm. It consisted of discussion with the registered manager, a tour of the accommodation, examination of some of the home’s required records and opportunities to speak with staff and service users. It was the first time that the inspector had visited the service, on behalf of the allocated inspector. The majority of the key standards had been assessed in October 2005 and that inspection, like this, reflected good practice at the home. Most of the service users were at the home, with two people in hospital and one on holiday. There had not been any new admissions to Birchwood since it opened. Prior to this visit, the home completed a questionnaire and distributed comment cards on behalf of the Commission. Nine responses were received, reflecting well run activities, staff facilitating contact between service users and family members and overall satisfaction with the quality of care provided at Birchwood. One person volunteered to the inspector in person that he is generally happy at the home. Everyone living at the home has complex disabilities and range in age from 26 to 74. The home’s registration status needs to be revised to ensure that it adequately reflects the ages and needs of service users and this will be followed up separately to the inspection. The manager, staff team and service users are thanked for their co-operation, assistance and hospitality during this visit. What the service does well: Appropriate activities are available to service users, to ensure that they have variety and stimulation. There is good access to the local community, in order that service users have community presence. Service users are enabled to see family and friends and to be involved in personal relationships, to maintain important social contacts and express their sexuality. A varied diet is provided for service users, which they choose. Personal support needs are adequately assessed and carried out by staff, to ensure that care needs are met. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 6 A wealth of equipment is in place to assist people with disabilities to facilitate daily living tasks and aid communication. Appropriate arrangements are in place for the management of service users’ medication, supplemented by training and pharmacy inspection. A well thought out and carefully planned environment has been created for service users, promoting safety, comfort and accessibility. Regular monitoring of the service is undertaken on behalf of the provider, to ensure that the quality of care is adequate to meet service users’ needs. What has improved since the last inspection? 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. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 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 Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 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): EVIDENCE: None of the standards in this section were assessed on this occasion. There have not been any new admissions to the home. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 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): EVIDENCE: None of the standards in this section were assessed on this occasion. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 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): 12, 13, 14, 15 and 17 Appropriate activities and leisure opportunities are available to service users, to ensure that they have variety and stimulation. There is good access to the local community, in order that service users have community presence. Service users are enabled to see family and friends and be involved in personal relationships, to maintain important social contacts and express their sexuality. A varied diet is provided for service users, which they choose. Records need to be maintained in order to establish the adequacy of diet and to facilitate assessment of nutritional input, if necessary. EVIDENCE: Day service provision operates from church premises close to the home and is attended by most of the service users. These premises have been adapted for people with disabilities and open onto the High Street which is pedestrianised and safe for service users. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 11 The home employs two activities co-ordinators who focus solely on this area of practice. Service users are involved with a range of pastimes, such as performing arts, painting, information technology and sensory stimulation. One person was on holiday in Nottinghamshire at the time of the inspection and plans were underway to celebrate a service user’s 70th birthday with her family invited to attend the party. There did not appear to be any restrictions on service users seeing family and friends and a telephone was observed in one person’s bedroom to enable her to keep in contact with people. The staff team support the long-term relationship between two service users, who have their own flat at Birchwood. Each lounge group has its own meals chosen by service users and the lunchtime meal ranged from pasta bake to liver and bacon casserole. Each kitchen was well designed, clean and well stocked with records of fridge and freezer temperatures noted. An environmental health inspection resulted in the home being given the silver award, which is considerable praise. The only matter that needs attending to is that the home has not been keeping a record of food consumed by service users, which would enable nutritional assessment of their diet. A requirement is made to attend to this, to fully comply with the records that care homes need to maintain. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 12 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): 18 and 20 Personal support needs are adequately assessed and carried out by staff, to ensure that care needs are met. A wealth of equipment is in place to assist people with disabilities to facilitate daily living tasks and aid communication. Appropriate arrangements are in place for the management of service users’ medication, supplemented by training and pharmacy inspection. Whilst errors are rare, the Commission needs to be notified of these to ensure that practice is safe and that appropriate remedial action has been taken. EVIDENCE: Birchwood is exceptionally well provided with technical aids and equipment to assist people with disabilities, ensuring that their care needs are met and their dignity respected. Considerable thought and planning has obviously gone into the design of the building, to accommodate current care needs and forward planning for future needs, such as hearing impaired service users. Care plan folders contain comprehensive information about assistance that each person requires, including preferences of carer gender-wise, accompanied by input from specialist advisors such as the speech and language therapist and physiotherapist who are part of the staff team. Anyone new coming to work at the home would instantly gain an accurate picture of care needs from looking at the care plans, thereby promoting continuity of care. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 13 The advocacy service People’s Voice is available to service users and an advocate was seen visiting a service user at the time of this visit. The contact took place in private, as appropriate. Medication practice was assessed, to follow up on a recommendation made during the last inspection. Revised policies are in place for the use of homely remedies and the ordering, administration, receipt and disposal of drugs, produced in consultation with outside agencies such as the community pharmacist and one of the Commission’s pharmacy inspectors. These are comprehensive and cover all necessary areas of practice within a care home. There had been two medication errors, one recently and the other last summer. Records had been completed within the home and appropriate action was taken such as notifying the senior on duty and contacting the doctor; no ill effects to the service users were apparent. It would be expected for homes to notify the Commission of such incidents and upon return to the CSCI office a check was made of records to verify that this had been done; no records of notification were evident. A requirement is made to address this, to ensure that any further occurrence is reported within 24 hours. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 14 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): EVIDENCE: None of the standards in this section were assessed on this occasion. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 15 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 A well thought out and carefully planned environment has been created for service users, promoting safety, comfort and accessibility. EVIDENCE: Birchwood blends in with the rest of the community in a quiet part of Chesham overlooking open countryside. The town is a short distance away and it was particularly encouraging to hear that some of the facilities in Chesham have proper access for people with disabilities such as banks, the Post Office and local supermarkets. Whilst none of the standards in this section needed assessment on this occasion, it was worth conducting a tour of the building to appreciate the effort that has been taken to create a high quality environment for people with complex disabilities. The building is divided into three communal living areas plus a flat for a couple. Each part of the home has been decorated, arranged and furnished to high standards and there is good light, ventilation and heating around the premises. Each bedroom has individual thermostatic control, to suit different preferences, and there are no radiators to provide hazardous surfaces due to Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 16 provision of under-floor heating. All parts of the home occupied by service users are accessible, with wide doorways and flat pathways. The premises were clean and odour free throughout. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 17 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): EVIDENCE: None of the standards in this section were assessed on this occasion. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 18 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 Regular monitoring of the service is undertaken on behalf of the provider, to ensure that the quality of care is adequate to meet service users’ needs. EVIDENCE: Records showed that the service is regularly assessed by Scope to ensure that the home is operating effectively and in line with the National Minimum Standards. The reports reflected that the environment, care practice and staffing issues are looked at as part of the visits and service users’ views are taken into account to evaluate provision. Whilst the frequency, content and report production are satisfactory, the visits are not being carried out on an unannounced basis, as required by the regulations applicable to care homes. A requirement is therefore made to attend to this. Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 x 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x x x 2 x x x x Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA17 Regulation 17(2), schedule 4.13 37 26(3) Timescale for action A record is to be maintained of 15/03/06 food consumed by service users, in order that the adequacy of diet may be assessed. The Commission is to be notified 15/03/06 within 24 hours of any medication administration error. Monitoring visits undertaken by 15/03/06 or on behalf of the provider are to be conducted on an unannounced basis. Requirement 2 3 YA20 YA39 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Birchwood DS0000061743.V274777.R01.S.doc Version 5.1 Page 22 - 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. 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