Inspection on 29/06/05 for Birchwood

This inspection was carried out on 29th June 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.

Other inspections for this house

Birchwood 04/05/06

Birchwood 04/01/06

Birchwood 06/10/04

Birchwood 19/05/04

Birchwood 02/02/04

Similar services:

Littledale Hall Therapeutic Community

Padgate House

Westcliffe House

Richards House

Turning Point (Hoole Road)

Stanfield House

Little Acre Care Home

Inward House Projects

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

CARE HOME ADULTS 18-65 Birchwood 23-25 Balls Road Oxton Birkenhead Wirral CH43 5RF Lead Inspector Helen Carton Unannounced Wednesday, 29 June 2005 10.45 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Birchwood Address 23-25 Balls Road, Oxton, Birkenhead, Wirral, CH43 5RF 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) 0141 653 4266 Arch Initiatives PC Care Home Only 14 Category(ies) of D Drug dependence past/present 14 registration, with number of places Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6/10/04 Brief Description of the Service: Birchwood is registered to provide care for fourteen adults with past or present drug dependence. The service is providing a detox programme with stays ranging between three and eight weeks. The service is comprised of two large adjoining three storey terraced houses and is situated in a mainly residential area next to a main road. It is close to shops, leisure facilities and within walking distance of Birkenhead town centre. All Bedrooms are single with lounges and the dining room being on the ground floor. There are bathrooms and shower rooms on both the ground and first floor.There is a large garden to the rear of the building and a small car park at the front. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were nine clients staying at Birchwood at the time of the visit the inspection was unannounced and took approximately six hours. The inspector spent time with all the clients and spoke to five members of staff two of which were managers. What the service does well: What has improved since the last inspection? What they could do better: Since the last visit the service has begun to produce risk assessments if concerns are raised by clients or other professionals involved in their care. They need to now take this information and with individual client’s involvement produce support plans to assist the client to reduce the risk. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 6 Birchwood must make sure that as part of their recruitment procedure any gaps in a person’s employment history is checked to safe guard clients. A record of checks made on staff must be held in the service. 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 F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 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 standard(s) 1,2,3 and 5 Clients have detailed information about the service prior to their admission allowing them to make an informed decision. EVIDENCE: People who enter the detox programme at Birchwood are provided with good information about the type of support offered and how it will be delivered. This includes a Terms of Treatment: Code of Conduct and Rules of the House. These documents tell clients about how they should behave to each other and the staff team during their stay with the level of behaviour being firmly enforced. With any problems discussed at group meetings and in one to one sessions. Birchwood has a detailed admissions procedure, which tells people interested in being admitted to the service or those supporting others what type of care and support they provide. All clients admitted to the service are provided with contracts signed by themselves and a senior manager from the organisation. Clients told the inspector they felt the rules of the house were fair and were happy to sign up to them. They discussed their admissions to the service and the information they were given. Particularly about what was expected of them and what they could expect from their stay at Birchwood. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 9 Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 10 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 standard(s) 6,7,and 9 Birchwood provides a specialist service and is open and honest with prospective clients about restrictions that are imposed during their stay. Identified risks are not being effectively managed leaving clients vulnerable and at risk. EVIDENCE: Birchwood provides a specialist service to support people to become drug free. The support plans produced by the service centre on this need, which will include looking at reasons why individuals have become dependent on drugs. Also supporting clients to develop safety mechanisms to prevent relapse into addictive behaviour. While staying at Birchwood clients’ are supported to prepare for their lives once they have completed their detox programme. This will include supporting service users with housing and benefit claims and providing information about rehabilitation services. Since the last inspection visit Birchwood has worked hard to identify possible risks for clients including episodes of depression, suicide attempts and self harming incidents. They have gained information from clients and others Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 11 involved in their care. However they have not developed support plans to reduce the impact of these risks. Therefore this needs further work to be undertaken to be able to fully safeguard all service users. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 12 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 standard(s) 11,12,13,16 and 17. There are restrictions placed on clients lifestyles however these are clearly documented. These restrictions support clients to focus on the causes of addiction and work towards effective recovery. EVIDENCE: The clients’ lifestyles are restricted during their stay at Birchwood with these restrictions being agreed before or during the admission process. All activities carried out by the clients are risk assessed by the managers’ and the staff team to make sure they do not have an adverse effect on the clients’ recovery. However clients are able to access a computer suite at the owner’s head office and they do attend arts and crafts sessions away from Birchwood. The clients’ told the inspector they accepted the restrictions that are placed on them during their stay at Birchwood as it benefits their recovery. Also they enjoy going on organised outings to places such as museums and places of local interest. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 13 The managers’ told the inspector they were appointing a part-time cook to cover when the full-time cook is off. The clients told the inspector they enjoyed the food and the cook asked them each day what they would like to eat. Also choices are always provided if they do not like the meals offered. They expressed their appreciation for the cook who they felt valued them. During a look around the building the inspector saw full bowls of fruit on the dining room tables. Since the last visit to the service the owner’s have purchased new dining room furniture and curtains. This makes the room much more attractive and comfortable. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 14 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 standard(s) 18,19 and 20. Clients physical and emotional health needs are met to a high standard. EVIDENCE: All the people who stay at Birchwood are able to carry out personal care tasks such as bathing and dressing. The clients staying at Birchwood are there to take part in a detox programme to help and support them to stop taking the drugs they have become addicted to in their communities. As part of the detox programme Birchwood provides specialist health care such as a GP’s who have specialist knowledge and skills in treating drug users. Also during the admissions process clients are weighed and asked if they are suffering from any illnesses or ailments such as toothache and skin sores. Appointments are then made with the necessary health care professionals. As part of the detox programme regular mouth swabs are taken to ensure clients are complying with the house rules of being non prescribed drugs and alcohol free. During the visit the inspector looked at the medication and records for six clients, they were accurate and provided good information to make sure the staff team give correct medication. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 15 Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 16 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 standard(s) 22 and 23. Clients’ views are actively sought and their concerns are dealt with sensitively. The service promotes openness and honesty and mutual respect. EVIDENCE: The service has produced a formal complaints procedure, which all clients are given in their handbook. The managers told the inspector house meetings take place every morning all clients must attend. Clients told the inspector at these meetings concerns and any conflict are shared within the group. The clients told the inspector they have regular one to one sessions with members of the staff team and feel confident to talk to the managers’ about any concerns they may have. Since the last visit to Birchwood one of the two managers’ has provided the staff team with training on the service’s protection of vulnerable adults policy and procedure. The registered owner’s have recently received a copy of Wirral social services Protection of Vulnerable Adults Policy and Procedures and will make sure their procedures are in line with this document. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 17 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 standard(s) 24,25,28 and 30. The service provides a comfortable, homely and safe environment for clients to use during their stay. EVIDENCE: Since the last visit the owner’s have continued to refurbish and redecorate the service. The managers’ told the inspector new sofas have been ordered for the main lounge area and new carpets are to be fitted throughout the house. Four clients invited the inspector to view their bedrooms they told her they were happy with the size, layout and quality of the furnishings. They said they were able to personalise their rooms as long as it did not involve putting holes in walls. As part of the detox programme clients are allocated domestic jobs at the morning group meetings. This work is carried out with the support of the homes support workers. Clients do not carryout heavy cleaning duties this type of work done by the support workers. Areas of the house seen during the visit were clean and tidy. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 18 Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,34,35 and 36. The staff team are competent skilled and provide sensitive support to the clients. Due to some gaps in the recruitment and selection process clients are not being adequately protected. EVIDENCE: Birchwood employs two groups of people to provide care and support to clients staying at the service. The substance misuse workers are responsible for supporting clients’ in group, and individual counselling sessions. They are responsible for producing risk assessments and care and support plans for clients. They must also document how clients are progressing through their detox programmes. The residential support workers are responsible for the cleanliness of the house and supporting service users in daily activities both in the house and the wider community. Clients told the inspector even though the staff team have two different roles they work and support each other to benefit them and their recovery. Since the last visit most of the residential support workers have begun a training programme that is specifically for people who work in the drug field. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 20 The managers told the inspector the staff team have also received training about protecting vulnerable adults, risk assessment, care planning and reviewing, medication administration and a drug awareness course. The managers are advised to make sure training records held in the home are regularly updated. A sample of staff records were looked at and the managers were advised to make sure gaps in peoples employment histories are looked at. Also checks that must be made by the owner before anyone starts working at the service must be recorded and held at Birchwood. All staff receive regular supervision from the managers, staff members told the inspector they felt well supported and that they were valued by their managers. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39, and 42. Clients are benefiting from a management team who are providing a positive ethos, good leadership, and a supportive and structured management approach. EVIDENCE: The clients told the inspector they felt the managers provided them with honesty and support that made them feel valued and safe. They believed the managers and staff teams approach to addiction helped them to stick to the detox programme and to look at ways to help and support themselves. Clients told the inspector they discuss all aspects of the programme at Birchwood daily and are confident their opinions are listened to and acted upon when necessary. Any accidents/incidents are recorded and action taken if needed. The fire log book recorded all the necessary checks and training needing to be carried out. Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 22 Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 23 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 3 3 4 x 4 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x x 3 4 Standard No 31 32 33 34 35 36 Score 3 3 3 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Birchwood Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 24 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 9 Regulation 13 Requirement The registered persons must ensure where risk assessments indicate cause for concern that a management/support plan must be put in place and advice sought from appropriate professionals. The registered persons must ensure the recruitment process is robust with particular regard to exploring gaps in employment histories. Also a record of checks made prior to employment must be held in the home. Timescale for action 15/8/05 2. 34 19 30/8/05 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 Good Practice Recommendations Birchwood F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Liverpool Area Office 3rd Floor, 10 Duke Street Liverpool L1 5AS 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 F52 F02 S18870 Birchwood V235106 270605 Stage 4.doc Version 1.40 Page 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. 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