Inspection on 04/01/06 for Birchwood

This inspection was carried out on 4th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Birchwood 04/05/06

Birchwood 29/06/05

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 Inspection 4th January 2006 11:00 Birchwood DS0000018870.V280262.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 DS0000018870.V280262.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 DS0000018870.V280262.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Birchwood Address 23 - 25 Balls Road Oxton Birkenhead Wirral CH43 5RF 0151 653 4266 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) Arch Initiatives Christina Maria Radford Care Home 14 Category(ies) of Past or present drug dependence (14) registration, with number of places Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 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 DS0000018870.V280262.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One client was being admitted to Birchwood during the inspection visit. The inspection was unannounced and took approximately two and a half hours. The inspector spent time with the manager. 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 lives. They need to now take this information and with individual client’s involvement produce support plans to assist the client to reduce the risk. The manager needs to make sure the pre admission assessments carried out are centred on what Birchwood can provide and the needs they can appropriately support. 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. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 6 The manager needs to make sure for health and safety reasons that a there is a member of staff with a first aid qualification on each shift. 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 DS0000018870.V280262.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 DS0000018870.V280262.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): 1&3 Clients have detailed information about the service prior to their admission allowing them to make an informed decision. The pre admission assessments are not carried out by staff from the service leaving potential clients being offered a placement that cannot meet all their assessed needs. 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 expected being firmly enforced. 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. The inspector looked at assessment information and noted a person employed by the owner’s undertakes pre admission assessments but does not work in the service. The inspector discussed this with the manager and advised her assessments carried out must fully take into account Birchwood’s facilities, Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 9 services they can provide. To ensure all the assessed needs can be met prior to an offer of a placement being made. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 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 the following standard(s): 6&9 The care planning and risk assessment systems in place are not consistent and do not provide the staff team with the detailed information they need to safely support clients. 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. At the last inspection visit to Birchwood the inspector commented that work had been carried out to identify possible risks for clients including episodes of depression, suicide attempts and self-harming incidents. With information being gained from clients and others involved in their care. However the service has not developed support plans to reduce the impact of these risks. This resulted in an assessment providing limited information about a past suicide attempt not being properly risk assessed and no support plan being put in place. This resulted in the staff team not being able to provide appropriate support and supervision. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 11 Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 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 the following standard(s): 15 & 16 Birchwood enables clients to take control of their lives and make positive changes in their lives. The systems for clients’ consultation are good with a variety of evidence that indicates that clients’ views are both sought and acted upon. 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 make it clear to clients’ that the development of sexual or intimate relationships while staying at Birchwood is not allowed as they take clients focus away from their recovery. The service supports clients to take control and responsibility for their lives including understanding consequences to actions. Particularly when breaking house rules including bringing drugs and alcohol into the building. If these Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 13 rules are broken clients will be asked to leave however this does not mean that clients cannot be referred back to the service in the future. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 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 the following standard(s): 18 Clients physical and emotional health needs are met to a high standard. EVIDENCE: The following information was gained at the last inspection visit and remains current at this visit: 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 regular mouth swabs are taken to ensure clients are complying with the house rules of being non-prescribed drugs and alcohol free. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 15 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): 22 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. House meetings take place every morning with attendance at them being compulsory. During these meetings concerns and any conflict situations are shared with the group. Clients’ are supported in one to one sessions by substance misuse workers’, which agreed upon on admission. At the time of the visit a new client was being admitted to the service the inspector did not feel it was appropriate to meet with them at this time. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 16 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): EVIDENCE: The inspector did not look around the building on this visit. Birchwood DS0000018870.V280262.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): 32 & 34 The owner’s are committed to providing appropriate training to enable the staff team to support clients in the most effective and supportive manner. The service is not able to evidence the recruitment procedures in place are effective and protect clients from possible abuse. EVIDENCE: The manager told the inspector the owner’s have a human resources department who carryout all the required checks on prospective staff. Resulting in the service not having all the required records as detailed in Schedule 2 of The Care Homes Regulations 2001. The inspector advised the manager to make sure the home has a record of the checks made prior to the offer of employment being made. And to make sure these records are available for inspection. The staff team are all taking part in the DANOS (Drug and Alcohol Occupational Standards) training. They have also taken part in training provided by the owner about care planning, case notes and group work. The inspector discussed with the manager the need to make sure that on each shift there is a member of the staff team with a first aid qualification. The manager told the inspector she intended to check all basic training such as basic food hygiene, fire safety training and first aid over the next six months. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 18 Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 19 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): 37 & 42 The manager has a clear development plan and vision for the service and is supported well by the senior staff team. EVIDENCE: Since the last inspection visit the manager has been registered with the Commission. The manager told the inspector there is a clear management structure now in place with a deputy manager with specific responsibilities and a team leader who takes the lead in staff deployment. The inspector discussed with the manager the need to provide greater detail in risk assessments and to provide support plans when necessary. Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 20 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 3 2 X 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 3 X X X X 2 X Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA2 Regulation 14 Requirement The registered person must ensure the pre admission assessment process is linked to the facilities and services to be provided at Birchwood. The registered persons must ensure where risk assessments indicate cause for concern. A management/support plan is put in place and advice sought from appropriate professionals. The care plan must indicate where on going support will be required with particular regard to an increase in one to one support. The registered person must ensure the staff team are provided with first aid training. The registered persons must ensure evidence is available to the Commission that demonstrates the recruitment process is robust and protects clients from possible abuse. Timescale for action 30/03/06 2 YA6YA9YA42 13 30/03/06 3 YA32 13 30/03/06 4 YA34 19 30/03/06 Birchwood DS0000018870.V280262.R01.S.doc Version 5.1 Page 22 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 DS0000018870.V280262.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 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. 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