Inspection on 30/04/07 for Birchwood Bungalow

This inspection was carried out on 30th April 2007.

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 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Birchwood Bungalow 16/05/06

Birchwood Bungalow 29/11/05

Birchwood Bungalow 04/08/05

Birchwood Bungalow 25/10/04

Birchwood Bungalow 26/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Birchwood Bungalow The Bridle Path, Off How Wood Park Street St. Albans Hertfordshire AL2 2QZ Lead Inspector Patricia Rogan Unannounced Inspection 30th April 2007 15:00p Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 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 Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 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 Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birchwood Bungalow Address The Bridle Path, Off How Wood Park Street St. Albans Hertfordshire AL2 2QZ 01727 874776 01727 874776 FP 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) Milbury Care Services Limited Manager post vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2006 Brief Description of the Service: Birchwood Bungalow is a small home, purpose built home providing personal and social care and accommodation for 7 people who have a learning disability. Milbury Care Services Limited owns the home. The property is a chalet style detached bungalow, which has been extended to provide its present accommodation and is set in two thirds of an acre of land. It is reached via a bridle path, one hundred yards long, which provides it with privacy whilst being close to local shops in a quiet residential area of St Albans. St Albans is an historic town, which boasts a lively town centre with various and wide ranging amenities. The town centre is a short car journey from the home. The home provides single bedrooms, each with a hand basin, for its occupants The home provides residential care in a family style environment for people who have a learning disability. The home has extensive and well-maintained, furnished and accessible gardens, and its own mini-bus to support service users to access their community. The Statement of Purpose, the Service User Guide and the published inspection report is available from the manager. The fees are variable according to the assessed needs of each individual service user. The fees and any costs of additional services such as hairdressing or outings would be discussed fully after the assessment and written into the individual service contract. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of all the key standards and took place when the service users were in the home. Time was spent in the communal kitchen and dining area, speaking with service users and staff and generally observing the interaction between the staff and the people who use the service. A tour was made of the premises and time was spent meeting in private with members of staff to hear their views about what it is like to work in Birchwood Bungalows and what training and support they have. Some records and case files were also inspected. There were positive aspects of the care provided and after some time without a manager, a new manager was due to start work the day after the inspection. However, considerable repairs and refurbishment was identified as essential in order to ensure the people who live in the home have a safe and pleasing environment. Therefore the outcome for service users is adequate. What the service does well: What has improved since the last inspection? What they could do better: Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 6 Repairs such as the loose stair rail, should be carried out as soon as possible after it is reported in order to ensure the safety of the staff and service users. The home is in poor decorative order and is in need of refurbishment so that people who use the service can live in a pleasing and safe environment. 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. The summary of this inspection report can be made available in other formats on request. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 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 Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide is available in the home. Service users needs are fully assessed prior to moving into the home. EVIDENCE: The Service User Guide and Statement of Purpose has been updated since the last inspection and can be made available in easy read formats. An inspection of two case files showed that the assessments had been carried out prior to admission and had included personal and social care needs and interests. The assessments had been signed by the assessor. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were detailed and described what assistance is needed to enable the service users to be treated as an individual within the home. The risk assessments were relevant and up to date. EVIDENCE: The care plans identified the individual care needs and how these would be met. Whole life reviews were also on file and this showed that options were explored to find ways that the service user could feel part of the life in the home and in the wider community. These records had been reviewed regularly and as needs changed. Risks were identified and ways that the risks could be minimised were recorded. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are treated as individuals and are given support to enjoy a lifestyle which is varied and appropriate to their age and interests. Staff were respectful and responsive towards residents. Meals are varied and nutritious and the preferences of the service users is included in the menu choices. EVIDENCE: The individual interests of the services users were recorded on file and reviewed to ensure these still reflected the service users physical and emotional needs. Opportunities to become involved in community activities such as day care or outings to the town was a regular occurrence. Staff appeared to know the service users well and there was a mutual respect between staff and service users. The menu was varied and nutritious with choices available and was freshly prepared in the communal kitchen. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care and physical and emotional support is provided in an individualised manner according to the abilities and needs of each service user. Service users have prompt access to their general practitioner and other health professions as required. Medication administration is carried out according to revised policy and procedures. EVIDENCE: The way in which personal care should be provided was recorded in the care plans. This had been reviewed on a regular basis and amended as the needs of the service user changed. This information was shared with the care staff to ensure that service users had continuity of care and so that care was provided in a manner familiar to them. Files showed when there had been contact with health and social care professionals and what advice had been given. This was an improvement since the last key inspection. Medication administration and storage had also been improved since the last key inspection and since an incident where medication was mislaid. All staff are aware of the revised policies and procedures. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints policy and procedure was in place. Some members of staff did not appear to be confident about reporting incidents or concerns via the whistle blowing or safeguarding adults procedures. EVIDENCE: Service users have complex needs and communication is very limited for some service users. Those staff who know the residents well understand the service users body language but there are new members of staff who have not had time to learn this and were less sure of how to recognise if a service user may be feeling vulnerable or unhappy. Staff have had training in Safeguarding Adults but some staff were unaware of the whistle blowing policy and did not know the correct procedure for reporting concerns or events which may adversely affect the well being of the service users. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Repairs are not always carried out in a timely manner to safeguard service users and staff. Some areas of the home are in need of refurbishment or redecoration. The premises were clean and hygienic throughout. EVIDENCE: The stair rail was loose and members of staff said this had been reported but no date for repair had been set. This put service users and staff at risk of falling if the rail pulled away from the wall. At least one door handle was broken and there were other repairs which were needed. Several areas of the home needed redecoration or refurbishment to ensure that the service users live in a home which is fit for purpose and of good quality. The office was sparse and lacked sufficient desk and storage facilities for efficient working. The premises were clean and hygienic and the laundry equipment is in an adjacent outbuilding. The grounds were in good order. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have induction training relevant to their roles. Staff recruitment is always audited by the operations manager. Experienced staff oversee new members of staff. The training programme is ongoing and reviewed for all staff. EVIDENCE: The members of staff who have worked at Birchwood Bungalow long term are experienced and respond well to sometimes challenging situations. They are able to support new members of staff during their induction. The operations manager audits all recruitment and ensures that the correct paperwork is in place prior to a person starting work in the home. Induction into the service and mandatory training is given to all staff and since the previous inspection, staff have fire safety training and drills on a regular basis. Some staff would benefit from refresher training in Safeguarding Adults and whistle blowing procedures. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager has not been in post for several months. An annual service review is underway. Repairs and refurbishments are not carried out in a timely manner to ensure the safety and wellbeing of service users and staff. EVIDENCE: An acting manager has been in post for several months and has been supported by the operations manager. The acting manager has been proactive in responding to the additional responsibilities of running the service. Service users are the focus of the service and the staff work hard in a sometimes challenging environment and this is reflected in reviews of the service. However, the repairs are not always attended to promptly and this could put service users and staff at risk and refurbishments and redecorations are overdue and can affect the wellbeing of the service users. Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 16 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 3 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 2 x Birchwood Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 17 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 YA23 Regulation 13(6) Requirement All staff must have training to ensure they know how to respond to evidence of abuse or neglect. Service users must live in an environment which is maintained in good decorative order throughout. Service users and staff must be protected from harm by repairs being carried out as soon as possible after they are reported. Timescale for action 31/08/07 2. YA24 23(2)(b) 31/08/07 3. YA42 23(4) 31/08/07 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 Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 18 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © 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 Bungalow DS0000019294.V337100.R01.S.doc Version 5.2 Page 19 - 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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