Inspection on 04/08/05 for Birchwood Bungalow

This inspection was carried out on 4th August 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Birchwood Bungalow 30/04/07

Birchwood Bungalow 16/05/06

Birchwood Bungalow 29/11/05

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, Herts AL2 2QZ Lead Inspector Hazel Wynn Unannounced 4 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Birchwood Bungalow Address The Bridle Path, Off How Wood, Park Street, St Albans, Herts, AL2 2QZ 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) 01727 874776 01727 874776 Milbury Care Services Limited CRH Care Home 7 Category(ies) of LD-7 registration, with number of places Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 25 October 2004 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. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the afternoon and evening of the 4th August 2005 and this report provides a snapshot of the Regulation Inspectors view of the home on that day. All of the National Minimum Key Standards were inspected and an update to the Statement of Purpose and Service user Guide were required in order that they show the Inspecting Body to be the Commission for Social Care Inspection at Mercury House (the remainder of the details were correct. Another requirement was made for the Care Plans to contain Risk Assessments that bear a current date and the next date of review. Generally, the home was well maintained and care and protection well managed by a competent staff team. What the service does well: What has improved since the last inspection? The home now has a full staff team and is on track to achieve at least a minimum of 50 of care staff who are undergoing training in NVQ at levels 2 and 3 (or who have already achieved this). A service user, whose needs could no longer be met adequately at the home, has been supported to resettle in a home geared to more adequately meet his needs; the home is still providing support to his new care team as he resettles. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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 Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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) 1-5 Prospective Service Users are supported to make (in as far as is possible) an informed choice about where to live. The home will not admit Service Users for who they do not have the capacity to meet needs. All needs are fully assessed by a competent person in conjunction with the Service User and all significant others. EVIDENCE: A Service User Guide is provided to the advocates of this group of service users who have profound learning disabilities. The Service User guide needed updating to show the correct details of the inspecting body as the Commission for Social Care Inspection, Mercury House (the remainder of the address was correct). Prospective Service users make frequent visits to the home (including overnight/weekend stays) as part of the assessment and transition process. The care plans and progress notes for two Service User were seen. A copy of the updated Service User Guide and Statement of purpose must be forwarded to the Commission for Social Care and Inspection. We saw full and comprehensive assessments in place on individual files and these included needs and wishes and were kept reviewed regularly. Individual activity Risk Assessments did not show review dates, some had been updated sixteen months previous and were in need of review; there had been Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 9 whole life reviews in this period but the risk assessment documents need to show that they are current. Contracts are with the Local Authority purchasing the service and Service Users have a copy of the Agreement on their individual files. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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, 8 and 9 Care plans contain a full and comprehensive assessment of Service Users personal needs, goals and aspirations and these are kept reviewed. Service Users are supported with an individual approach to make decisions. The needs of the service users influences how the home is run. Risk management is conducted within a risk management framework to promote independence. Information about Service Users is securely stored and confidentiality is protected. EVIDENCE: Two care plans were seen and these contained clear information and guidance in order to meet needs, goals and known wishes. Individual Risk Assessments did not show a current date and a requirement was made to show these had been reviewed. We observed the service users being gently and sensitively being supported to leave their transport on return from the day centre. Two of the service users were ready for a holiday the day after this inspection and two had been two weeks previous and two were taking their holiday in September; the venue Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 11 chosen had been tried before and the service users had seemingly enjoyed themselves and in this way the staff were able to ascertain that it would be their choice and that they would be able to take part in challenging activities of their choice whilst maintaining a reasonable level of safety. One service user is quite new and still settling in, she does not like leaving her new home and suffers anxiety if away too long; short trips have been planned for her to enjoy this year to support her in her anxieties and help her to develop certainty about returning to her home. Confidentiality is maintained and records securely stored; data protection policies are in place and staff are introduced to these as part of their induction. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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 - 17 Age, peer and culturally appropriate opportunities are provided for personal development and leisure, both at home and in the local community. Personal relationships are supported and rights and responsibilities respected and recognised. A healthy diet is provided and enjoyed. EVIDENCE: Most of the service users attend a day centre and all have a care plan that provides evidence that opportunities are provided for personal development. One of the service users is supported at home and takes part in various activities with staff throughout the day; the deputy explained how much happier he is with this arrangement and additional funding to provide one to one support for day time activities is being looked in to. The care plans, progress notes and diary provided evidence of various activities enjoyed in the local community and further a field in holidays and trips taken (as aforementioned in the previous section). There was also evidence in the documentation of the support given to enjoy personal relationships. A compliments letter had been received by the home, and was Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 13 seen, from a family for gifts received on Fathers Day; (The service user had been supported in this activity). Policies, procedures and staff training were seen to be in place to support the protection of rights and responsibilities of service users in their daily lives. The dietician gives regular input to the home and the menus seen reflected healthy eating choices. The evening meal was being served and service users were keen to settle to enjoy their meal. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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 Personal support is provided according to preference of the individual. Emotional and physical needs are met. Medication is managed appropriately. EVIDENCE: Care plans and progress notes provided evidence that personal support is provided according to individual preference and further evidence was also gained from discussions with staff. The Service Users enjoy taking part in age, peer and culturally appropriate activities with the support of the care staff team and also with family member and friends; evidence of this was seen in progress notes. Service Users are well known in the local area and use local resources with details in the care plans ssen. Policies and procedures are in place to protect Service User rights and for the recognition of their responsibilities; we observed this in practice during staff and Service User interaction. The dietician provides regular input at the home and the menus showed a variety of wholesome meals. Alternatives are provided and any alternative meal consumed is recorded. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 Service Users views are listened to and acted on. Service Users are protected from abuse, neglect and self-harm. EVIDENCE: We observed service users being supported to air their views/express themselves and the staff responded appropriately to provide a positive outcome. Behaviour Management Plans are in place to support the Service Users to express themselves in positive ways whilst respecting others. Staff had attended non violent crisis intervention courses and abuse awareness training. Policies and procedures were in place at the home and these support vulnerable adult protection strategies. Evidence was seen of robust recruitment practices being conducted to provide protection to service users. Staff files contained CRB (Criminal Records Bureau Checks) POVA (Protection of Vulnerable Adult Check, where recruited since July 2004) and employment references. Finances are well managed and a sample of these were checked by us and found to be transparent and accurate. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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 standard(s) 24, 27, 28 and 30 The Service Users benefit from living in a clean and comfortable home. The home is well maintained and a safe environment is managed. EVIDENCE: During a tour of the home, we observed it to be clean, homely and inviting. The Service Users own rooms are personalised and reflect the personalities and interests of the Individual Service users. Adequate bathing facilities and toilets are provided were hygiene and personal needs can be met in privacy and safety. The home provides adequate shared space and large well-maintained gardens. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 36 The home is adequately staffed and provides training, policies and procedures to ensure Service Users are cared for by a competent team in a safe manner and that their health, welfare and safety are well managed. EVIDENCE: Staff spoken with stated that all new employees receive a staff handbook that contains their job description and a flow chart that shows the roles and responsibilities of others in the organisation. Formal supervision is provided and this also aids clarity of own role and roles of others as well as tracking performance and Service User progress. There is a training programme in place for all new care staff and the Learning Disability Award Framework is used for this; this is completed during the probationary period and staff are encouraged to follow on with National Vocational Qualifications. Staff training plans were seen to contain all mandatory and additional training needs. An audit had been carried out recently by the organisations training manager to ascertain an up to date training profile for all staff. Some of the training evidence seen included the provision of food hygiene courses, non-violent crisis intervention, first aid, updates in management training, protection of vulnerable adult training, disciplinary and grievance, fire safety and manual handling training, Health and Safety, Risk Assessment, Epilepsy, Person Centred Planning and autism Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 18 courses. A record was seen of who had attended the courses provided and when. Evidence was also seen that the home is on track to achieve employing at least 50 of care staff with National Vocational Qualifications. Staff files contained their application form with any gaps explored, at least two professional references, a medical declaration, and appropriate forms of ID and CRB/POVA checks. Staff stated that they were very happy working in the home and that their manager is very supportive and has built a strong united team. Staff appeared happy and joviality together with professionalism was observed both in the interactions of staff with staff and staff with Service Users. The rotas we observed showed that the home is consistently adequately covered and that rotas were planed ahead. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 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 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) 39, 40, 41 and 42. Throughout this inspection we were satisfied that the home is well run and that safeguards are in place for the protection of and well being of Service Users and Staff. EVIDENCE: We noted that records pertaining to the Service Users, health, personal and social care needs were well maintained. Health and Safety records were up to date including: emergency lighting and call point testing in case of fire and other safety checks which included COSHH (which is extremely well maintained by one of the care staff). A fire safety equipment had been checked and serviced by a contractor and the records for this was seen by us. Records were seen of staff training, which is provided through accredited and recognised resources. Records were seen to provide evidence that formal Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 20 supervision and staff appraisal is in place and staff confirmed that this is a positive time of sharing and support. The organisation carries out a monthly audit of the service, progress of Service Users, and of the records in place, Policies and procedures were seen to be in place and Risk Assessments have been carried out in respect of all known risks both regarding the environment and the health, safety and welfare of both Service Users and Staff regarding work and daily living activities; however, the inspector discussed with the deputy that although there was evidence of regular review of care plans, the risk assessment documents must be dated to avoid any confusion. The communication book was well-utilised and contained positive communication between the team members. We looked at a sample of Service User financial records and observed these to be transparent and accurate. Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 21 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 1 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 1 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Birchwood Bungalow Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 3 3 3 x I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 22 NO 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 YA1 Regulation 5 Requirement The statement of purpose and service user guide must be updated and a copy sent to the Commission for Social Care Inspection. Current risk assessment (safeguards) must be in place. (Prioritise these so that those risks posing the greatest concern receive attention as soon as possible and that all Risk Assessments are reviewed by 30.09.05). Timescale for action 30.09.05 2. YA7 15 30.09.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Birchwood Bungalow I52 s19294 Birchwood Bungalow v230279 04.08.05 Stage 4.doc Version 1.30 Page 24 - 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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