Inspection on 21/09/06 for Birchy Hill Nursing & Residential Home

This inspection was carried out on 21st September 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 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

Birchy Hill Nursing &... 08/01/10

Birchy Hill Nursing &... 16/11/09

Birchy Hill Nursing &... 18/09/09

Birchy Hill Nursing &... 23/10/07

Birchy Hill Nursing &... 12/01/06

Birchy Hill Nursing &... 07/04/05

Birchy Hill Nursing &... 13/10/04

Birchy Hill Nursing &... 08/06/04

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

CARE HOMES FOR OLDER PEOPLE Birchy Hill Nursing & Residential Home Birchy Hill Sway Lymington Hampshire SO41 6BJ Lead Inspector Tracey Box Unannounced Inspection 20th September 2006 09:30 X10015.doc Version 1.40 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 Birchy Hill Nursing & Residential Home DS0000011414.V306355.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 Older People. 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. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birchy Hill Nursing & Residential Home Address Birchy Hill Sway Lymington Hampshire SO41 6BJ 01590 682233 01590 682217 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) Angel Care Plc Shirley Gibbs Care Home 50 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (50), Mental disorder, excluding learning of places disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (50) Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be over 60 years of age Date of last inspection 12th January 2006 Brief Description of the Service: The home provides nursing and residential care for up to 50 older people. They are people who have dementia or who have mental health issues. The registration enables the home to admit older people over 65 (but some service users admitted may also be aged between the ages of 60 and 64). The premises have 11 shared and 28 single bedrooms (with bedroom accommodation on the ground and 1st floors, served by a passenger lift)). There are 3 residential sections: Poplars Unit (13 beds): [4 double (1 with en-suite facility) & 5 single)], Pines Unit (16 beds):) [4 double (1 with en-suite facility) & 8 single] and Cedars Unit (21 beds): [3 double (all with en-suite facility) & 15 single (3 with en-suite facility). The premises have good car parking facilities. There is a garden at the rear. The village of Sway (in the New Forest) has a train station (but no bus service) and has shops, chemist, post office, GP surgery, church, hotels and pubs. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The people living at Birchy Hill prefer to be referred to as residents, therefore the rest of this report will reflect this The opportunity was taken to look around the home, view records, procedures and talk with residents and staff. The inspector also had the opportunity to observe the interaction between residents and staff. Three residents were spoken with who stated that they were happy at the home. The staff on duty during this visit felt they were supported to do their job. Two relatives said they were very happy with the care and support their relative receives, they are made to feel welcome at the home whenever they visit. The manager confirmed the fees for the home range between £550.00 £675.00 per week. What the service does well: What has improved since the last inspection? What they could do better: The manager is continuing to improve the service by taking into account resident’s their families and staff’s views. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 6 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. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home have a comprehensive pre admission assessment form which enables each resident to be fully assessed to ensure the service users needs can be fully met by the home. The home does not provide intermediate care. EVIDENCE: The pre admission form has been greatly improved, the manager completes the assessments, which she says are easy to follow and more comprehensive. The inspector looked at the most recent pre admission assessment records, which included a social workers assessment, the manager visited the prospective resident to complete the home’s pre admission assessment, the resident’s family and the staff from the care home the resident lived were involved providing information also. The pre admission assessment includes a moving and handling assessment. The manager confirmed she is appropriately qualified to complete these assessments. The manager confirmed the home do not provide intermediate care. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 9 Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect the individual’s health, personal & social needs which ensure resident’s personal needs are met. Residents are protected from the homes medication policies & procedures. Residents feel they are treated with dignity and respect & that they are given information to enable choice. EVIDENCE: Members of staff had a good knowledge of resident’s healthcare needs. Staff said the care plans provide them with the information they need to support the individual in their own home. One resident confirmed they are fully aware of, and are included in the reviewing of their care plans and risk assessments, the inspector looked at three care plans and risk assessments and records showed that they had been reviewed within the last three months. Residents have access to GP’s, optician, dentist and private chiropodist. At night a nurse is on duty and a nurse administers medication which was stored securely and MAR (medication administration record) sheets seen were up to date (and had photographs of residents attached). Trained nurses check the Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 11 medication when it arrives to the home from the pharmacist, records of this was seen on the MAR sheet. Records of the disposal of medication were seen. Controlled drugs were securely stored, the nurse said two staff administer and countersign controlled drugs. Staff said they receive regular monitoring by the manager, as well as training in administration of medication. Staff induction records showed that privacy and dignity and the provision of personal care are covered during the induction process, and the response from residents indicated that the carers treat them with dignity and respect and that they are trustworthy. One resident told the inspector that staff respected their choice and privacy at all times. The inspector witnessed staff talking to residents in a respectful manner. Staff said they are aware of the importance of dignity and respect, one staff said “ I treat people as I wish to be treated”. The manager confirmed that policies and procedures are reviewed and available for staff to access regarding residents health and personal care, and that residents access healthcare professionals when required. Records of doctor, chiropodist and physiotherapist visits were part of individual’s care plans. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents social, cultural and religious needs are met and they are able to participate in a programme of suitable activities, receive visitors as they wish and are offered a choice of nourishing well-presented meals served in a relaxed atmosphere. EVIDENCE: Residents spoken with said that they were able to exercise choice over their daily living activities and participate in a variety of things, which are arranged by an activities coordinator who works at the home, the inspector spoke with her and she said that she has worked with the residents for some time, and is aware of the activities they enjoy, from board games to driving to the sea side for an ice cream. On the day of the inspection the majority of residents watched a show, provided by a volunteer drama group who visit the home approximately once a month. Residents were heard singing and clapping along with the show, one resident said they really enjoyed it. Records of individual residents attending activities are recorded in their files, this is one way the activities coordinator can see if residents are enjoying them or not. Photographs were displayed on the walls of recent visits to a safari park, and a summer fare which families and friends attended and residents birthdays. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 13 The manager said she has recently attended some Dementia training, since then she has introduced red, orange and yellow coloured mugs for residents to drink out of, as research shows people with Dementia type needs can identify this colour clearly and recognise it as a colour associated with drinking and eating. The manager is researching purchasing plates in these colours. All toilet and bathrooms are clearly identified, posters with pictures are placed half way up the door, the manager and staff confirmed this is the best place for a sign for people with Dementia to see. All pictures, photographs and posters were displayed half way up walls to meet the resident’s needs. The manager confirmed that policies and procedures are in place to ensure residents are supported to lead active lives as they prefer, care plans reflected this. The registered manager said that there were no residents from an ethnic minority at present but that if a resident had cultural or religious interests every effort would be made to accommodate them. The home have a Church of England once a month for residents to attend if they wish. The home has an open visiting policy. This was evidenced by records of visitors to the home and confirmed by relatives and one relative, who confirmed they visit at different times of the day and are always welcomed. The inspectors observed residents eating lunch in the dining room, the atmosphere was relaxed, residents were offered choices of main meal and desserts. Cold drinks, tea and coffee with biscuits were available throughout the day and staff are able to access the kitchen at night to provide hot drinks and snacks for residents who wish them. The cook said that fresh vegetables are ordered once a week, and were due to be delivered the day after the inspection. The fridges and freezers were well stocked with produce, all foods were covered and dated. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure, which residents feel able to use and an adult protection procedure to safeguard residents from abuse. EVIDENCE: Residents spoken with were aware of whom to complain to, should they have a need to, although at present they were happy with the care they receive. Records of complaints received were logged appropriately. One staff said ‘I am aware that reporting any concerns or complaints is important to improve things, I know that I should speak with the manager, or the owner if it is about the manager. I have received training in Adult Protection issues.’ The home have included the corporate Hampshire County Council and adult protection procedure, which includes a whistle blowing policy. The manager confirmed that policies and procedures are reviewed and available for staff to access regarding complaints and protection, and that staff receive training in Adult protection, training records were available to support this. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment provides residents with a warm and comfortable home. There is a good infection control procedure at the home to safeguard the welfare of residents. EVIDENCE: The home was warm and welcoming, all parts of the home seen ware well maintained and tastefully decorated. There was ample communal space, the home has three lounges and three dining rooms. Residents live in comfortable bedrooms. It was evident that residents are encouraged to bring in items of personal belongings. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 16 One resident commented about the “lovely” garden and the views from their rooms and communal areas. Seating was available and the garden was accessible to residents. The home has an internal laundry that was well maintained. Infection control procedures were in place. Staff were observed to follow these guidance, equipment such as gloves and aprons were available. The inspector saw certificates showing staff had received infection control training. The home employ one housekeeper who line manages four domestic staff, cleaning is provided over weekends as well as during the week. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are appropriately trained, there is sufficient skill mix within the team to meet the residents needs. The recruitment procedure for the home ensures the vulnerable people living in the home are protected. EVIDENCE: The home has sufficient staff numbers and skill mix to meet the residents needs. The home has a duty rota which reflects this. Staff confirmed there are enough staff on duty to meet individual’s and group needs. It was evident from practices and interactions observed that staff had developed good relationship between themselves and residents. Comments from residents included that staff were very kind and always helpful and that they were a “good team”. One resident praised the domestic staff for their hard work in keeping their bedrooms clean and tidy. The inspector examined copies of three staff recruitment records. These were all found to be in order. There was evidence that written references had been obtained, application forms had been completed and evidence of personal identification was available. Appropriate checks had been undertaken with the Criminal Records Bureau and the Protection of Vulnerable Adults register. New employment contacts had been supplied by the company to all staff. Staff confirmed they are working towards their induction and foundation standards in line with skills for care guidelines. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 18 The manager explained at present she is encouraging the majority of its workforce to work towards their level 2 or 3 NVQ (National Vocational Qualification). The manager is highlighting this with individual staff within their supervision. The inspector sampled records of the fire drill log, which shows un announced fire drills occur regularly, all records of fire alarm and equipment were satisfactory. The manager explained staff have received adequate training, and three staff said they had received appropriate training to enable them to carry out their role correctly, certificates were available to show that staff have attended mandatory training in health & safety, moving & handling, first aid, fire safety and infection control. Evidence of the cook receiving recent food hygiene was available. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is managed well and run with their best interests in mind. The home’s procedure for dealing with residents’ finances ensures thier interests are safeguard. The procedures and practices for the health and safety of residents and staff are good. EVIDENCE: The manager has been registered with the CSCI since January 2006. The manager is a registered nurse and has taken an advanced diploma in clinical nursing (mental health). The manager enjoys keeping up to date of current information by reading publications such as the nursing times and community care. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 20 The home has an internal audit system in place that seeks the views of residents, relatives and other healthcare professionals on a regular basis. Records of feedback from residents seen demonstrate that there is a high degree of satisfaction regarding the care provided. Comments such as ‘Staff are very polite, always helpful and always listen to me’ were included in the feedback. One negative comment was received from a relative, the manager promptly addressed the issue by telephoning the relative and followed it up with a letter which clearly stated what action the manager had taken to rectify the situation. The provider undertakes monthly reviews of the environment, residents and staff views are sought and reports of these are available to the Commission, either when an inspector visits or they would be sent to the Commission if requested. The reporting of incidents under Regulation 37 is made to the Commission. The manager confirmed the home do not deal with any financial affairs of the residents. Staff said they feel supported by the manager and said they receive regular structured, formal supervision, records of these were seen. The home has a policy, procedures and information on health and safety. A sample of policies and procedures was seen and it showed that these are reviewed regularly. All COSHH materials are maintained safely. There is an ongoing system in place that ensures that all appliances are serviced. The employer’s insurance liability certificate was displayed and current. Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Birchy Hill Nursing & Residential Home DS0000011414.V306355.R01.S.doc Version 5.2 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!