Inspection on 31/05/05 for Birdhurst Gardens

This inspection was carried out on 31st May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Birdhurst Gardens 22/05/07

Birdhurst Gardens 09/05/06

Birdhurst Gardens 21/11/05

Birdhurst Gardens 26/07/04

Birdhurst Gardens 26/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Birdhurst Gardens 15 Birdhurst Gardens South Croydon Surrey CR2 7DT Lead Inspector James OHara Announced 31 May 2005 09:30 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. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Birdhurst Gardens Address 15 Birdhurst Gardens, South Croydon, Surrey, CR2 7DT 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) 020 8680 6876 020 8681 1649 Surrey Oaklands NHS Trust Mrs Ruwami Trabelsi Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26/07/05 Brief Description of the Service: Birdhurst Gardens is registered to provide care for up to nine adults with learning disabilities. There are currently seven service users living at the home. The home also provides respite care to four service users.Birdhurst Gardens is situated in a quite residential street of similar properties in south Croydon. The home is a large detached property built over three floors. Each of the service users has a single bedroom; there is also a communal lounge/dining room as well as, bathrooms, an office and kitchen. To the rear of the premises is a pleasant garden, which is well used in the summer months. The home has an outside laundry facility and parking to the front. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This home was inspected under the National Minimum Standards Care Homes for Younger Adults. The inspection took place over one day. Methods of inspection included a tour of the premises observation of contact between staff and service users, interviews with a service user, a member of staff and discussion with a service user relative and the registered manager. A large number of comment cards were returned to the Commission for Social Care Inspection as feedback from service users and relatives. Records examined included service user plans, risk assessments, complaints, staffing records, training records, Criminal Records Bureau Checks and menus. Requirements and recommendations from the previous inspection were also discussed with the registered manager. What the service does well: What has improved since the last inspection? What they could do better: Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 6 As a result of this inspection there are eleven requirements and two recommendations. Service users plans are generally good and are reviewed on a six monthly basis however these should improve further when Person Centred Plans are introduced. In general staff at the home are very well trained in the medical needs of the service users however staff should be trained in epilepsy. There have been some improvements to the environment of the home and in general the home is in good decorative order however the toilets and bathrooms require attention. There is also a need for new living room and dining room furniture. The homes staffing records and information still require attention. The inspector would like to thank the service users, the staff and management of the home and all of those who provided feedback for their support in the inspection process. 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. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.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 Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.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, 2 and 3. Information available to prospective service users is of s good standard which would allow prospective service users to make am informed decision about moving to the home. EVIDENCE: The homes Statement of Purpose now contains details of the experience and qualifications of staff as recommended at the last inspection. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, and 9. Service users plans are generally good and are reviewed on a six monthly basis however these do not include the level of personal care a service user needs and the service users preferred routines. This could result in service users not receiving the appropriate level of personal care in the way that they prefer. Generally service users have had individual risk assessments and risk management strategies carried out thus enabling them to participate in activities in the home and in the community with appropriate support. EVIDENCE: Two service user files were examined. Service users have regular reviews at least twice a year. Service users have a plan called My Plan but when this was reviewed it was called a Life Plan Review. The level of personal care support a service user needs and the service users preferred routines was recorded in the My Plan but not in the Life Plan. This should become clearer when the home completes service users Person Centred Plans. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 10 The registered manager says that she plans to introduce Person Centred Plans to the home in the near future. The registered manager must ensure that the level of personal care support a service user needs and the service users preferred routines are recorded in the Person Centred Plans. This Person Centred Plans will be reviewed at the next inspection. Individual service user risk assessments are reviewed at the review meetings. One service user was admitted to hospital last month and on the day of the inspection the registered manager said that there was a discharge meeting to be held at the hospital to discuss if the home could still meet the needs of this service user. The registered manager must review all risk assessments and guidelines for staff to follow with the service users care manager in the event of the service user moving back into the home from the hospital. The registered manager said that she will monitor the situation when the service user moves back to the home and that there was provision for extra night wake in staff should the need arise. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17. Provision is made so that all service users attend appropriate social activities, day centres and therefore have a better opportunity to become part of the local community. Appropriate arrangements are made so that all service users have regular contact with their friends and families. EVIDENCE: Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 12 The service users have a varied programme of social activities with an emphasis on using community facilities. They attend day services at Geoffrey Harris House four days per week from Monday to Thursday. Each Friday the home organises a community activity such as bowling, swimming or a trip to the cinema. A record of all the service users activities is kept on their files. They also use the local pub and go into nearby Croydon to restaurants and cafes. Service users have freedom bus passes. The home has established good relationships with their neighbours and hold regular social events such as barbeques and parties. Neighbours are invited to these events. The home has a small car and a seven-seated people carrier. The registered manager said that the service users go for meals out in the evenings and day trips to the coast and amusement parks. Each service user has an annual holiday. This year the service users plan to go on holiday to Spain. A number of relatives comment cards returned to the Commission for Social Care Inspection, in general comments were positive, however two relatives indicated that they were not aware of the homes complaints procedure. It is recommended that the home send a copy of the complaints procedure to all of the service users relatives. The menus at Birdhurst Gardens are based on a four-week rota and are based on the likes and dislikes of the service users and are then checked by the trusts dietician for nutritional balance. The home has made a pictorial menu for the service users. Menus seem varied and also included some ethnic option meals. Service users are offered an alternative to the main meal on offer. The registered manager stated that the two respite service users who have diabetes eat what is on the menu, however staff are aware of their condition and substitute drinks, biscuits and jams with a diabetic option. There was evidence that staff had attended training on diabetes. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 13 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) 19, 20 and 21. With one exception the arrangements made for the health care needs of the service users are good and the home has the support of the local pharmacist for advice on medication. Thus ensuring that their overall health needs are being met. EVIDENCE: One service user was admitted to hospital last month and on the day of the inspection the registered manager said that there was a discharge meeting to be held at the hospital to discuss if the home could still meet the needs of this service user. The registered manager did not inform the Commission for Social Care Inspection that the service user had gone into hospital as required under regulation 37 of the National Minimum Standards. The registered manager must ensure that the Commission for Social Care Inspection is informed of any serious illness of a service user at a care home were nursing care is not provided. This service user had been to hospital twice last year and suffers from epilepsy. The registered manager explained that there are guidelines for staff to follow should this service user have an epileptic seizure. Staff must call an ambulance and the service user should be taken to accident and emergency. Although staff has had training on administering rectal diazepam there is no Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 14 indication that staff has had training on epilepsy. The registered manager must ensure that all staff has training on epilepsy. The registered manager said that a new Cabinet suitable for storing medication has been ordered for the home. The registered manager has obtained information regarding the service users wishes on illness and death. This information is now kept on the service user file as recommended at the last inspection Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.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. The home has an appropriate complaints procedure in place. The home has suitable vulnerable adult protection and abuse prevention measures in place to ensure the service users are so far as reasonably practicable protected from abuse, neglect and/or harm. EVIDENCE: The registered manager said that no complaint has been made since the last inspection visit. The homes complaints procedure has been amended to include details of the Commission for Social Care Inspection. A copy of the Croydon Councils Protection of Vulnerable Adult Policy was available in the home as well as the trust’s own procedure. All staff had training on Adult Protection 25/06/04. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.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 and 28. There have been improvements to the home since the last inspection and in general the home is in good decorative order. However in order for the service users and their representatives to feel confident that the home will continue to provide a homely, comfortable and safe environment the planned repair and refurbishment programme must be continued. EVIDENCE: The wooden gate at the front of the house has been painted as required at the last inspection. Carpets in bedroom seven and the respite room have been replaced as required at the last inspection. Sealant around the kitchen sink has been replaced as required at the last inspection. Administration records have been removed from the dining area as recommended at the last inspection. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 17 The living room has three settees and a number of chairs, however some of this furniture is badly worn. A report from a recent visit by the trusts fire officer stated that any furniture that is damaged or worn to the extent of foam infill showing through covers should be removed from the premises and repaired or replaced. The registered manager said that there are plans to buy new furniture for the living room. The registered manager must ensure that new settees are purchased for the living room. The dining area contained suitable domestic tables however the registered manager said that there are plans to purchase new chairs and at present some service users are using garden chairs to sit at the dining table. The registered manager must ensure that new dining room chairs are purchased for the service users. Files previously stored in the corner of the dining room have been removed and stored in the office or away from the service users shared space as recommended at the last inspection. In general the home is in good decorative order however the toilets and bathrooms require attention. The registered manager must ensure that the sealant around the homes baths is replaced and toilet seats in the home require tightening. The bath panel on the first floor bath is loose and cracked. The registered manager must ensure that the bath panel on the first floor bath is replaced. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 18 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, 32, 33, 34, 35 and 36. A competent and effective staff team who are committed and have worked together for a number of years provide consistent support to the service users. Some areas in respect of the recruitment records require attention in order that service users continue to be protected by the policies in the home. EVIDENCE: Staff at the home appear to be well trained and supervised. The home has a committed and well-established staff team that have worked together for a number of years, there has been very little staff turnover and this has been of great benefit for the service users, providing stability and consistency. Criminal Records Bureau Checks were seen for eight if the homes ten staff. The registered manager must write to the Commission for Social Care Inspection when she receives the other two members of staffs Criminal Records Bureau Checks and arrange a date for these to be inspected. The registered manager has yet to obtain all the staffing information as required at the last inspection. The registered manager must write to the Commission when this has been achieved and arrange a date for these to be inspected. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 19 Staff training records indicate that staff has recently had training on Fire Safety, Moving and Handling, Health and Safety, Medication, First aid, Adult Protection and Diabetes. Staff must have training on epilepsy. At present there are nine care staff working at the home, one staff has NVQ level 2 and 3, five staff have NVQ level 2 and two staff a re working towards achieving an NVQ level 2. Supervision records indicate that all staff receive regular formal supervision. To date none of the staff have completed an appraisal this year. The registered manager must ensure that all staff have an annual appraisal. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 20 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) 37 and 39. The registered manager has worked at the home since it opened in 1997 this has been of great benefit to the service users, providing stability and consistency. There are clear lines of accountability within the home and the management style is open and transparent. The home has developed a quality assurance system involving questionnaires for service users, their relatives and visitors. This should give confidence to the service users and their families that their views will be taken into account in the running and future development of the home. EVIDENCE: The inspector recommends that staff have to sign and date as evidence that they have read and understood all the homes new policies and procedures. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 21 The registered manager has been the manager of the home since its registration in 1997. She is a qualified first level nurse and has a D32/33 assessor award as well as a BTec in management and a Certificate in Leadership and Management. She has achieved her National Vocational Qualification level four in Management but still needs to complete two care components/units to be awarded the Registered Managers Award. The home has sent out relative’s questionnaires for feedback about the service provided by the home. These have been returned to the trust to be analysed the registered manager said that she is awaiting feedback from the trust. Service users also have questionnaires, these had been filled in by staff at the day service and information gained will be used with the relative’s feedback to improve services at the home. This quality assurance system will be reviewed at the next inspection. Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 2 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 3 x x 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 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Birdhurst Gardens Score x 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 23 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. 2. Standard 3. 9. Regulation 18(1) c (i). 13(4) c. Requirement The registered manager must ensure that all staff has training on epilepsy. The registered manager must review all risk assessments and guidelines for staff to follow with the service users care manager in the event of the service user moving back into the home from the hospital The registered manager must ensure that the Commission for Social Care Inspection is informed of any serious illness of a service user at a care home were nursing care is not provided. The registered manager should purchase a new Cabinet suitable for storing medication. The registered manager must ensure that new settees are purchased for the living room. The registered manager must ensure that new dining room chairs are purchased for the service users. The registered manager must ensure that the sealant around the homes baths is replaced and toilet seats in the home require Timescale for action 31/07/05 31/07/05 3. 20. 37(1) d. As stated. 4. 5. 6. 20. 24. 24. 13(2) 23(2) g. 23(2) g. 31/07/05 31/07/05 31/07/05 7. 27. 23(2) d. 31/09/05 Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 24 tightening. 8. 27. 23(2) b. The registered manager must ensure that the bath panel on the first floor bath is replaced. 31/08/05 9. 34. 19(1) b. The registered manager must As stated. write to the Commission for Social Care Inspection when she receives the other two members of staffs Criminal Records Bureau Checks and arrange a date for these to be inspected. The registered manager must write to the Commission for Social Care Inspection when she obtains staff the information as required in Regulation 19 (1) b and Schedule 2 National Minimum Standards and arrange a date for these to be inspected. The registered manager must ensure that all staff have an annual appraisal. The registered manager must ensure that the level of personal care support a service user needs and the service users preferred routines are recorded in the Person Centred Plans. As stated. 10. 34. 19(1) b. 11. 12. 35. 6. 18(1) c. 15(1) 31/09/05 31/07/05 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. 2. Refer to Standard 22. 40. Good Practice Recommendations It is recommended that the home send a copy of the complaints procedure to all of the service users relatives. The inspector recommends that staff have to sign and date as evidence that they have read and understood all the homes new policies and procedures Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor, Grosvenor House 125 High Street, Croydon CR0 9XP 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 Birdhurst Gardens G53-G53 S25755 BirdhurstGardens V195021 310505.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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