Inspection on 22/03/10 for Birdsgrove Nursing Home

This inspection was carried out on 22nd March 2010.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Birdsgrove Nursing Home 07/12/09

Birdsgrove Nursing Home 21/01/09

Birdsgrove Nursing Home 30/01/07

Birdsgrove Nursing Home 07/02/06

Birdsgrove Nursing Home 29/09/05

Birdsgrove Nursing Home 13/12/04

Birdsgrove Nursing Home 04/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Random inspection report Care homes for older people Name: Address: Birdsgrove Nursing Home Warfield Road Bracknell Berkshire RG12 2JA zero star poor service 07/12/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Denise Debieux Date: 2 2 0 3 2 0 1 0 Information about the care home Name of care home: Address: Birdsgrove Nursing Home Warfield Road Bracknell Berkshire RG12 2JA 01344422261 01344423629 birdsgrove@asterhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Counties Care Limited (Aster Healthcare) care home 87 Number of places (if applicable): Under 65 Over 65 0 87 dementia old age, not falling within any other category Conditions of registration: 87 0 The maximum number of service users to be accommodated is 87 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Birdsgrove Nursing Home is registered to provide personal and nursing care for up to eighty seven older people, twenty of whom may have a primary diagnosis of dementia. The home is situated on the borders of Bracknell in a residential area on the main thoroughfare to the village of Warfield. The home is divided into three wings Care Homes for Older People Page 2 of 15 0 7 1 2 2 0 0 9 Brief description of the care home determined by the development of the establishment over time. The Surrey Wing (23 places) was originally a large domestic home which has been converted, the Berkshire Wing (35 places) a purpose built two storey extension, and the Kent Wing (20 places), a single storey extension built in the 1990s for residents with dementia. Fees range from £568 to £725 per week. This information was provided on 7 December 2009. Care Homes for Older People Page 3 of 15 What we found: The purpose of this random inspection visit was to assess the homes compliance with a statutory requirement notice served on the provider following the last key inspection on 7 December 2009. The requirements of that notice were that the provider: 1. Have a system in place to ensure that service users or their representatives are consulted about their preferences in relation to social activities. 2. Ensure that service users choices and preferences are clearly recorded in their care plans. 3. Make ongoing arrangements to ensure that each service user is able to engage in activities of their choice, and in accordance with their assessed abilities. In order to assess compliance we visited the communal areas of each wing and looked at the social care records for six of the current fifty residents. We spoke with two residents participating in an activity and additional information was provided by the manager, the homes two activity organisers plus two other on duty care staff members. Service users at this home prefer to be referred to as residents. For clarity and consistency this term will be used throughout the remainder of this report. COMPLIANCE FINDINGS We looked at the three elements of the notice: 1. Having a system in place to ensure that service users or their representatives are consulted about their preferences in relation to social activities. In their improvement plan dated 12 March 2010 the manager advised us that: When new service users are being assessed prior to admission the RN completing the assessment will ensure that the section detailing social contacts is completed in full. Biographies have been completed by some residents and the remaining ones have been sent to relatives and advocates to ascertain individual preferences. We have received the majority of these back into the Home. Based on the individual assessment of need, an Activity Care Plan has been devised for each resident, taking into account their cognitive, sensory and physical impairment and dementia. These have also taken into account their likes, dislikes and preferences and abilities. The manager explained that many of the biographies had been returned but that there were still some that they were waiting for the relatives to return. The home is keeping a list and making telephone follow up calls every 10-14 days where the biographies havent been returned. The biography form has been newly introduced at the home and the first page gathers information about the persons past interests, family, occupation(s), pets etc. The second page lists the organised activities already provided at the home and asks Care Homes for Older People Page 4 of 15 the person which they would be interested in. There is a further question asking if there is any additional information that the person wants to give. As stated above, this form is new to the home and is still being developed to fully meet their needs and to ensure that the staff are able to identify, with each resident, suitable social activities that are based on that persons individual preferences and assessed abilities. In five of the six files sampled we saw completed biography forms with detailed information about the activities and pastimes the resident would enjoy. One of the files sampled was for a resident who had moved to the home very recently. It was seen that the biography form had been completed with this resident the day after her arrival at the home. For the sixth resident there was no biography form completed and the manager ascertained that this was one of the forms that had not been returned by their relative. However, it was felt that this resident would be able to complete most of this form himself, with staff assistance where needed, and the manager agreed that she will arrange to have this done in the next few days. In their improvement plan the manager described how they will make sure that what they are doing will be effective: A new care plan audit tool has been designed and agreed. It is now in use with all senior care staff. When the pre-admission assessment is being discussed with the senior team prior to an admission decision social contact details on the preadmission assessment will be checked in full. The manager explained that they will be auditing 10 of all care plans each month and that the responsible individual for the provider had recently audited all care plans as a starting point. 2. Ensure that service users choices and preferences are clearly recorded in their care plans. In their improvement plan dated 12 March 2010 the manager advised us that: All care plans have been revisited and are current detailing social care needs which are being obtained through the Biography as well as personal and health needs. In five of the six files sampled, the information from the individual biographies had been used to draw up an individual activity/social care plan for each person and it was seen that the plans were starting to incorporate the residents identified choices, preferences and interests, although there was an interest noted on one persons preadmission form, completed prior to admission, that had not been picked up when someone else had completed their biography and social care plan after they had moved into the home. The social care plan for the sixth resident was less developed as this persons biography has yet to be completed. It was seen that this work is very new and was obviously a work in progress as the manager and staff team explore ways to fully integrate social care needs planning into the existing personal and health care planning system. Staff are also working with all current residents to develop their social care plans fully and looking for ways to provide, in a care home setting, activities that relate to each residents past and present interests. In their improvement plan the manager described how they will make sure that what they are doing will be effective: Activity Care Plan being reviewed monthly. The manager Care Homes for Older People Page 5 of 15 also explained that the activity organisers write up the social/activity care plans from the information in the biographies and from discussions with the residents. The care plans are then discussed with the registered nurses and the completed social care plans are checked by the deputy manager. 3. Make ongoing arrangements to ensure that each service user is able to engage in activities of their choice, and in accordance with their assessed abilities. In their improvement plan dated 12 March 2010 the manager advised us that: Small and larger group activities are being implemented as well as one to one activities for residents who are not able to come to the day room. New reminiscence materials have been purchased with the individual preferences and abilities taken into consideration. We have made the reminiscence materials accessible to all and some of our relatives take some of these materials and hold mini sessions with their own mothers and other ladies in the lounges. Further reminiscence materials will be obtained if biographies or pre admission assessment show a new hobby or interest that we need to cater for. The manager explained how recently, following information obtained on biographies and drawing up care plans with residents, they have identified additional activity material that is currently being sourced. E.g. staff have found out that one resident used to enjoy tapestry work and that others would benefit from aromatherapy activities using essential oils. In their improvement plan the manager described how they will make sure that what they are doing will be effective: To reduce the risk of social isolation registered nurses are co-ordinating social activities both in group and one to one and all care and activities staff are taking part in activities. These activities are being recorded within the daily activities sheet. We are making sure that what we are doing is effective by asking for feedback from the residents, their relatives, advocates and the staff. We looked at the activity record sheets, for the month of March, for the six residents whose activity records we sampled. The individual activity recording sheets for five of the six residents evidenced that these residents were being offered opportunities to take part in social activities that they were interested in, in both group and individual one to one sessions. For the sixth resident his activity recording sheet only had five entries for March and as the home still need to complete the biography with this resident and identify his interests and preferences, it was not possible to assess whether this residents social care needs are being met. The manager explained how some residents do not want to engage in the group activities in the home and that some choose to stay in their rooms all day. Finding ways for the staff to assess and evidence that the social care needs for these residents are being met, outside of group activities, and that these residents feel they are able to engage in daily activities that are meaningful to them, needs some further development and implementation. The home plans to arrange and offer community outings for residents at the home this summer, especially for those that do not usually have the opportunity to leave the home. The manager advised that the provider has allocated funds for this and is fully supportive. STAFFING The home employs two activity organisers, both have worked at the home for Care Homes for Older People Page 6 of 15 a number of years, originally as care staff. One has been working as an activity coordinator for the last year and the other transferred over from the care staff six weeks ago. Both work 9am to 3pm Monday to Friday with one taking main responsibility for the activity provision on the Berkshire wing and the other covering the Surrey and Kent wings. At present care staffing levels for the mornings are worked out on a one staff member to five residents basis, with the activity organisers being additional to this figure from Monday to Friday. The manager explained how additional staff are brought in for specific projects, which could be if an event is planned at the home or if a specific, large piece of work needs to be done e.g. the recent work in auditing and reviewing all care plans. The manager felt that this level is sufficient to meet the personal, health and social care needs of all residents at the home at this time. This was also confirmed by the activity organisers when we spoke with them. When asked what improvements they felt there had been since the key inspection in December, the activity organisers were both very positive. Their comments included: increased staff morale; increased access to resources; improved joint working; care staff are involved in activity planning and delivery; able to offer a more varied programme and have more time to spend on one to one activity time with individual residents. One of the activity organisers explained how the care staff are reading the biographies and care plans and using the information to chat with residents. Both activity organisers felt that working closely with the registered nurses in activity planning is successful, has led to more variety in the activities being offered, reduced duplication and led to care staff spending more one to one time with residents that does not involve meeting personal or health care needs. Both felt that the whole staff team is working together and that they are being fully supported by the management and that all staff are on board. STAFF TRAINING Training from an external specialist in providing activities for people with dementia has been arranged at the home for mid May, with places available for twenty staff. Of the two activity organisers, one has been on an activity provision distance learning course for the past year and feels it is really useful. The other will be attending the training arranged for May and then plans to look at additional training when she has been in her new post for a little longer. ENVIRONMENT During this visit it was seen that the staff have also been making changes to the environment, in line with current good practice guidance. The furniture in the communal lounges has been re-arranged to provide smaller seating groups providing a more homely atmosphere and the manager reported that more residents are choosing to spend more time in these areas. The pictures and wall decorations in the hallways are being replaced with pictures and objects that will have more relevance to the residents, for example: posters and pictures of the local area and famous British landmarks; examples of older, well know brand name advertising objects; and in one wing there is a collage of members of the royal family over the past sixty to seventy years. The manager explained how care staff are also getting involved and bringing in items that they have found that could be used. What the care home does well: Care Homes for Older People Page 7 of 15 The manager and staff spoken with were enthusiastic about the improvements made so far and voiced a firm commitment to fully meeting the social care needs of all current and future residents at the home. New systems are in place to enable the manager to monitor and ensure that the improvements already made will be sustained and built upon. The two activity organisers feel fully supported by the management, the registered nurses and the care assistants and feel that all staff at the home are now working together as a team towards developing and providing for the social care needs of all residents. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 8 of 15 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 The registered persons must 31/03/2009 ensure that all service users have an up to date plan of care setting out actions that staff need to take to meet the needs of the service users. The plans must include social care needs as well as personal and health care needs. Daily notes need to evidence that staff are following the actions set out in the plan to meet the service users needs and reduce any potential risks to their health or wellbeing. The home also needs to evidence that service users or their representatives have been involved in and agreed to their plan of care. This requirement also applies to National Minimum Standard 8. In order that service users can be confident that they or their representative will be fully involved in the planning of their care, that all aspects of their personal, health and social care needs are met and that the care provided is consistent and takes into account their personal wishes and preferences. Care Homes for Older People Page 9 of 15 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 2 12 16 The registered person must 21/06/2009 provide facilities for recreation and make arrangements to enable each service user to engage in meaningful social activities that are based on their individual preferences and abilities, particular attention should be paid to those with dementia, cognitive impairment, sensory impairments and physical disabilities. In order that service users can be confident that the home can meet their social care needs and takes steps to reduce the risk of social isolation. 3 18 13 The registered person must 07/01/2010 make arrangements to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person must ensure that actions taken, when any incident is identified that could potentially be a safeguarding concern, are fully recorded. The registered person must also ensure that staff are able to recognise potential safeguarding concerns and fully understand when, and how, safeguarding referrals should be made to the Bracknell Forest Borough Council safeguarding team and Page 10 of 15 Care Homes for Older People Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action ensure that any concerns are referred without delay. In order that residents can be confident that the home safeguards them from abuse and neglect and takes prompt and appropriate action to follow up any concerns. 4 27 18 The registered person must 21/02/2009 ensure that staff are available in sufficient numbers, and at all times, to meet the personal, health and social care needs of all service users. The registered person must ascertain and take into account the number of staff needed to provide the level of supervision indicated by the difficulties presented by the layout of the building and the numbers of service users who are unable to use the call bell system if they need assistance. In order that service users can be confident that their personal, health and social care needs will be met and that the home is staffed so as to protect and promote their health, safety and independence. 5 29 19 Where the registered person 07/01/2010 permits a new worker to start work pending receipt of an enhanced criminal record bureau certificate, the Page 11 of 15 Care Homes for Older People Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action registered person must: appoint a member of staff the staff member who is appropriately qualified and experienced to supervise the new worker; so far as is possible ensure that the staff member is on duty at the same time as the new worker; and ensure that the new worker does not escort residents away from the care home premises unless accompanied by the staff member. In order to protect the residents from the potential risk of harm and/or abuse. 6 29 19 The registered person must 21/02/2009 ensure that all staff involved in recruitment are fully aware of, and adhere to, the requirements of the Care Homes Regulations 2001 as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004 and ensure that no person is employed to work at the home without all the required checks and documents having first been obtained. In order to protect the service users from the potential risk of harm or abuse. Care Homes for Older People Page 12 of 15 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 7 33 10 The registered person must ensure that there are methods in place for the manager to monitor that staff are aware of and complying with the policies and procedures of the home and any legislation that applies to the running of a care home. In order that service users can be confident that the home is run and managed in their best interests and in a way that protects and promotes their health, safety and independence. 21/03/2009 8 33 24 The registered person must 21/02/2009 put in place a quality assurance system to monitor and ensure that staff are following the requirements for care planning, meeting assessed needs and reducing potential risks, as set out in the Care Homes Regulations 2001 and their own policies and procedures. In order that service users can be confident that the home is run and managed in their best interests. Care Homes for Older People Page 13 of 15 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 14 of 15 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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