Inspection on 01/08/05 for Birkin Lodge Care Home

This inspection was carried out on 1st 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 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

Birkin Lodge Care Home 12/04/07

Birkin Lodge Care Home 12/06/06

Birkin Lodge Care Home 07/02/06

Birkin Lodge Care Home 21/11/04

Birkin Lodge Care Home 19/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Birkin Lodge Care Home Camden Park Hawkenbury Tunbridge Wells TN2 5AE Lead Inspector Lynnette Gajjar Unannounced 1 August 2005 08:40 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 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. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Birkin LodgeCare Home Address Camden Park Hawkenbury Tunbridge Wells TN2 5AE 01892 533747 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) Four Seasons Homes Mrs Aline Ongley CRH Care Home 50 Category(ies) of OP Old Age registration, with number of places Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Subject to 25 Beds being used for nursing care, 5 of which may be used for terminally ill. Registration is restricted to providing care for one service user diagnosed with dementia whose date of birth is 30 March 1923. Date of last inspection 21 November 2004 Brief Description of the Service: Birkin Lodge is a large detached premise set on the outskirts of Tunbridge Wells and is surrounded by gardens. Accommodation is on three floors with access to the upper stairs being enhanced by two shaft lifts. Fifteen bedrooms have en-suite facilities and all bedrooms have a staff call point, television point and some have a telephone point. The home currently provides care with nursing for 25 residents and residential care for 25 residents. The nearest shops, church, post office and hairdressers are approximately five minutes walk away and buses to the Tunbridge Wells stop nearby. A large public park is also near the home. There are areas for car parking to the front and side of the building. With a large garden and two patios for use by residents. The homes senior staffing team comprises of the Manager and Deputy Manager. The home employs nursing and care staff that work over a 24-hour roster. The home also employs staff for activities, catering, domestic and maintenance duties. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 08:40am to 15:30pm. The home currently has 49 residents and is running with one vacancy. One resident was currently in hospital. The visit was spent talking directly with residents, both privately and collectively, with staff and the registered manager. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the residents in the report. Some judgements about quality of life and choices were taken from direct conversation with residents and observation followed by discussion with support staff and evidencing records held at the home. A partial tour of the premises was undertaken. What the service does well: Personal health care needs are well supported. Residents are encouraged to maintain regular contact with other agencies and professionals to manage their health care and personal preferences. Relatives strongly commended the staff on their caring but also the good communication about their relatives care. Residents are happy that family and friends can visit the home at any time. Residents feel the social activities programme offered by the activity coordinator are good, especially the monthly outings currently on offer. Individual key - working is very much welcomed by residents as it offers regular support and trust with their carers. Comments shared by residents included: “Very happy dear no grumbles” “I have been here 8 years and am very happy, no concerns at all” “ The staff are so good, can’t do enough for you, I couldn’t ask for more” “Foods good you get 3 good square meals a day.” Comments from relatives included: “(Relatives name) is very happy here, staff always phone us if he’s not well, lovely staff, very caring, nothings too much for them. Foods good too” Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 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 standard(s) 3,4,5 Residents and representatives are given all the information they need to be able to make an informed decision to live at Birkin Lodge. EVIDENCE: Residents spoken with detailed involvement in visiting the home and the staff visiting them where they were living to assess their needs prior to deciding to move in. Many residents spoke of how they had left this to their relatives due to being in hospital at the time and not being well enough to visit. Files evidenced pre admission assessments taking place. Relatives spoken with today felt staff had been very supportive and shared a lot of information at this time. A statement of purpose and residentguide is available but was not assessed on this occasion. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7,8,10,11 Residents are treated with genuine respect and dignity by all staff. Individual health and social care needs are managed well. EVIDENCE: Care plan records seen were sufficiently up to date, detailed and contained clear information to support staff to meet the needs of the individuals. Daily recordings varied in content from giving a good overall view of care and wellbeing of the resident to that only detailing the direct care given. Residents spoken with had varying understanding of their care plans, some with no interest at all. Those spoken with were aware of paperwork needing to be done but were happy to leave that to the staff. A letter has been placed in the entrance hall, asking relatives to talk with staff regarding the care plans and assist in developing the information held. One file assessed had the whole social portrait completed by the relative, giving first hand background information and social history. Care staff spoken with and observed were mindful of how to prevent risk of falls, taking action to ensure safety for individual residents and this is clearly recorded. Residents talked of regular contact with the GP, chiropodists, opticians and consultant appointments. Records supported this and are stored securely. Interaction between residents and staff is good showing genuine respect and appropriate familiarity with each other. Personal wishes in the event of illness and death, although a difficult Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 10 subject, are discussed sensitively with residents and families to ensure appropriate levels of support are respected and personal dignity maintained at such times. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12,13,14,15 Residents are encouraged to make choices about aspects of their daily lives, through support of a range of activities, services and health care in the home. Residents have benefited immensely through the social monthly outings currently offered. EVIDENCE: The home has effective working relationship with the local health and social care professionals, supporting residents in their health and social care needs. Care plans seen recorded regular contact both at the home and their local practices/work place. Reviews with care managers take place. Discussion took place with residents regarding the food at the home. The majority of feedback was exceptionally positive; all spoke with high regard to the two cook’s versatility, willingness to make any alternatives and the good standard of food provided. Regular activities and events are booked to stimulate and encourage interaction with peers, such as the recent summer fayre, VE day celebration tea, and forthcoming family BBQ. A number external outings have taken place each month, trip to Hastings for fish’n’chip tea, Merriments Garden Centre and afternoon tea, as well as forthcoming, trip to Igtham Mote and the Hop Farm. Residents spoke highly of the activity staff and they’re commitment to arrange things to do. Others preferred to not join in and occupy themselves with TV, reading, listening to radio and personal hobbies. There was a steady flow of visitors to the home, all received warmly by staff. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 12 Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16,18 Residents and relatives feel confidant to raise concerns or complain, as they feel they are listened too and action taken to resolve them. Protection from abuse is promoted through staff training and understanding of the support and actions they may need to take. EVIDENCE: Residents spoken with knew who to talk to if they had a concern or wished to make a compliant; this included their relative, the manager, and their care manager. There is a complaint procedure are available in the home Relatives felt confident in raising any concern with staff and the manager as they felt they were always so open and approachable. Staff who have been spoken shared a good understanding of how to protect and prevent abuse. Reporting under local procedures. There are no current adult protection alerts relating to this home. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19,20,22,23,24,26 Residents live in a friendly and welcoming home, that would be enhanced further by better bad odour control by the front door, adequate and safe laundry facilities, and the on- going internal redecoration and replacement of equipment. EVIDENCE: The home has been adapted with purpose built extensions over a number of years, over three floors. Accessible by shaft lifts. Finding your way around the home is easily confusing due to the adapted layout. Corridors are narrow and heavily damaged from wheelchairs use and knocks in places. Some corridors do not allow two people to pass especially if using a Zimmer frame or wheelchair. The home offers two lounge/dining areas, and one small lounge of the second floor. The whole external building had been redecorated since the last inspection, with ongoing internal decorations planned. There are extensive well-maintained garden and grounds. A review of the current small and unsuitable laundry has taken place but no formal proposals submitted to the commission. From discussion the proposals do not offer satisfactory separate clean and dirty storage. Overall cleanliness in the home has improved. Most Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 15 areas of the home were free of offensive areas. There is ongoing work in one area identified today being reassessed by the staff team and incontinence advisor. Individual rooms varied in size, but had been made personal by residents through photographs, pictures and personal items. Staff do not have a designated break area away from communal areas of the home and garden. Breaks are taken on lounge/dining room or seating area at the side of the home. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Resident’s benefit from the support and care of competent and skilled staff, resulting in good morale and commitment to improve their quality of life. EVIDENCE: Staff discussed attending a number of courses related to health and safety core training and nursing care, increasing their personal knowledge and understanding of individual care needs and their responsibilities. Staff felt the company were very supportive to training requests and attendance. The home continues to aim to support care staff to complete their NVQ 2 and 3 in care with 50 . Both qualified nurses and care staff spoken with and directly observed evidenced clear and good understanding of different individual care needs. Residents talked fondly of individual staff and their kindness (particularly key workers). Staff were seen to support individuals respectfully but also with respectful familiarity resulting in some fun joking and banter from both parties. Staff files seen evidenced good recruitment procedures to ensure safety of residents and staff training and competencies, including adaptation over seas nurses. Regular recorded formal supervision is in place. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,38 Residents’ personal preferences about care needs are encouraged through the registered managers open leadership and the promotion of a safe home and working environment. EVIDENCE: The registered manager has worked with older persons for a number of years and is a qualified nurse RN1 level and currently working towards the NVQ 4 in Management. Residents and staff expressed a high regard for the management approach to the home. Residents felt the registered manager was approachable and all staff spoken with said they felt well supported by the manager and company. Regular formal supervision takes place. The registered manager and lead nurse demonstrated through discussion, a very clear understanding of the needs of current residents and current issues. Monitoring health and safety in the home is to a good standard through the maintenance staff. Equipment is serviced as required to maintain a safe home and facilities. Risk assessments are completed for individuals and staff activities in the home and care duties. Staff and the manager have a full Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 18 understanding of accident/incident recording and reporting under regulation 37 to the commission. The manager evidenced regulation 26 visits taking place. Detailed financial recordings and storage is in place for small amounts of resident personal monies held by the home. Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 x 3 3 3 x 1 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 2 Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 20 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 OP19 Regulation 23(3) (a) Requirement The registered person shall provide for staff suitable facilities and accommodation, other than sleeping accommodation icluding, facilities for the purpose of changing. In that the flat offered previously is currently being used as permanent residency for one staff member and not accessible to all staff As has been identified in previous inspections under the Care Standards Act 2000: The registered person shall having regard to the number and needs of the Service Users ensure that:The physical design and layout of the premises to be used as the care home meets the needs of the service users.The registered person must provide an adequately size laundry to provide clean and dirty areas with safe and good infection control and ventilation for the registered 50 service users. The registered person shall have regard to the number and needs of the service users ensure that all parts of the home are kept Timescale for action 30th October 2005 2. OP26 23(2)(a) 31st December 2005 3. OP26 23(2)(d) 31st December 2006 Page 21 Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 clean and reasonably decorated.With particular attention concentrated on communal areas and damaged corridors. 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 OP3 Good Practice Recommendations The assessment forms should be stored within the care file so that the current care plan and support strategies do not get confused with the initial assessment information.All documentation should be both signed and dated on completion. There is evidence of staff working get care plans signed by representatives but this is an on-going recommendation It is recommended that daily write ups in care plans contain overall well-being, social interaction, health and care given, so as to give a clear picture of the service user overall not just recording the care given by staff. It is strongly recommended that nursing and care staff is familiar with the contradictions of some fruit juices (grapefruit and cranberry) with particular prescribed medication. This must be clearly discussed with residents and detailed in care plans. It is strongly recommended that a survey and assessment by a qualified occupational therapist is carried out regarding specialist equipment and management of the smaller rooms, corridors and specialist assisted bathing equipmentThe manager stated that this continues to be discussed with Four Seasons. Nothing formal has been submitted for work to be completed It is recommended that staff are provided with adequate break out area away from the communal areas of the home/garden. It is strongly recommended that advice and assessment be sought from the Environmental Health Officer and Kent and Medway Infection Control Unit with regard to the most suitable and functional layout of the laundry room to meet the needs of 50 service users. The action plan from the last inspection 19th May 2004 stated that this has been undertaken and that alternative laundry facilities are being H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 22 2. OP7 3. OP7 & OP9 4. OP19,OP21 5. 6. OP19 OP26 Birkin Lodge Care Home 7. OP26 8. OP38 9. OP38 explored by Four Seasons. Proposals were shared during this visit but the commission strongly recommends advice from Infection Control team to appropriate infection control and separation of dirty and clean laundry for those shared. It is strongly recommended that the offensive odour located by the front door is closely monitored and alternatives continue to be explored by the manager to reduce this as quickly as possible. It is recommended that due to the size of the home, internal adaptations and heavy damaged to corridors and communal areas consideration to increasing handy person allocation or external contractor should be explored to assist in maintaining internal decoration. It is recommended that electrical wiring outside bedroom hanging loose from wall outside bedroom 33 be secured in a safe manner Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone, Kent ME16 9NT 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 Birkin Lodge Care Home H56-H06 S44478 Birkin Lodge V223184 010805 Stage 4.doc Version 1.40 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!