Inspection on 07/02/06 for Birkin Lodge Care Home

This inspection was carried out on 7th February 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

Birkin Lodge Care Home 12/04/07

Birkin Lodge Care Home 12/06/06

Birkin Lodge Care Home 01/08/05

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 Inspection 7 February 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 Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 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. Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Birkin Lodge Care Home Address Camden Park Hawkenbury Tunbridge Wells TN2 5AE 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) 01892 533747 Four Seasons Homes (No 6) Limited (A wholly owned subsidiary of Four Seasons Healthcare) Mrs Aline Ongley Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Subject to 25 beds being used for Nursing Care, 5 of which may be used for Terminally Ill. Registration is restriced to providing care for one service user diagnosed with dementia whose date of birth is 30 March 1923. 1st August 2005 Date of last inspection Brief Description of the Service: Birkin Lodge is a large detached premise set on the outskirts of Tunbridge Wells and is surrounded by gardens. The home is managed by Fours Seasons Homes (No 6) Limited (A wholly owned subsidiary of Fours Seasons Healthcare) 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. 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 DS0000044478.V269928.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 09.30am until 11.00am, due to a gastric virus being identified at the home over night. Advice from the Health Protection Unit was to confine the small number of residents affected, visits out of and to the home should be stopped to reduce the spread of the virus. The inspector therefore was unable to speak to any residents, staff directly or tour the building on this occasion. Time was spent talking to the manager to ascertain the action taken to protect unaffected residents and staff, as well support those displaying symptoms. The manager and staff were following all good universal precautions and instigating guidelines and care as required by the Health Protection Unit, to ensure residents safety and minimise the spreading of the virus. The home currently has 49 residents and is running with one vacancy. No new admissions will be accepted until the home is clear of the virus. For a detailed inspection, please refer to the previous report dated 4th August 2005 where all key standards were assessed. Requirements and recommendations from the last inspection will be assessed in full at the next planned inspection. What the service does well: What has improved since the last inspection? What they could do better: Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 6 To ensure a safe working areas, the organisation must address the very small working area of the current laundry. With clearly defined clean and dirty laundry areas for effective infection control to meet the needs of processing all laundry (including linen) can be carried out and stored safely. Due to events today, close monitoring of the increased levels of laundry should be risk assessed with appropriate action taken due to the limited space and capacity of the current laundry facilities. 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 DS0000044478.V269928.R01.S.doc Version 5.0 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 Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 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): Not inspected on this occasion, please refer to the previous inspection of 4th August 2005. EVIDENCE: Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 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 the following standard(s): Not inspected on this occasion, please refer to the previous inspection of 4th August 2005. EVIDENCE: Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 10 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): Not inspected on this occasion, please refer to the previous inspection of 4th August 2005. EVIDENCE: Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 11 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): 18 The manager, who is confident in using local adult protection procedures, promotes protection from abuse. EVIDENCE: The manager through notifications to the commission has actively referred residents at risk of abuse to social services and the police using local adult protection procedures. Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 12 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): 26 Residents live in a friendly and welcoming home that would be enhanced further by 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. There are extensive well-maintained garden and grounds. A review of the current small and unsuitable laundry has taken place. A tour of the building was not possible today, however the manager was able to confirm: Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 13 • • • • • That new flooring has been laid in the identified bedroom from the inspection. Cancelled the flooring company due to lay similar flooring in another room today due to current situation. Budget allocation has been agreed from April for internal redecoration and refurbishment of corridors and communal areas. Electrical wires have been secured safely. Plans have been drafted for new laundry facilities but no completion date yet agreed by Four Seasons. Following the over night concerns of illness, the manager was greeting all entering the home and advising not to visit home today. Full universal precautions have been reinforced. Resident showing symptoms are receiving isolated care in their rooms. The Health Protection Unit have been fully notified and the manager and staff are following their guidance. Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 14 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): 27,29 Residents’ needs are being met through the support of existing staff and agency staff at this time. EVIDENCE: The home currently has full capacity of Qualified nursing staff. Due to illness one RGN was unable to report for duty today and the manager was supporting the qualified staff. There are currently three care worker vacancies. Currently covered by agency staff. There are two new carers undertaking 3-day induction supernumerary to the working roster. Their programme today was watching Health and Safety Videos and moving and Handling induction by trained trainer. AS further new carer is due to start but awaiting Criminal Record clearance and reference checks to be completed. The current virus has too affected staff and cover has been arranged through existing staff taking extra shifts and agency staff. Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 15 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): 31,38 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 has achieved NVQ 4 in Management. The manager has today shown good leadership and support to the staff team. Good understanding of infection control management and working openly and transparently with the Health Protection Unit, G.P’s, the Commission and those arriving to visit the home. Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 1 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 17 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 OP19OP26 Regulation 23(2)(a) Requirement 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 Residents ensure that:The physical design and layout of the premises to be used as the care home meets the needs of the residents.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 residents. Plans to be submitted to the commission and An action plan stating when the work commencing and estimated completion date The registered person shall have regard to the number and needs of the residents ensure that all parts of the home are kept clean and reasonably decorated.With particular attention concentrated on communal areas and damaged corridors. DS0000044478.V269928.R01.S.doc Timescale for action 12/03/06 2 OP19OP26 23(2)(d) 12/03/06 Birkin Lodge Care Home Version 5.0 Page 18 An action plan is to be submitted to the commission of the work commencing and estimated completion date 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. Not assess on this occasssion and will be reassessed at the next inspection. 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 residents overall not just recording the care given by staff. Not assess on this occasssion and will be reassessed at the next inspection. 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. Not assess on this occasssion and will be reassessed at the next inspection. 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 equipment. The manager stated that this continues to be discussed with Four Seasons. Nothing formal has been submitted for work to be completed. Not assess on this occasssion and will be reassessed at the next inspection. It is recommended that staff be provided with adequate DS0000044478.V269928.R01.S.doc Version 5.0 Page 19 2 OP7 3 OP7OP9 4 OP19OP21 5 OP19 Birkin Lodge Care Home 6 OP26 7 OP26 8 OP26 9 OP38 break out area away from the communal areas of the home/garden. Not assess on this occasssion and will be reassessed at the next inspection. 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 residents. The action plan from the last inspection 19th May 2004 stated that this has been undertaken and that alternative laundry facilities are being explored by Four Seasons. 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 close monitoring of the increased levels of laundry today and over coming few days should be risk assessed with appropriate action taken due to the limited space and capacity of the current laundry facilities to promote safe and effective infection control management. 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. 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. Not assess on this occassion and will be reassessed at the next inspection. Birkin Lodge Care Home DS0000044478.V269928.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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. 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