Inspection on 19/07/06 for Birling House

This inspection was carried out on 19th July 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Birling House 30/06/08

Birling House 05/12/05

Birling House 17/05/05

Birling House 04/01/05

Birling House 21/07/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Birling House 91 The High Street Snodland Kent ME6 5AL Lead Inspector Ruth Burnham Key Unannounced Inspection 19th July 2006 09:30 Birling House DS0000023894.V301580.R02.S.doc Version 5.2 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 Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birling House Address 91 The High Street Snodland Kent ME6 5AL 01634 244689 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) The Mortimer Society Mr Neil Channon Care Home 27 Category(ies) of Learning disability (9), Physical disability (18) registration, with number of places Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The eighteen residents with a physical disability may also have a learning disability. Care of five service users is restricted to five persons whose date of birth is 24/12/40, 10/03/06, 24/01/41, 07/08/39 and 26/01/36. 5th December 2005 Date of last inspection Brief Description of the Service: Birling House provides care and support to adults with Huntingdon’s Disease and associated physical disability. It also provides support to a number of people with learning disabilities. Birling house is a large home situated in the town of Snodland. The shops and local amenities are a short drive away and the train station is located 2 minutes away. There are 3 vehicles for use by residents including wheelchair adapted transport. Residents are accommodated in single bedrooms with the exception of 2 people who have chosen to share a room. Residents have access to several communal lounges, a dining room, sufficient bathroom facilities and a large garden. Staff support is provided 24 hours per day. Fees range from £800 to £1200 per week. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was carried out by one inspector who was in the home from 8.30 am to 1.30 pm, it focused on the views and experiences of the residents of the home. The Service Manager gave feedback on progress and a number of staff and residents were spoken with. Some records were inspected and a tour of the premises was undertaken. Comment cards were received from a number of relatives and visiting professionals who all gave positive feedback about the way in which the home is run and residents are cared for. What the service does well: What has improved since the last inspection? What they could do better: Financial recording systems need improvement to ensure that all transactions on behalf of residents are recorded in detail and receipts are kept with the records. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 6 An effective quality assurance system must be put in place based on action, planning and review which produces a report to the Commission at regular intervals in line with the regulations. 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. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Birling House DS0000023894.V301580.R02.S.doc Version 5.2 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 the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who are considering moving to the home are provided with sufficient information upon which to base their judgment as to whether the home is suitable for them. EVIDENCE: People who are thinking about moving to the home have their needs assessed to ensure that these needs can be met. The prospective resident then has the opportunity to visit the home, meet staff and other residents and to stay for a trial visit if they wish. Once a resident moves into the home their placement is reviewed after a month to ensure both parties agree it meets and can continue to meet the needs of the person. Residents have a contract with the home stating the service they will receive and the terms and conditions of the home. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 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 the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live in the home have their needs met in a way which maximises their choice and independence whilst minimising risk. Financial recording systems need improvement to protect residents’ monies. EVIDENCE: People who live in the home have a plan of care that meets their physical, emotional and social needs, these are currently being revised to provide more detailed information and guidance for staff, they are reviewed regularly. Some residents have signed their care plan and those spoken with said they were happy with the care and support they receive. Residents are encouraged to make decisions about their lives and a number of communication aids are in place to assist residents to communicate their wishes. They benefit from the services of an independent advocate who holds residents meetings every month and each resident has a keyworker. Most residents deposit money with the home for safekeeping and overall the records of this were accurate. However, insufficient detail is recorded on records of expenditure and it was difficult to audit individual transactions where receipts Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 10 were not always kept. Residents are supported to take reasonable risks to ensure they have fulfilled lives. These risks have been assessed and minimised as far as possible. The Manager reviews risk assessments every 6 months. Birling house has a policy on confidentiality and all residents’ records are stored and managed securely. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 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 the following standard(s): Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. People who live in the home benefit from the support of a committed team of staff dedicated to providing a range of individualised activities in the home. Residents are supported to use community facilities as often as possible and encouraged to build and maintain relationships. EVIDENCE: People who live in the home benefit from a wide range of activities at Birling house. A team of activity workers organise home and community activities based on individuals needs and preferences. The activity staff described how residents are encouraged to give their views on the activities and to help plan them. Records showed that in the last month residents have taken part in cookery, relaxation, music, bingo, trips to the theatre, cinema, pub, restaurants, indulgence days, aromatherapy, shopping, social club and library. Residents’ participation is monitored to ensure they are receiving the service they want. The staff demonstrated an excellent understanding of people’s individual and differing needs. Residents are supported to build relationships Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 12 both within the home and outside. They are encouraged to maintain contact with friends and family and visitors are welcomed at anytime. Some residents go to stay with family at weekends. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 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 the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents’ health needs are well met and they know that they will be supported sensitively at the end of their life. EVIDENCE: People who live in the home are registered with a GP of their choice and appointments can be made either at the surgery or the home. Records show that opticians, dental and chiropody appointments are made for residents and other services are accessed as needed. Residents said they feel they are well looked after. It was good to see that, despite the number of residents with physical disabilities, there were no residents with pressure sores at the home, preventative measures are taken following advice from the district nurse. The home employs a speech therapist and has the support of a physiotherapist who visits the home fortnightly. Residents’ wishes in the event of death have not been discussed with them. It has been recorded in the care plan that their relatives have agreed to take responsibility for this area of their care. Some staff have received training in bereavement and dying. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 14 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 the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live in the home are listened to and feel free to offer comment or complaint, they are protected from abuse. EVIDENCE: People who live in the home are listened to and feel free to offer comment or complaint. The complaints procedure for the home is up to date and displayed for residents to use. There are effective systems in place to protect residents from abuse. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 15 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 the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The well equipped and comfortable and safe environment enhances the quality of life for residents. EVIDENCE: Residents live in a safe, clean, comfortable and spacious home. They have their own rooms that meet their needs and access to plenty of bathroom facilities. There is a continual programme of redecoration and some areas had been newly carpeted Residents have a bedroom that meets their needs and they have personalised their rooms with their belongings. Residents’ bedrooms are fully furnished and some new adjustable beds have been purchased. Residents have single bedrooms with the exception of 2 people who have chosen to share. Residents spoken with said they really liked their rooms. There are sufficient bathroom and toilet facilities around the home and these have been adapted for people with physical disabilities. Portable and fixed hoists are available. There is a choice of lounge areas for residents to use and Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 16 a dining room. People who live in the home also benefit from a well equipped sensory room and activities areas. The gardens are well laid out and easily accessible. The home is kept clean and hygienic and safe procedures are in place for managing laundry and waste. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live in the home benefit from the support of sufficient numbers of committed, competent and qualified staff, they are protected by safe procedures for recruiting staff. EVIDENCE: People who live in the home benefit from the support of staff who are well informed and have a clear understanding of their role. There are sufficient care staff on duty to meet the needs of the residents and additional activity, kitchen, domestic, maintenance and management staff are employed. Staff have undertaken a range of training to do their jobs. The training programme and records continue to show that this is one of the strong points of the home, staff feel valued and enjoyed training. Over 50 of care staff have completed their NVQ award and a number of staff are working to achieve it. Staff files were inspected and these showed that residents are protected through robust recruitment procedures. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 18 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live here benefit from a well run home and are consulted about their views, they are protected by the homes policies and procedures and their safety and welfare are promoted and protected. EVIDENCE: People who live in the home benefit from the support of a well qualified management team who are enthusiastic about providing a good quality of life whilst meeting their needs. The Manager is a registered nurse and is due to complete the Registered Managers Award shortly. Residents have been consulted about their views of the home. and are also encouraged to share their views through the monthly residents meetings. There is no formal quality assurance system in place which produces a report in line with the regulations however, outcomes in the home indicate that management systems are effective and improvements continue to be evident during inspections. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 19 People who live in the home benefit from good management systems which include clear policies and procedures which are reviewed regularly, staff are introduced to the policies of the home through their induction. All residents’ records are stored securely and their health and welfare is protected in the home through safe working practices including regular safety checks of all equipment and installations. The building does not present any significant risks to residents and all individual activities have been assessed and the risks reduced as far as possible. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 20 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 Standard No Score 1 x 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000023894.V301580.R02.S.doc 3 2 3 3 3 LIFESTYLES Standard No Score 11 x 12 4 13 3 14 4 15 3 16 x 17 x Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Birling House Score x 3 x 3 3 x 2 3 3 3 x Version 5.2 Page 21 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 YA7 Regulation Sched 4.9 Requirement Financial recording systems need improvement to ensure that all transactions on behalf of residents are recorded in detail and receipts are kept with the records. An effective quality assurance system must be put in place based on action, planning and review which produces a report to the Commission at regular intervals in line with the regulations. Timescale for action 31/08/06 2 YA39 24 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 3. Refer to Standard YA37 Good Practice Recommendations It is strongly recommended that the Manager complete the RMA as soon as possible. Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI Birling House DS0000023894.V301580.R02.S.doc Version 5.2 Page 23 - 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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