Inspection on 19/07/05 for Silver Birch Lodge Nursing Home

This inspection was carried out on 19th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Silver Birch Lodge Nursing Home 19/06/07

Silver Birch Lodge Nursing Home 14/02/06

Silver Birch Lodge Nursing Home 25/01/05

Silver Birch Lodge Nursing Home 29/06/04

Silver Birch Lodge Nursing Home 24/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Silver Birch Lodge Nursing Home Silver Birch Lodge Bold Lane, Holt Green Aughton, Lancashire L39 6SH Lead Inspector Anne Taylor Announced 19 July 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Silver Birch Lodge Nursing Home Address 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) Silver Birch Lodge Bold Lane Holt Green Aughton Lancashire L39 6SH 01695 424242 Silver Birch Lodge Mrs Joan Parr Care Home 27 Category(ies) of Old Age (OP) registration, with number of places Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered to accommodate a maximum of 27 service users in the cateogory of OP (old age, not falling within any other category). 2.Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any other guidelines which may be issued through the National Care Standards Commission regarding staffing levels in care homes. Date of last inspection 27th January 2005 Brief Description of the Service: Silver Birch Lodge is a registered care home providing personal and nursing care. The home is registered to accommodate people over the age of sixty-five years of age. Accommodation is provided for twenty-seven residents of either sex. At the time of inspection there were twenty-six people living in the home, twelve receiving nursing care and fourteen receiving personal care. Mr and Mrs J Parr privately own the home. Mrs Parr, a registered general nurse is also the registered manager with overall responsibility for the day to day running of the home. All rooms are at ground floor level, fifteen of which have en-suite bathrooms. Twelve single rooms have private washing facilities. There is a lounge/conservatory and lounge /dining facilities. The home is situated in a quiet village location, set in well-kept grounds. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one full day in July 2005. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. Comment cards received from residents, relatives and other health care professionals have also been used in the production of this report. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. What the service does well: The procedures and management processes in place to assess and address health care needs were highly developed and individual needs were met in a supportive and caring environment. The staff team worked well together and showed a good understanding of the needs of the people living at the home. The staff team received appropriate training and guidance that provided them with the knowledge and experience needed to care for this client group. This care home put the needs of residents first and made sure residents were supported to live an independent lifestyle whenever possible. People living at the home benefited from the happy relaxed atmosphere and good relationships have been established between residents and staff. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 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. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 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 Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 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 A thorough pre admission procedure ensured that prospective residents could be involved in the process and their individual wants and needs properly assessed. EVIDENCE: Pre admission assessments carried out by the home and social workers involved prospective residents and or their relatives. This helped residents to know what sort of care they should expect to receive when they came to live at the home. The assessments were detailed and showed the individual needs of each client. When asked residents said, “my daughter looked round and chose it, (the home) and someone came to see me and talk to me about it”. The manager said that she or another experienced nurse usually carried out pre admission assessments for prospective clients. This meant that both the home and any prospective resident could be sure that an appropriately trained person had done the assessments. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 9 Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 10 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 The care planning and risk assessment processes were thorough enough to ensure the needs of residents were properly identified and managed. The provision of basic nursing care and management of health care needs was of a high standard and made sure the health and welfare of clients was put first. EVIDENCE: Care records seen showed that each resident had a plan of care that had been agreed with him or her or a relative. This meant that residents or their relatives had some idea of what care they should expect to receive whilst living at the home. It also gave them the opportunity to discuss any concerns and identify any specific needs or preferences. Risk assessments that enabled health care to be provided safely were in place so staff were confident about this part of their job and residents able to feel safe when being assisted with personal care needs or receiving nursing care. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 11 When asked about care plans residents did not show any interest in them and most said that their relatives would deal with it. One resident said, “I’ve not seen a care plan but my son and daughter have, I’m not interested”. Residents spoken to said that they felt staff understood their needs and worked hard to meet those needs. Residents were settled, appropriately dressed and well cared for. Records showed that the home had a positive and proactive approach to the management of health care so the outcomes for individuals were extremely good. When asked about the care they received residents said, “in general the care is good, I get whatever I need” and “I’m much better now than when I came in”. Comments from a General Practitioner that has patients at Silver Birch noted, “Silver Birch is a really excellent nursing home, medically superb and a pleasant and friendly atmosphere, exceptionally good”. One relative commented, “I have piece of mind knowing my husband is well looked after”. Staff were able to discuss the individual needs of the people they cared for and how they organised their workload to ensure those needs were met. They made reference to way they used the care plans and attended regular handovers when there was a change of shift, so that they were kept informed of any changes to the care residents needed. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 12 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) 14 & 15 Residents were helped to exercise choice so that they had some control over their lives. The importance of providing a well balanced diet was recognised by the home so that clients were able to eat healthily and given a choice about what they ate. EVIDENCE: During conversations with residents and staff it was evident that residents were able to make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised and residents were given the opportunity to choose the colour scheme of their bedroom when it was due for redecoration. A record of all items brought into the home by residents was kept so that staff knew which items belong to each resident. Residents not able to exercise full control over their financial affairs were mainly helped by a family member. The manager was able to give examples of when she had arranged for an advocate to act on behalf of a resident without a representative to ensure that any decisions made were in the best interests of that resident. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 13 Detailed records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. Some residents had chosen to eat in the dining room, others in their bedroom. One resident said, “I have breakfast and tea in my room and lunch in the dining room”. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “I have no complaints about the food. I get a choice, whatever I want really”. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 14 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 The home had a clear complaints procedure that ensured residents knew how and who to complain to. Management processes in relation to abuse were thorough enough to ensure the protection of any vulnerable residents. EVIDENCE: A complaints procedure was in place and residents spoken to know how and who to complain to one resident said, “I’d go to the boss if I had a complaint, not that I’ve needed to so far”. Resident’s spoken to felt that they were encouraged to raise any concerns they might have about the home, that they would be listened to and action would be taken on any issues raised. Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and be sure they were listened to. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 15 The home had its own adult abuse policy and whistle blowing policy, in addition to a copy of guidance issued by the department of health. Discussion with staff showed that they were aware of the above documentation and were quite clear about what they would do if an allegation or suspicion of abuse came to their attention. The manager was aware of her responsibilities in relation to protecting people living at the home and making sure staff were appropriately trained to recognise and act upon any signs of possible abuse. Induction training records for new staff included a training pack about abuse with a multiple-choice test at the end to assess knowledge and understanding. Staff confirmed that they received regular updates so that they continued to be made aware of the need to protect the people they care for. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 16 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, 25 & 26 The home was clean, comfortable, and homely. And provided an environment that was suitable for it’s stated purpose. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside and all accommodation was at ground floor level. Outside the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. An assessment of risk regarding the small outdoor pond should be done to make sure any risk to residents is removed or appropriately managed. Residents spoken to were happy with their private accommodation and most had personalised their rooms so that they felt more at home. One said, “I like my room, everything is alright and I have enough space for my things”. A programme for maintenance and refurbishment was in place so that furnishings, fittings and décor in all parts of the home could be renewed and kept up to date when needed. A number of radiators were unguarded and did not have a guaranteed low surface temperature. Unprotected radiators present Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 17 a possible health and safety risk to residents. The programme to fit guards to all radiators and cover all exposed pipe work should be completed as soon as possible. The home was clean and free from offensive odours. One resident said, “ My room is always clean and tidy”. One visitor said, “ it’s always clean and tidy, it never smells or anything”. Policies and procedures were in place that identified infection control measures in place at the home. Staff were able to discuss infection control procedures so the risk of cross infection between residents was minimised. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 18 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 The skill mix of and number of staff on duty was sufficient to ensure the needs of residents were met. The recruitment process was thorough enough to ensure the continued protection of residents EVIDENCE: Staff rotas showed the number and skill mix of staff on duty at any time and that enough staff were on duty to ensure the needs of residents could be met. Comment cards completed by relatives also confirmed that there was always sufficient numbers of staff on duty so that residents were looked after and attended to properly. When asked about staff residents said, “the staff are good, they do what they can and I have no grumbles”. Staff spoken to felt that there was enough staff on duty so that they were able to provide a good standard of care to residents. A recruitment checklist had been introduced to assist the recruitment process and records showed that the recruitment procedure had improved since the last inspection. The improved recruitment process was thorough and took into account the need to protect residents. Discussion with the manager showed that she was aware of her responsibility to appoint suitable staff that would be Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 19 able to provide good care and the continuing need to protect people living at the home. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 20 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) 35 & 38 The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. The systems in place for managing health and safety matters were thorough enough to ensure the continued safety and welfare of people living and working at the home. EVIDENCE: The home had a policy of not handling personal allowances for residents. Any money brought in by relatives for residents was stored in the home’s safe. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents. When asked about access to their money residents said, “my son and daughter look after my money” and “I have some money in the safe here at the home, my daughter looks after everything else”. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 21 Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment used by the home to make sure they were safe to use. Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number safe working practices were verified at the time of inspection. Training in relation to health and safety issues had been provided for all staff so that they were able to promote the health, safety and welfare of the people they cared for. Residents felt safe living at the home one said, “I feel safe and well looked after here”. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x 2 3 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 Standard No 16 17 18 Score 3 x 3 x x x x 3 x x 3 Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 23 YES 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 25 Regulation 13(4)(a,c) Timescale for action Radiator guards must be fitted to 31ST all radiators that do not have a October guaranteed low surface 2005 temperature. An assessment of the outside 31s August pond must be carried out to 2005 identify and remove or minimise any risk to residents. Requirement 2. 19 13(4)(a,c) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 25 Good Practice Recommendations Pipe work in all rooms should be guarded. Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley, Lancashire, PR7 1NW 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 Silver Birch Lodge Nursing Home F57 F08 Silver Birch S25573 V226817 190705 Stage 4.doc Version 1.30 Page 25 - 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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