Inspection on 13/01/07 for Silver Birches - North Yorkshire County Council

This inspection was carried out on 13th January 2007.

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 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

Silver Birches - North Yorkshire... 14/12/05

Silver Birches - North Yorkshire... 27/04/05

Silver Birches - North Yorkshire... 15/12/04

Silver Birches - North Yorkshire... 21/07/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Silver Birches - North Yorkshire County Council Silver Birches Station Avenue Filey North Yorkshire YO14 9AH Lead Inspector Brian Hallgate Key Unannounced Inspection 13th February 2007 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 Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.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 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 Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silver Birches - North Yorkshire County Council Address Silver Birches Station Avenue Filey North Yorkshire YO14 9AH 01723 513563 01723 513006 silver.birches-nycss@btinternet.com 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) North Yorkshire County Council Ms Samantha Taylor-Rose Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users for intermediate care (up to a maximum of 4), will be accommodated within the rehabilitation unit on the top floor and be in category OP. 14th December 2005 Date of last inspection Brief Description of the Service: Silver Birches is a purpose built property standing in its own well-maintained grounds. It is situated a few minutes walk from the town centre. The building, occupying two floors, provides accommodation for a maximum of 31 residents. There are 27 places offered on a permanent basis. A four-bedded rehabilitation unit is also provided jointly with the health authority. A ten-place day centre is also available. The rooms offered are all single. There are communal bathrooms and toilets on each floor. There is a passenger lift. Communal rooms are located throughout the premises. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to inform this report was obtained from the information documented in previous inspections reports, a pre-inspection questionnaire completed by the registered manager of the service, a site visit, completed survey forms and discussions with five service users, one relative, four members of staff and the registered manager. Prior to the inspection six survey forms were sent to service users and five were returned, four survey forms were sent to GPs and one was returned, one survey form was sent to the district nurses but was not returned and one survey form was sent to a care manager but was not returned. This unannounced inspection took place on the 13th February 2007, commencing at 9.30am. A number of records were inspected including service users’ assessments, care plans, medication and health and safety records. A tour of the home was made and staff were observed interacting with a number of service users. The fees on the day of the inspection ranged from £325£375. What the service does well: What has improved since the last inspection? What they could do better: Conflicting views were put forward on the quality and choice of food. Some service users stated the food was marvellous and some stated that it was very poor. The registered manager is discussing the menu with all service users Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 6 with a view to ensuring that they enjoy their meals. The home has a number of volunteers and these volunteers may be able to take those service users who wish into the local community. 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. The summary of this inspection report can be made available in other formats on request. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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 Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users who are admitted to the intermediate care unit are provided with a good multi-disciplinary service that enables most of them to return home. The assessments before admission to the main unit have considerably improved. EVIDENCE: All prospective service users receive a full care management assessment before being considered for admission to the home. A member of the senior management team visits potential service users either at home or in hospital and undertakes a written assessment to ensure that their needs can be met by the environment of the home and the skills of the staff team. There is a separate intermediate care unit for four people based on the first floor of the home. A multi-disciplinary team of health workers assesses people referred to the unit. The main reason for admission to the unit is for rehabilitation work to be undertaken with a view to service users returning to their own homes. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 9 Considerable success has been achieved by the staff in enabling over 90 of people admitted to the unit to return home within a six-week period. One service user stated, “I am making much more progress in my rehabilitation here than I ever did in hospital. I will be ready to go home before my sixweek period is up. It is a wonderful place”. Comprehensive assessments were seen for people admitted to the main home and the rehabilitation unit. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. In depth plans of care and independence plans are included in each persons case-file. EVIDENCE: Independence plans are devised for each service user from the care management assessment and the observations of the staff team. Independence outcomes for each service users are then discussed and recorded to ensure all staff are working to the same aims for each service user. The plans are clear and enable staff to work towards enabling service users to be as independent as possible. The plans are reviewed and recorded on a regular basis and at least once a month. Meetings with health personnel are held weekly in respect of people admitted to the intermediate care unit. Service users spoken to stated that they were allowed choice of what to do during the day. A service user stated “The staff always listen to me and support me in anything I say”. A small number of service users prefer to spend the majority of the time in their own rooms. People stated that the staff Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 11 treated them very well and they could always talk to a member of staff if they needed to. A minority of service users self medicate. All service users have lockable facilities in their rooms for medication and valuables. Service users in the rehabilitation unit keep their own medication as part of their rehabilitation. There is a monitored dosage system for service users in the main home who are unable to self-medicate. Staff administering medication have received appropriate training. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Visiting arrangement allow service users to maintain good contact with their family and friends. EVIDENCE: Service users spoken to stated that their relatives and friends could visit at anytime and the staff welcomed them. Some relatives take service users out of the home on occasions. A relative spoken to confirmed that she could visit when she wished and take her relative out into the community. The routine of the home allows service users to get up and go to bed at times that they want. Activities are available within the home and time is spent in planning activities. Some service users stated that they did not wish to be involved in any organised activities. Visiting entertainers perform at regular intervals. Residents meetings are held monthly. The menu rotates over a four-week period. There are choices for service users at meal times. Some service users considered that the food was marvellous and some considered that it was very poor. One service user stated, “I always like the meals”. Another comment was “We have a wonderful cook”. Another service user stated, “I don’t have any favourite food. I just don’t like the food that is offered. I never like the Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 13 meals at the home”. A further comment was “I like the food at the home and I eat well but I preferred the food at the hospital”. Service users confirmed that they could always have an alternative meal if they wished. The registered manager is undertaking further work to ascertain if all service users can enjoy food that is available for them or consider other options for the menu. One service user goes out to church on a regular basis. Members of churches visit the home regularly to provide pastoral care and to administer Holy Communion to those service users who wish to partake. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory complaints and abuse policies and staff were aware of what action to take if a complaint or suspected abuse situation occurred. EVIDENCE: North Yorkshire Social Services has a complaints policy and procedure that the home follows. One complaint has been received since the last inspection. This was dealt with in the timescale stated in the policy document. The home has a copy of the York and North Yorkshire Vulnerable Adult Policy and staff spoken to were aware of what action to take in the event of a suspected abuse situation occurring. All staff have now undertaken adult abuse training. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained for the comfort of service users. EVIDENCE: The home is at present undergoing major re-decoration. A number of bedrooms have been decorated and on the day of the inspection decorators were working in the main entrance hall and corridors. New carpets are being fitted when the decorations have been completed. Service users spoken to said that they were very pleased with their own accommodation and the accommodation in the lounge areas and dining room. The home was clean, pleasant and homely. A service user stated, “I feel very comfortable in Silver Birches”. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users receive a good standard of care from the staff employed in the home. EVIDENCE: All service used spoken to stated that they were happy with the care that they received from the staff. One service user stating in her questionnaire “I am very happy with the care and support that I receive”. They said that they were allowed to do what they wanted in the home and staff would always assist if they needed any assistance with a particular task. The aim of the intermediate care unit is to enable service users to gain sufficient independence to enable them to return home. Service users in this unit stated that they were very grateful for the input of the staff to enable them to be able to return home. The necessary employment checks are undertaken before new members of staff are appointed. Many staff have been employed in the home for many years and there were no recent employment records to inspect as no new members of staff have been appointed. A CRB clearance form was available for each member of staff. These are renewed every three years. Staff had undertaken appropriate training during the past year. A training plan for the year was seen and training records are being kept and are up to date. Staff spoken to confirmed that they had undertaken the training as detailed on the records. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A new registered manager has been appointed and the administration of the home and record keeping has been improved considerably. EVIDENCE: A new registered manager has been appointed since the last inspection. The manager has a number of years experience in the care of older people and has an NVQ Level 4 in management. All service users spoken to considered that the home was well run by the senior management team. The home undertakes a quality monitoring exercise on a regular basis and obtains the views of service users. The questionnaires were available for the last exercise. The manager and staff consider if they can re-assess any of the services that Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 18 service users state could be improved. The home reviews how it meets the National Minimum Standards on a three monthly basis. Residents meetings are held every month to enable service users to voice any concerns and suggest any improvements to the services that they receive. A number of service users deposit money for safekeeping. Records of income and expenditure and receipts are maintained and the cash is kept securely. All health and safety issues inspected were in order and up to date. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 4 x x 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 4 x x 4 Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 OP15 Good Practice Recommendations The registered manager should continue to discuss the menu with all service users to ensure that it is suited to all individuals within the home. Silver Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Birches - North Yorkshire County Council DS0000034517.V329484.R01.S.doc Version 5.2 Page 22 - 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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