Inspection on 14/12/05 for Silver Birches - North Yorkshire County Council

This inspection was carried out on 14th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 Birches - North Yorkshire... 13/01/07

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 Unannounced Inspection 14th December 2005 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.V272751.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. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 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 Mr Paul Douglas Farmer 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.V272751.R01.S.doc Version 5.0 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. 27th April 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 22 places offered on a permanent basis and five available for respite care. 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.V272751.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 14th December 2005, commencing at 9.30am and took six hours, including preparation time. A tour of the premises was made with a member of staff and a number of records were inspected. Eight service users, a relative, an occupational therapist, a general assistant from the Community Assessment Rehabilitation Team and five members of staff were spoken with. The key standards not inspected on this occasion were inspected at the previous inspection held on the 27th April 2005. What the service does well: What has improved since the last inspection? The dining room has been improved by the provision of a new carpet. Admissions have been restricted due to the difficulty in recruiting resource centre staff. A CRB disclosure is now obtained before staff are employed within the home. The hoists have been serviced. Service users are more involved in their plan of care and attend their reviews. All plans are reviewed and recorded at least once per month by keyworkers. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 6 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 Birches - North Yorkshire County Council DS0000034517.V272751.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 Silver Birches - North Yorkshire County Council DS0000034517.V272751.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): 3 and 6 Service users referred for intermediate care are provided with a good multidisciplinary service that enables the majority to return home after rehabilitation. No progress has been made on the home undertaking a written assessment prior to admission. EVIDENCE: There is a four-bedded intermediate care facility based within the home. This is on the upper floor and is a joint venture with health and social services input. Service users are admitted from hospital or from their own homes to prevent hospital admissions. Health service staff assess the level of rehabilitation required and staff from the home and health staff jointly work to achieve improvement. Records inspected showed that the majority of people admitted to the unit are rehabilitated. Regular reviews are held. The maximum period in the unit is six weeks. A recommendation was made at the last inspection that a member of the management team undertakes an assessment of potential service users to the other beds available within the home. There is no evidence on the case files of Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 9 people admitted since the last inspection to show that this occurs. This is considered good practice to ensure that the environment of the home and the qualifications and skills of the staff can provide the necessary care to proposed users of the service. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 and 9 The systems for the administration of medication are poor and potentially place service users at risk. EVIDENCE: There is a policy and procedure in respect of the administration of medication. The checks made showed that the procedure was not being followed and potentially puts service users at risk. There is a monitored dosage system prepared by a pharmacist and computer generated record sheets for staff to complete each time they administer medication. The checks showed that on numerous occasions the tablets had been taken from the cassettes but no record had been made on individuals record sheets stating that the medication had been given. Eye drops prescribed three months ago had been opened and no date had been recorded when the eye drops had been opened. The bottle clearly stated that the eye drops were to be disposed of 28 days after opening. They were still being used on the day of the inspection. An immediate requirement notice was issued that medication must be administered in accordance with the policy and good practice. All service users are registered with a GP, a district nurse visits daily and service users have access to chiropody, dentist and optician as required. Other health services are referred Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 11 through the GP. There was substantial evidence of multi disciplinary working with health service staff particularly in the intermediate care unit. Each service user has a plan of care and input is sought from service users and relatives. Keyworkers review the plans on a monthly basis and record the review. A yearly review takes place with the care manager. A yearly review was taking place on the day of the inspection. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 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 the following standard(s): 14 and 15 Visiting arrangements are good allowing service users to maintain good and regular contact with family and friends. The dietary needs of service users are well met with a varied menu offering choices. EVIDENCE: Service users and a relative stated that visitors could see their relatives and friends at anytime and the staff welcomed them. Some relatives take service users out of the home. Service users stated that they had choice of what they wished to do on a daily basis. Times of getting up, baths, what to wear, what activities to take part in and the time of going to bed were all flexible. Activities were available within the home and some staff hours are available to plan and involve service users in activities. Visiting entertainers perform at the home on a regular basis. Residents meetings are held on a monthly basis. The menu is a four-week rotating menu with plenty of choices for service users. All service users spoken to stated that they enjoyed their meals and confirmed an alternative was always available if they did not wish to each a meal detailed on the menu for the day. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Staff spoken to had basic knowledge of what action to take if a suspected abuse situation occurred but had not received the training as required at the previous inspection. EVIDENCE: All staff spoken to stated correctly what they would do if they suspected a service user had been abused. There is a written policy on dealing with abuse. At the last inspection a requirement was made that all staff attend adult abuse training. Staff spoken to stated that they had not received any training. Senior staff spoken to said that only three members of staff had received the necessary training. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The standard of the environment is good providing service users with an attractive and homely place in which to live. EVIDENCE: The only outstanding environmental issue at the previous inspection was that the dining room carpet needed replacing. This has occurred. The home was clean, pleasant and hygienic. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 15 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, 28, 29 and 30 The service users receive a good standard of care from the motivated staff. EVIDENCE: All service users and a relative stated that the care staff gave was of a high quality. Independence and choice was promoted and staff assisted only where necessary to enable service users to be as independent as possible for as long as possible. There was considerable evidence of this in the intermediate care unit. Newly appointed staff had received the necessary references and CRB clearance before they commenced employment. Staff had received some training since the last inspection but finding evidence of this from staffing records available was not possible. Staff spoken to stated that they had received training in dementia awareness, fire training and health and safety. Staff spoken to had not received the necessary training in adult abuse as required in the last inspection report. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 16 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): 31,33,35 and 38 The management of the home is satisfactory overall but records are not always well managed. This practice could potentially place service users at risk. EVIDENCE: The registered manager was not on duty at the time of the inspection. The senior member of staff, who had considerable management experience, had some difficulty in finding some of the relevant records required for the inspection. Staffing records were difficult to identify, up to date training records were not found, medication records were not acceptable and a requirement from the previous inspection that the fire alarm system be tested on a weekly basis had not been complied with. Some of these issues could potentially place service users at risk. The home undertakes a quality monitoring exercise on a yearly basis by asking all service users to complete a questionnaire. Questionnaires are also given to service users on a random basis asking for their comments on the choices available to them. The quality Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 17 monitoring could further be developed by asking relatives, GP’s, care managers and other professionals to complete a questionnaire on the services provided within the home. Regular residents meetings are held to enable service users to give views on the care that they receive. Service users finances are mainly dealt with my relatives. A solicitor is involved with one service user. Service users may deposit money with staff for safekeeping. This is kept in a secure place on an individual basis. There are clear records of income, expenditure and the balance for each service user who deposits money. Records were up to date and in good order. Cash and records checked were accurate. Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 18 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 2 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 1 3 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 3 x 3 x x 1 Silver Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13 & 17 Requirement The registered manager must ensure that the administration of medication is carried out in accordance with the policy and procedures. All staff must have training in the Adult Protection Procedure. The registered manager must ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users The registered manager must ensure that the fire alarm system is tested weekly. Timescale for action 14/12/05 2. 3. OP30OP18 OP31 13 12 31/01/06 14/12/05 4. OP38 23 14/12/05 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 A member of the management team should carry out their own assessment of potential residents and keep a record of this assessment. DS0000034517.V272751.R01.S.doc Version 5.0 Page 20 Silver Birches - North Yorkshire County Council Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Birches - North Yorkshire County Council DS0000034517.V272751.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!