Inspection on 22/08/06 for Silver Birches Residential Home

This inspection was carried out on 22nd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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

CARE HOMES FOR OLDER PEOPLE Silver Birches Residential Home London Road Rake Liss Hampshire GU33 7PG Lead Inspector Keith Hopkins Unannounced Inspection 22nd August 2006 11:30 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 Residential Home DS0000065889.V301590.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 Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silver Birches Residential Home Address London Road Rake Liss Hampshire GU33 7PG 020 7929 3444 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) www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Mrs Tina Mary Foster Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (27) Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31/08/05 Brief Description of the Service: Silver Birches is a care home for twenty-seven service users over the age of sixty-four. It is registered to take service users who have a mental disorder or dementia. Silver Birches is situated on a site with two other homes owned by Ashbourne (Eton) Ltd. The twenty one single and three shared rooms, as well as the communal areas, are arranged across two floors and there is a lift. The home has well-maintained and secure gardens that are accessible to service users. Silver Birches is in a rural setting near to local amenities in Liss. Fees range from £400 to £655 per week. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four and three-quarter hours were spent visiting the home, during which time the opportunity was taken to look around the home, view records and policies and to talk to the manager. The inspector also spoke privately with two members of the care staff and the cook. Most of the service users were observed making use of communal areas and their bedrooms. Service users have dementia so the inspector was only able to have very limited conversations with two people, although he was able to speak with two visitors. What the service does well: What has improved since the last inspection? Service users are better protected through more detailed Statements of Terms and Conditions, which now include details of the room to be occupied. Service users’ relatives have been given the opportunity to comment on the service through the introduction of a questionnaire. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 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 Residential Home DS0000065889.V301590.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 Residential Home DS0000065889.V301590.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has assessed the needs of its current service users well. These needs are clearly recorded and known to staff. EVIDENCE: Three service users’ files, one relating to a more recently admitted person, were inspected and needs assessments seen within these files contained a good level of detail. There was, for example, information regarding speech, hearing, eating and drinking, and a good medical history. The more recently admitted service user’s assessment indicated, for example, a specific dietary need as a result of a medical condition. The manager explained that it was usually herself together with deputy who undertook the initial assessment prior to any decision regarding admission, although it was sometimes the case that a carer would be involved to gain experience of the process. The assessments also had information regarding social preferences with one service user being said to ‘ like to be on her own’ and another ‘needing to be encouraged to join in social activities’. The inspector also saw evidence that assessments were reviewed after admission, with family members being Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 9 involved where appropriate. Staff spoken with were clearly aware of the needs assessments. The cook, for example, explained that when a new person moved in she was made aware of any particular dietary requirements. The home does not admit service users for intermediate care. Silver Birches Residential Home DS0000065889.V301590.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good care planning regime, which addresses identified personal, social and health care needs and involves families where service users may have a degree of mental infirmity. EVIDENCE: Three care plans were examined and contained information for staff to ensure that all aspects of health, personal and social care needs could be met. Plans, for example, contained separate assessments relating to moving and handling, continence and pressure areas and there was also a risk assessment relating to falls. Plans are reviewed on a regular monthly basis and the manager explained that it was usual practice to involve relatives every three months, as service users with dementia had limited ability to fully participate in the review process. Plans contained information regarding more specific needs such as chiropody and dentistry, and there were also very detailed dementia assessments. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 11 The home has a policy and procedure for dealing with medication, which would enable any capable service users to deal with their own medication although the inspector was informed that none of the current group of service users were capable of doing this. The drugs trolley, and the controlled drugs cabinet, were secure at the time of the inspection. Records relating to three service users were examined and were in order and up to date. The manager said that the home was not currently needing to deal with any controlled medication although the inspector noted that a controlled drugs register was available. Medicines requiring refrigeration were kept in a separate dedicated fridge which had a continuous readout of temperature on the front. Staff responsible for dealing with medication have been trained. Staff were observed to be providing assistance to service users in a calm and dignified manner, and knocked on doors, awaiting a response, before entering. Service users’ wishes regarding the way in which they are addressed by staff are recorded in their care plan and respected by staff. Silver Birches Residential Home DS0000065889.V301590.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 at least once during a 12 month period. 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. Service users enjoy varied lifestyles and undertake activities of their choice. Visitors to the home are encouraged. Service users enjoy attractively presented meals in congenial surroundings. EVIDENCE: Care plans clearly detail what each service user’s interests are and service users themselves were said by the manager and staff to enjoy activities such as bingo, karaoke and playing board games. The home employs an ‘Activities Organizer’ for 30 hours a week and a wide range of individually tailored activities is provided. The inspector observed the organizer interacting with three service users at the recently developed lunch club. This enabled three different service users each day to have lunch together separately from the main group. The manager said that this had proven to be very successful and the three service users observed appeared to be enjoying themselves. A church service is held every week and recent ‘one-off’ events included trips out on 7th and 10th of the month, the inspector being told that the home had recently been provided with a new minibus. On the day of the iinspection a ‘pat dog’ was in the home. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 13 The inspector spoke with two visitors to the home who were pleased with the services offered to their relative. The visitors had been welcomed and provided with tea and biscuits in the garden. Service users are able to move freely around the building and were seen to be making use of all communal areas as well as their bedrooms. Menus at the home were varied and the inspector observed an attractively presented meal being served in the dining room at lunchtime. Staff were observed to be providing assistance in a discreet and dignified way to service users who needed help with eating. The dining room was in need of a little renovation and redoration which the inspector saw taking place during the afternoon. There was a choice of two main midday meals with a further alternative being made available if need be. The cook was clearly aware of individual needs and choices, which were met, and a record was kept of these. Silver Birches Residential Home DS0000065889.V301590.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 inspected at least once during a 12 month period. 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. The home has a suitable complaints procedure, which service users’ relatives are aware of. Service users are protected through an adult protection policy and procedure known to and understood by staff. EVIDENCE: The home has a complaints policy and procedure with an appropriate timescale. A service user’s relative returning a questionnaire confirmed that she was aware of the complaints procedure but had never had to make a complaint. She also confirmed that she had access to inspection reports on the home. It was reported by the manager that the home had had no complaints to deal with in the previous 12 months. Staff when interviewed said that they would report to a more senior person if they felt that a service user appeared unhappy in any way. The home also has a policy and procedure relating to adult protection, with information produced by Hampshire Social Services being available for staff to consult. Staff have been trained in this and when interviewed confirmed their understanding of what to do in the case of suspected abuse. Both members of staff interviewed said that they would report anything they needed to. Silver Birches Residential Home DS0000065889.V301590.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 at least once during a 12 month period. 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 provides a comfortable environment, which is suitably furnished and well maintained. EVIDENCE: The tour of the building showed this to be clean and tidy throughout and there were no undue odours. Communal areas were well furnished and adequate bathroom and toilet facilities with aids were available. The decoration in some of the communal areas appeared a little worn but the inspector was informed of plans to address this and observed some redecorating being undertaken. The inspector looked into four bedrooms, which were all adequate in size, and had clearly been personalised, to considerable degrees. The manager explained that there were plans to redecorate bedrooms and to paint each bedroom door a different colour so that service users could better identify their own rooms. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 16 Service users were observed to be freely making use of communal areas, such as the lounge and other communal areas and accessed their bedrooms as they wished. The home’s laundry was inspected and was fit for purpose with machines being capable of meeting disinfection standards. Machines werer industrial in nature, fed automatically with detergent and had a sluice cycle for dealing with soiled items. Members of staff spoken with were clearly aware of good practice and there were procedures in place to deal properly with soiled items. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are appropriately trained and are employed in sufficient numbers to meet service users’ needs. Service users are protected through the soundness of the home’s recruitment practices. EVIDENCE: The inspector examined three staff files, one relating to a more recently appointed person. These contained evidence of written references being obtained following the completion of an appropriate application form and interview. There was evidence of Criminal Record Bureau (CRB) disclosures having been obtained. Staff have job descriptions and there was evidence in files of an induction period for new staff. Files contained evidence of the various short courses undertaken which included Dementia, Basic Food Hygiene, Fire Safety, Moving and Handling, and Safe Handling of Medicines The inspector discussed staff supervision with the manager and deputy who explained that this took place on an ‘as and when needed’ basis’. The inspector explained that this would need to be more structured in order that best practice recommendations be met During the inspection the inspector observed staff members interacting with service users in a friendly yet professional manner. It was explained to the Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 18 inspector, and confirmed by the rota, that there were usually four members of care staff on duty during the day. There are two members of staff on waking duty at night. Staff were observed to be attending to service users’ needs in a calm and unhurried manner, although said that they were busy at times. It is understood that from a care staffing complement of twelve persons, five have obtained a National Vocational Qualification at Level 2, three are currently doing the course and a further three people are to commence shortly. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a competent manner, the manager being supported by comprehensive policies, which are known to staff. EVIDENCE: The home’s manager has worked in the home for a number of years in a senior position and is due to start the Registered Manager’s Award shortly. Following a recommendation made at the previous inspection the home has undertaken the first of what is anticipated to be an annual review of the home’s services by way of a questionnaire to service users’ relatives. Seven questionnaires were returned and were all positive about the service offered containing phrases such as, ‘very impressed’, ‘thank all the staff’ and ‘ … communicate well by post, telephone and verbally’. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 20 The home has a clear policy regarding supporting service users, none of whom can fully deal with their own financial matters. Service users each have a relative or other representative to manage their affairs, and where the home makes small purchases for service users of needed items then clear records are kept. The home has a policy for the control of substances hazardous to health known to staff. Chemicals and other items were securely stored in locked cupboards and staff were aware of health and safety issues. The home has a health and safety policy known to staff. A sample of policies, procedures and records required by regulation were inspected and were in the main in order and up to date. A minor omission in the home’s fire book was pointed out to the manager who agreed to investigate this. Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 21 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 X 3 X 3 X X 3 Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Silver Birches Residential Home DS0000065889.V301590.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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