Inspection on 02/02/06 for The Birches

This inspection was carried out on 2nd February 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

The Birches 17/05/07

The Birches 15/11/05

The Birches 27/09/04

The Birches 26/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 The Birches Grammar School Road Brigg North Lincolnshire DN20 8BB Lead Inspector George Skinn Unannounced Inspection 2nd February 2006 09:30 The Birches DS0000002811.V262176.R01.S.doc Version 5.1 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 The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Birches Address Grammar School Road Brigg North Lincolnshire DN20 8BB 01652 652348 01652 653803 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) HICA Miss Michelle Lawes Care Home 31 Category(ies) of Learning disability (31), Learning disability over registration, with number 65 years of age (31) of places The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: The Birches is purpose-built accommodation situated in the town of Brigg. It provides personal care and accommodation for up to 31 adults with a learning disability in both categories of younger people and over 65 years. The home is owned by HICA Specialised Care Homes. The accommodation is provided in three eight-bedded bungalows, one fourbedded bungalow and two self-contained flats. Each bungalow has its own bathroom, shower room, toilets and living/kitchen area providing domestic facilities and equipment. All bedrooms are single rooms and all but two have en-suite facilities. The bedrooms without en-suite have a hand washbasin provided. A central core building contains offices, main kitchen, central laundry, meeting room, sensory environment and a lounge. There is a large garden area with well-tended lawns and parking to the front of the building. The home has its own mini bus. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over 3 hours, the majority of the time was spent talking to the residents and looking at a sample of their care programs. All those Minimum Standards assessed were met. What the service does well: 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. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Residents are helped to make decisions concerning their lives. EVIDENCE: Residents are provided with information, assistance and support to make decisions about their lives and this was documented in care plans. there was evidence in care plans that residents attended their own reviews. Where residents need help to make decisions, staff are able to demonstrate why these decisions have been made and explain the reasons. Limitations on choice are only made in the resident’s best interests; where possible they are encouraged to maintain their own finances. The key worker system and residents meetings enabled everyone to be involved in wider decision making within the home. During the inspection the majority of resident had gone to day services, however those who were still at home were offered choices of when to get and of what to eat. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Residents are enabled to take part in age, peer and culturally appropriate activities. EVIDENCE: Local day centres and adult education centres are accessed by the residents and staff where needed support residents with their finances and benefits. The home welcomes visitors at all reasonable times and friends and relatives are encouraged to maintain contact with the residents. The maintenance of family links is detailed in the homes’ Statement of Purpose and specific arrangements are identified within individual care plans. Residents confirmed that they have visitors whenever they wanted and could see them in private. The resident said that they were able to phone home in private and that they were supported to make home visits. The home showed it was supportive to residents who had intimate personal relationships, and has a sexuality policy for the staff to refer to if required. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 10 Carers meetings are held on a regular basis, giving relatives the opportunity to have their say about the running of the home. Observation indicated that residents were able to make choices in all aspects of their daily lives with daily entries in care plans evidencing individual choice and agreement. Residents rights and choice is promoted through staff induction and training and their preferred form of address is documented in care plans, interaction between the care staff and resident was seen to be relaxed, informal and friendly. Each bedroom is fitted with a suitable locking device and residents are provided with a key unless the risk assessment indicates to the contrary. The agreed responsibilities for household tasks was documented in the resident guide and individually in care plans. Staff confirmed that residents open their own mail with support from them if needed. The home’s admission agreement gave the rules on smoking, drugs and alcohol and there was also a smoking and alcohol policy. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Residents have choice in the way they are supported. EVIDENCE: The maintenance of resident’s privacy and dignity forms part of the staff induction programme. Medical examinations and treatment are conducted in the privacy of the resident’s own room. All residents had a key worker identified in their care file; these also included mobility plans and manual handling risk assessments identifying how they are guided or transferred. Care plans clearly identify the support residents require in completing personal care. It was observed that resident’s dress was individual, age, occasion and climate appropriate. Residents had been provided with appropriate aids and adaptations this was evidenced in care plans with additional specialist support being accessed where necessary. Resident’s health care needs are met and staff ensure they have access to health care services to meet their assessed needs. Resident’s case files The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 12 confirmed that they are enabled to access specialist-nursing services, dental, chiropody and ophthalmology. A record of health screening and visits to and from health care professionals was kept in each care file. Residents who could not access the GP on their own were supported to do so by staff. Residents could see visiting health professionals in their own bedroom. There is a detailed medication policy in the home about the handling of medication. Records of medication received into the home are well maintained along with their administration and disposal. Residents aiming for greater independence are enabled to self medicate as appropriate and a lockable space would be provided. Those residents whom wish to self medicate would be enabled in this process, subject to an assessment and agreement, however, none of the current residents do self medicate. Senior staff that have been trained and assessed as competent administer medication in the home and sample signatures are retained. The health of residents on medication is monitored and recorded in case files regular medication reviews takes place with the GP. The organisation has developed a medication-training package, which will extend to a formal assessment process based on competency and understanding. Those staff designated to administer medication have undergone accredited training. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Residents live in a home, which is clean and tidy. EVIDENCE: The premises were clean and hygienic with systems in place to reduce the risk of odours. It is the organisation policy that where minor odours are identified as a problem that cannot be rectified by cleaning then new carpets are purchased. Policies and procedures for the control of infection are in place along with the provision of protective clothing. The location of laundry facility is suitable and ensures that dirty laundry is not carried through food storage, preparation or dinning areas. The laundry is fitted with industrial washers and driers and there are separate hand washing facilities. The covering on the laundry room floor is impermeable and easily cleaned. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Resident’s benefit from a well trained staff group. EVIDENCE: HICA has a detailed induction programme which incorporates all mandatory training; inspection of staff files confirmed that this had been undertaken. The company has a thorough training programme, which equips staff for their role and ensures they are able to meet the changing needs of residents. Along with mandatory training a variety of other training can be accessed e.g. challenging behaviour, care of the dying, epilepsy and diabetes. The company has been in negotiations regarding induction and foundation training to ensure that it meets TOPPS standards and have received their endorsement. Those staff spoken with during the inspection were knowledgeable about their role and the varying aspects of caring. Staff told the inspector that the organisations learning disability training does cover some of the Disability Discrimination Act. Further training called diversity, equality and rights has been developed which goes into further details. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 Residents’ views underpin all the homes self-monitoring and development. EVIDENCE: The manager has worked with people with a learning disability since 1982 in both the statutory and independent sectors and has extensive experience of working with people who exhibit behaviours that are a risk to themselves and others. She was a registered nurse for people with a learning disability and has a BA(Hons) in Managing Health and Social Care. She is also an NVQ assessor and practice teacher for social work students. The home has not got 50 of the care staff trained to NVQ level 2 but should achieve this in the very near future. The company have developed a quality assurance system which fully involves the service users and their relatives. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 17 A report is published which outlines the home goals and objectives and the result of any surveys undertaken this is available to all interested parties. This was very detailed with a summary of each of the areas measured and details of what action has been taken to meet any sort falls. The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x LIFESTYLES Standard No Score 11 x 12 4 13 x 14 x 15 3 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x x x The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 19 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. 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 The Birches DS0000002811.V262176.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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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