Inspection on 28/04/05 for The Birches Nursing Home

This inspection was carried out on 28th April 2005.

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 Nursing Home 15/02/07

The Birches Nursing Home 19/10/05

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE The Birches Nursing Home 239 Water Lane Totton Southampton SO40 3GE Lead Inspector Marilyn Lewis Unannounced 28/04/05 09:30 a.m. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Version 1.10 Page 3 SERVICE INFORMATION Name of service The Birches Address 239 Water Lane, Totton, Southampton SO40 3GE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 023 8066 7141 Harcare Ltd. Mrs Lesley Kay Head CRH 21 Category(ies) of OP 65 years and over 21 PD 18 - 65 years 4 registration, with number PD 65 years and over 21 TI 18 - 65 years 4 of places TI 65 years and over 21 Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29/11/04 Brief Description of the Service: The Birches is a care home providing accommodation and nursing care for twenty-one residents who are sixty-five years of age or over, phyically disabled, terminally ill or frail. A maximum of four residents may be accommodated at any one time who are physically disabled and terminally ill between fifty and sixty-five years of age. Accommodation is provided on two floors, with nine single bedrooms and six shared rooms. The home has a lounge and dining area and a small garden with sitting area. The top floor of the home has an office, staff training room plus a sleep over room and bathroom. The Birches opened in 1991 and is privately owned by Mr Peter Harrison and Mr Paul Harrison. The home is situated in a residential area ofTotton, Southampton and is close to all local amenities. Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours on the 28th April 2005. The inspector toured the home and spoke with five residents, two visitors, two staff members, the registered manager and the registered providers Mr Peter Harrison and Mr Paul Harrison. What the service does well: What has improved since the last inspection? Major refurbishment has been taking place at the home. The upper floor of the building has been changed from a general store area to an office, a staff training room, a sleep over room and a bathroom. The sleepover room and bathroom now provides facilities for any relative who may wish to stay the night when a resident is very ill. The refurbishment has also provided two new bedrooms with en-suite facilities and has enabled a shared room to be changed into a single room. Version 1.10 Page 6 A bathroom that was being used as a store room and not for residents use, at the last inspection has received attention and is now available to residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 5 and 6 The home provides clear information enabling prospective residents and their relatives to make a decision about daily life at the home. EVIDENCE: The home has a statement of purpose and service user guide that provides clear information for prospective residents and their relatives. The documents include the philosophy of the home, the services and facilities provided and the management structure of the home. The experience and qualifications of the registered manager and the number and qualifications of the staff are also documented. Each resident is provided with a written contract of terms and conditions for living in the home, including the actual room to be occupied. A breakdown of fees is provided and services that require additional payment such as hairdressing are listed. Version 1.10 Page 9 Prospective residents and their relatives are encouraged to visit the home before making a decision about moving in. Residents are admitted for a trial period of four weeks. The home does not provide intermediate care and therefore standard 6 is not applicable. Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, 10 and 11 Staff have a good understanding of the support required to meet the residents’ care needs throughout their life at the home, by having access to good care plans and risk assessments and the sound procedures for dealing with medicines minimise the risk of error in administration of medication. EVIDENCE: Care plans were seen for four residents. The plans contained a full needs assessment and plans for ongoing care including personal fulfilment, personal hygiene, eating and drinking, mobility and orientation. The plans contained risk assessments for all aspects of health and social activities. The registered manager said that she would be changing the format of the risk assessments to allow more information to be documented, such as which hoist was to be used, as the current risk assessment forms have limited space. Consent had been obtained from the resident or their relatives when bed rails were put in place. The home has sound procedures for dealing with medicines. Medication records seen for eleven residents had been completed appropriately and records for Version 1.10 Page 11 two residents who were prescribed controlled medicines matched the supply held. Residents are able to receive visits from GPs and other health professionals in the privacy of their own home. Staff were seen to knock on doors before entering rooms. The five residents spoken to commented on the respectful manner of staff. The home has a policy for caring for the dying that is sympathetic to the needs of the resident and their relatives and friends. The document states that relatives are to be supported to care for their loved one if they so wish and it also reminds staff that other residents will be concerned too. All new staff are required to read the document during induction. Two, of the four records seen for staff members, contained certificates for attendance at Care of the Dying training sessions. Version 1.10 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents are able to exercise control over their participation in social activities, including visits by relatives and friends and enjoy a varied selection of food that meets their needs and choices. EVIDENCE: The home does not employ an activities co-ordinator, but staff provide a programme of activities suitable for the resident group. During the inspection staff were holding a general knowledge quiz with residents in the lounge and two residents who preferred to spend time in their own room said that staff spent time chatting to them. Some residents take part in wheel chair dancing at a local centre each week. The activities programme includes videos, Bingo, discussions and chats about past events and experiences. Ministers from local churches visit monthly for Communion services and residents are able to attend local church services if they wish. The five residents spoken with said that their relatives and friends could visit at any time and two visitors agreed, saying that they were always made to feel welcome by staff. Version 1.10 Page 13 It was evident during the inspection visit that residents are able to exercise choice and control over their daily lives. Some residents preferred to spend time in their rooms and also to take their meals there, while others wished to have the company of other residents and joined with them in the quiz, taking place in the lounge. One resident commented on the caring attitude of staff who respected her wishes with regard to her faith. All residents spoken with commented on their enjoyment of the home cooked meals provided. On the day of the visit, the meal served for lunch was faggots or steak pie with potatoes and cabbage, followed by bananas and custard. Home made cakes were on the menu for tea and the cook said that supper menu had been changed to accommodate the wishes of the residents who had asked for various sandwiches or salads instead of corned beef hash. Version 1.10 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 17 The homes’ complaints documents require improvement to include information that states the Commission can be contacted at any time during the process and to provide a clear record of all complaints received. EVIDENCE: The homes’ complaints procedure does not indicate that a complaint can be made to the Commission at any time but states that the Commission can be contacted if the complainant is unhappy with the outcome at the home. Although the home takes all complaints seriously, complaints are documented in a manner that makes it difficult to do an audit of issues that have been raised. The registered manager said that she would produce a clear log record for complaints. The registered manager said that all the residents were on the electoral role and had received postal voting papers for the forthcoming elections. Version 1.10 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 standard(s) 19, 21, 22, 23 24 and 26 The home provides a clean, comfortable homely environment that is furnished and equipped to meet the needs of the residents and all those working and visiting there. EVIDENCE: The refurbishment of the upper and first floor of the home has almost been completed, providing an improved office area, a much needed staff room that can also be used for training, a bedroom and bathroom facilities. Two new bedrooms have been provided on the first floor and a shared room has been changed into a single room. The registered providers said that the refurbishment programme will continue to extend the dining area and lounge and to redecorate and renew carpet in some rooms and corridors on the ground floor. Residents have been involved in the choosing of colours and carpets for the home. The providers said that every effort had been made to minimise the noise and inconvenience to the Version 1.10 Page 16 residents and a resident whose room was in the area on the first floor where new rooms had been provided said that he had not been unduly disturbed. Residents’ bedrooms looked clean and homely and contained many personal items. Some of the toilet facilities in shared rooms are screened off with a curtain. The resident manager said that this allowed easy access when a hoist was required due to the resident’s poor mobility. The registered manager said that all prospective residents were made aware of the toilet facilities in rooms they may occupy. One of the two bathrooms was not available to be used by residents at the time of the last inspection. Improvements have been made to the bathroom and it is now suitable for use. There are plans to build a shower room and this will be followed up at the next inspection. A resident commented on being admitted to a shared room but offered the choice of moving to a single room as soon as one became available. Specialist equipment such as hoists, pressure relieving mattresses and stand aids are provided for those residents assessed as requiring them. Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The home has a stable workforce and staff are provided with training opportunities resulting in high staff morale and a caring team able to support and meet the needs of the residents. EVIDENCE: The home employs a registered manager, six trained nurses, seventeen carers and separate staff for catering, laundry and domestic duties. The staff rota Indicates who has actually worked each shift. The registered manager said that staffing levels are increased as required with regard given to the number and dependency needs of the residents. Records seen for four staff members included three of the most recently employed. Records contained all the information required including proof of identity, written references and Criminal Records Bureau checks. The registered manager is enthusiastic about staff training and provides staff with opportunities to attend training sessions both in house and external. Two staff members spoken to said that they were encouraged and supported to attend training sessions and obtain qualifications. Version 1.10 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 38 The registered manager provides strong leadership, support and encouragement to staff, residents and visitors, which appears to promote and protect the residents health, safety and welfare. EVIDENCE: The registered manager is a trained nurse who holds a BSc degree and the Registered Managers Award. Mrs Head has been employed at the home since 1993, taking over as manager in 1999. Two staff members spoke of the support and encouragement they received from the registered manager. Residents and visitors also commented on Mrs Head’s caring and supportive manner. Staff meetings are held on a six monthly basis at present but the registered manager said that this was being changed to two monthly. Mrs head said that Version 1.10 Page 19 a trial period to decide on a team leader system, to promote leadership skills was underway, with all carers given the opportunity to take the position. All staff had received training in moving and handling and infection control. On the day of the inspection, the kitchen looked clean and in good order, with food stored appropriately. Cleaning substances were stored securely. Fire records indicated that all staff except two staff members who worked occasional bank shifts had received fire safety training and fire drill practice. The registered manager said that fire drills would take place when the two bank staff next worked. Records will be checked again at the next inspection. Version 1.10 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 3 3 3 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 Standard No 16 17 18 Score 2 3 x 3 3 x x x x x 3 Version 1.10 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP16 Regulation 22 Requirement The registered person must ensure that a record is maintained for all complaints and that the procedures indicate the Commission can be contacted at any time in the process. Timescale for action 31/05/05 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 Good Practice Recommendations Version 1.10 Page 22 Commission for Social Care Inspection The Birches Nursing Home 239 Water Lane Totton Southampton SO40 3GE 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 Version 1.10 Page 23 - 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. 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