Care Home: Birchwood Bungalow

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What the care home does well All seven residents appeared well cared for. A relative commented, "My [name] is always clean and well dressed every time I see them. I have no complaints. All the staff are very friendly and helpful." Staff know their roles and responsibilities. The staffing level is very well maintained and this benefits all residents in the home. The members of staff present during the visit interacted well with the residents in their care and were readily available to assist them. In a recent questionnaire survey by us, all the residents gave positive feedback about the care and service provided. There were no additional written comments included on the surveys. What has improved since the last inspection? All Statutory Requirements have been met since the last key inspection. The home manager, appointed since the last inspection, has worked hard to raise the standards of care and service in the home. A deputy manager has been appointed. He has been in post three months.There has been extensive redecoration of the communal areas and bedrooms, which benefits the people who use the service. A ramp has been erected in the car parking area at the entrance to the kitchen/diner and the doorway has been widened to give easy access to wheelchairs. What the care home could do better: The home manager is currently applying to be registered with us. The manager said that further building work is starting on the 12th May 2008 and includes the construction of a ramp to the front entrance to the building, next to the existing ramp leading to the kitchen/diner. The door that leads to the kitchen from the car park is to be re-hung to ensure easy access for wheelchairs. Consideration should be given to see if a recliner chair may be more suitable for a named resident who prefers to sit in their own wheelchair rather than an armchair. The wheelchair has been replaced with a non-tilt one following a risk assessment. The manager has agreed to make a referral to the funding authority to review this situation as soon as possible. CARE HOME ADULTS 18-65 Birchwood Bungalow The Bridle Path, Off How Wood Park Street St. Albans Hertfordshire AL2 2QZ Lead Inspector Yoke-Lan Jackson Unannounced Inspection 28th April 2008 10:30 Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 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 Birchwood Bungalow DS0000019294.V363212.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 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. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birchwood Bungalow Address The Bridle Path, Off How Wood Park Street St. Albans Hertfordshire AL2 2QZ 01727 874776 01727 874776 FP 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) Milbury Care Services Ltd. Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th April 2007 Brief Description of the Service: Birchwood Bungalow is provided by Milbury Care Services Ltd. It is a residential care home for 7 people with learning disability. It is situated in How Wood, a short walking distance away from the local shops. The town of St Albans is a short car journey from the home. There are parking spaces in front of the building. The home has two minibuses, which provide transport for the people who live in the home. The property is an extended chalet style detached bungalow situated next to woodlands and off a bridle path. There are 7 bedrooms, each of single occupancy. Each bedroom has a hand basin. The bathroom and toilet facilities are nearby. The surrounding ground is extensive with a back garden that is attractively designed and equipped with garden furniture. The garden is wheelchair accessible. The home charges £1,292.85 to £3346.98 per week. Information about the home and the service it offers is contained in the Statement of Purpose and Service Users Guide. A copy of these and the most recent CSCI inspection report are available in the home. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use the service experience good quality outcomes. The unannounced inspection was carried out on 28/04/08. The home manager was present. The home has 7 residents. The inspection included a tour of the premises. Time was spent observing how the staff interacted with the residents. Staff, residents and a visitor were spoken with and key documents were examined. Information received by us (The Commission for Social Care Inspection) since the last inspection was reviewed. This included the written survey questionnaires and the Annual Quality and Assurance Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how the outcomes are being met for people using the service. What the service does well: What has improved since the last inspection? All Statutory Requirements have been met since the last key inspection. The home manager, appointed since the last inspection, has worked hard to raise the standards of care and service in the home. A deputy manager has been appointed. He has been in post three months. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 6 There has been extensive redecoration of the communal areas and bedrooms, which benefits the people who use the service. A ramp has been erected in the car parking area at the entrance to the kitchen/diner and the doorway has been widened to give easy access to wheelchairs. 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 summary of this inspection report can be made available in other formats on request. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 7 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 Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients can be assured that a pre-admission assessment will be completed before they are admitted to ensure that the home can meet all their care needs. EVIDENCE: The home has not had an admission since the last inspection but the home manager said that the management team would carry out a thorough assessment of care needs before a client is admitted. The pre-admission documents of existing clients were seen in the care plan folder. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will have written care plans so that staff are able to identify goals and care needs appropriately. This gives the people an opportunity to make everyday choices with staff respecting their preferences and requests enabling them to achieve independent lifestyles. EVIDENCE: Residents are supported to make decisions about their lives with assistance when needed. On the day of the site visit, members of staff were observed to interact well with the residents who seemed happy and content. Some residents had gone out for the morning but returned in time for lunch. Each resident has a care plan. Risk assessments and changing needs were reflected in the care plans examined. The manager said that all care plans are currently being revised to include a more comprehensive and person-centred format. Residents’ care needs are reviewed monthly and there is an annual Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 10 review of care needs that involve the resident, their relatives, the social worker and other healthcare professionals. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect that their rights will be respected and that they will be encouraged to maintain contact with their friends and family and to lead an independent lifestyle and engage in communal activities. A healthy diet is promoted which meets their needs and expectations. EVIDENCE: The daily routine promotes independence and individual choice. The activity programme is planned to suit individual needs and interests. Residents are encouraged to participate in activities of their choice, and to make use of local leisure facilities. Some residents attend the local day centre. Members of staff assist each day with the transportation, which is provided by the home. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 12 Members of staff were busy on the day of this visit escorting residents for outdoor activities. Some residents had a trip out after breakfast in the minibus driven by the home manager as the driver is currently on annual leave. A parent brought presents for a resident who was celebrating their birthday during this visit. Two members of staff later escorted the resident to London for shopping and a sight seeing tour. The home offers residents a nutritious and balanced diet. There were bowls of fresh fruit on the dining room table for the residents to help themselves. On the day of the visit, a resident was seen enjoying a plate of fruits before lunchtime. A member of staff was assisting the resident. Residents have a menu to choose from and the menu is in picture format. Each member of staff takes turns to cook the meals. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are treated with dignity and receive personal care and support in the way they prefer and require, including a full range of healthcare facilities. They can be assured that their medicines will be administered safely since they are not able to administer the medicines themselves. EVIDENCE: Staff have a good working knowledge of the residents’ conditions, and their likes and dislikes, and deliver care and support in the way residents prefer and require. Most of the residents are not able to communicate verbally but all the staff understand their gestures and assist them accordingly. Residents were seen during the visit to be treated with respect. A trained member of staff administers the medication in accordance with the home’s medication policy and procedures for the receiving, recording, storage, handling and administration of medicines. Since the last inspection there have been no medication errors. The manager audits medication regularly. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 14 There are no controlled drugs in use at the present time. The Medication Administration Record charts seen were accurately recorded. The home has the support of health care professionals such as the General Practitioner and the Community Learning Disability Teams and behavioural concerns are referred to them for immediate assessment. The support plans regarding their physical and emotional healthcare are assessed regularly. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will be listened to and that they will be protected from self-harm and abuse. EVIDENCE: The home has not received any complaints since the last inspection. The manager said that all members of staff recently had training on issues regarding abuse and safeguarding adults (the protection of vulnerable adults) as well as the Whistle-blowing policy. The manager ensures that all staff are aware of the joint agency Safeguarding Adults (Adult Protection) procedures of Hertfordshire County Council Adult Care Services. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 24, 25, 26, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the provider is working towards making the service more homely, safe and comfortable to live in. EVIDENCE: Since the last inspection, window restrictors have been installed in two of the bedrooms to ensure people are kept safe from accidental falls. There is new kitchen flooring which improves the homeliness of the service for the benefit of the people who live there. The entrance door from the kitchen/diner to the front car park has been widened with a ramp for wheelchairs. The manager said that the workman will re-hang the same entrance door to make it more accessible for wheelchairs and a second ramp will be made for the front entrance in May 2008. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 17 Some communal areas and the office have been redecorated as well as some of the bedrooms, which have personal items on display to suit individual tastes. On the day of the site visit, a member of staff and the decorator were helping the residents to decide on the colour scheme for their bedrooms, which are due to be redecorated in May 2008. The surrounding grounds and the back garden are well maintained. The front gate is fixed with an electronic alarm system so that staff can ensure safety for residents since the car parking area is in the front of the building. Residents have access to the surrounding grounds. On the day of the inspection, a worker from the Wheelchair service was in the home showing a member of staff how to fix additional support to a non-tilt wheelchair. The resident (from choice) often sits in the wheelchair rather than the armchair. A risk assessment has been done to ensure the resident’s safety. However, a reclining chair may be more suitable (and comfortable) for this resident. The manager has agreed to make a referral to the funding authority to review this situation as soon as possible. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home has an effective staff team who will support them and can be confident that they are safeguarded by the home’s robust recruitment policy and procedures. EVIDENCE: On the day of the site visit, the staffing level was well maintained. A new member of staff was given time to work on the computer using learning aids called ‘EL-Box.’ The member of staff said that induction training included a period of shadowing trained staff. Mandatory training includes Moving and Handling, Fire Safety, First Aid and Food and Hygiene. Security checks were carried out and work only commenced after the Criminal Bureau Record checks were completed and clearance was confirmed. Each member of staff has an annual appraisal and a monthly supervision. The staff files examined included training certificates, supervision notes and a cover note with the reference number of CRB certificate. All recruitment records are kept at the head office. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 19 There is an annual training programme, including refresher courses on medication, mental health and other medical conditions. Since the last inspection, all staff have had training on Equality and Diversity and Safeguarding Procedures. Six members of staff have completed their training on learning disability and related issues. Two members of staff have completed NVQ2 and one has NVQ3. The home has appointed a deputy manager as well as two part-time senior support workers. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the care and service provided will continue to improve under the new management. They can be assured that their health and safety are promoted and protected. EVIDENCE: The standards of administration and management of the service have improved under the new manager. She is currently working towards NVQ4 Registered Management Award in Care and Management. She has now applied for registration with the Commission. All records for the protection of the residents are kept secure and handled in accordance with the Data protection Act 1998. The servicing records have been well maintained to provide an accurate audit. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 21 The service has an annual quality assurance survey by the provider and this includes written questionnaire feedback from residents (in picture format), relatives and others. There is a monthly proprietor’s report in compliance with regulations. The audit documents were readily available for inspection. The Annual Quality Assurance Assessment (AQAA) forms issued by the Commission were received on time for this inspection. The information provided was included in this report. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 22 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 x Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA29 YA24 Good Practice Recommendations It is recommended that a suitable recliner chair, subject to an occupational therapist assessment, be made available for a resident if required. Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Birchwood Bungalow DS0000019294.V363212.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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