Care Home: Birchwood Court Residential Care Home

What has improved since the last inspection? There is now an experienced activities co-ordinator at the home who has helped to improve the lifestyle opportunities for people living at the home. What the care home could do better: The manager should complete the review and transfer of care planning records to the new system. The manager should improve the way that medication that is carried forward from one prescription period to another is recorded to make it easier to check. Menus should be available at each mealtime so that people can male choices about the meals they would prefer. The planned redecoration of the home should continue to take place. Risk assessments which reduce the risks to people who use bedrails should be updated in line with best practice and current Department of Health Guidance. Key inspection report CARE HOMES FOR OLDER PEOPLE Birchwood Court Residential Care Home Seaside Lane Easington Colliery Peterlee County Durham SR8 3XZ Lead Inspector Steve Tuck Key Unannounced Inspection 1st May 2009 10:30 DS0000071053.V375256.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birchwood Court Residential Care Home Address Seaside Lane Easington Colliery Peterlee County Durham SR8 3XZ 0207 0343220 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.europeancare.co.uk European Care (England) Ltd Ms Jean Stephens Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, Code OP - maximum number of places 43 The maximum number of service users who can be accommodated is: 43 2nd May 2008 2. Date of last inspection Brief Description of the Service: This purpose built home is in a residential community away from the main road. It is in a quiet location with no through traffic. There are shops and other community facilities. Birchwood court provides care, including nursing care, to older people over the age of 65 years. It is owned by European Care and is situated on the same site as Ashwood Park, which is another residential home owned by the same company. There is level entry to the ground floor and the upper floor has passenger lift access. There are lounge/dining areas on each floor and communal areas and bathrooms are placed around each floor to make access easier. All bedrooms provide single room accommodation each with its own bathroom facilities. Outside, the home is well-kept, providing visitor parking spaces and access to colourful gardens with seating areas. The Statement of Purpose and Service User Guide is available in the home. The Guide also includes information about how peoples’ rights will be respected regardless of age, gender, sexual orientation, race and religion. At the time of this inspection fees charged ranged from £434.50 to £614.25 per week. The costs of newspapers, hairdressing, and toiletries are not included in the fees. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 5 Fees vary depending on people’s circumstances, further details can be found in the homes Service User Guide. Payments for nursing care is set nationally and is added to the fee rate. Fees for private chiropody and hairdressing are in addition the these charges. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The home has been registered with the Commission to provide nursing care in September 2008. This is the first inspection since that date and was carried out to assess how well the staff and manager support all of the needs of people who live at the home. Before the visit We looked at: Information we have received since the last Key Inspection. How the service dealt with any complaints & concerns since then. Any changes to how the home is run. The provider’s view of how well they care for people. We asked them to examine their own service and write to us with the results. The Visit An unannounced visit was made on 1st March 2009. During the visit we: Talked with the people who use the service the staff, the manager and visitors to the home. Observed life in the home. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. Checked on what improvements had been made since the last visit. We told the manager what we had found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. The quality rating for this service is 3 Stars. This means the people who use this service experience Excellent quality outcomes. What the service does well: Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 7 The home has a friendly atmosphere and the staff who work there are open and welcoming. The people who live their and their relatives or visitors feel comfortable supported and are put at ease. A relative of a person who lives at the home said, “My mother lived in another home before we found this one and we are much happier here.” People who move to the home have their needs assessed by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important as people often have complicated needs that require well managed and agreed ways of supporting them. Nursing and personal care is provided to people with a wide range of needs with varied expectations and backgrounds. This diversity is reflected in the staff team, giving the manager the opportunity to recruit staff from the same background as the people living in the home. This match helps staff to understand people’s needs and people who use the service are more reassured that they get support from staff who understand them. Both care practice and staff recruitment practices are governed by equal opportunity principles. There are always fully trained nurses available to meet peoples nursing care needs. As well as this there are enough well trained care staff employed at the home to make sure that peoples needs can be properly met and the way that staff are recruited makes sure that they are suitable for working with vulnerable people. The home has a qualified and experienced manager and senior managers who show that they are have the commitment to invest time, skill and finances in the home to produce good outcomes for the people who live there. They have the confidence of the staff who work well with them. The manager talks to visitors, relatives and people living at the home to make sure that they are happy with the service they receive and people are asked for their views so that changes and improvements can be made if these are required. The home is visited by senior managers who check that the manager and staff are working well and following the organisations way of working. The staff have formed good relationships with the people living at the home and make sure their rights to privacy and dignity are met. The residents were complimentary about all aspects of the service. Comments from people who live at the home included, “They have a good sense of humour”, “I am able to keep myself to myself but know I can get help when I need it”, Visitors are made welcome and there are good links with the local community. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 8 People living at the home and their relatives said that they would be able to use the complaints procedure if they had a grievance and they have shown that effective working with the Police or local council can safeguard people from abuse. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 9 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 Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 3 and 6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Trained staff from the home find out and understand the needs of people who wish to live there before they move in. This information helps to make sure that peoples needs can be met at the home and agree the ways in which staff are to support them EVIDENCE: By looking at the record kept at the home we could see that each persons needs are assessed before they move to the home, either by health services staff local authority social workers and the manager. This is so that the manager has a good understanding of peoples’ health and social care needs and can be sure that the home is going to be suitable for people who are going Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 11 to live there. Where possible the person themselves or their representative is involved in the assessment process. The manager also finds out what cultural and lifestyle needs people have to make sure that these can be met. The manager and senior nursing staff have also had training which has given them the skills to find out what peoples needs are. As a result of these measures, all of the people living at the home at present have been properly placed and the home is able to meet their needs. One relative said, “They were very professional from the start but also friendly. I could see that they were finding out information about my husband which they used when they talk to him. Its like they’ve known him for years.” There is good information about the home in the Statement of Purpose and a Service User Guide is available for people and their relatives who live or are interested in moving there. The Service User Guide has information in it about what it is like to live at the home, how people can be supported, what the accommodation is like, how to make a complaint and a copy of the recent inspection report. This is available in the home and relatives said that they were given information which told them all about the home before their relative moved in. The Guide also includes information about how residents’ rights will be respected regardless of age, gender, sexual orientation, race and religion. The information is in a style to make it easier for people to understand and the manager said that it can be translated into any language or format that people require. There is clear information about the terms and conditions and fee rates. The home does not provide intermediate care for people who require specific rehabilitation after an injury or illness. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care and health needs are well supported at this home and the way that staff give out medication makes sure that they get the treatment that has been prescribed. And every person has a plan of their care which shows in detail how their nursing and care needs will be met and gives the practice guidance that staff need; people get excellent support at the end of their lives. EVIDENCE: All people living at the home have a detailed plan of care, which gives a thorough description of how their physical, emotional and lifestyle needs are to be met. Staff know how each person is to be supported and how they prefer their care to be given. Staff have a good understanding of peoples histories, needs and preferences which they need to support people. They also work closely with other community-based health and social support staff to make sure that peoples wider needs are supported by fully co-ordinated care. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 13 For example there are regular visits from GP’s and other health professionals including, dentists, opticians and chiropody services. The way that care plans are written down shows that how they are to be supported and there are examples of where a great deal of thought consideration and care has gone into this planning. For example how the home supports end of life care and how family and partner relationships are supported. Care plans are regularly reviewed and updated according to changes in social, personal and health care needs. For example those people who have reduced appetite or low weights are regularly weighed and treatment advice sought from dieticians. Their recommendations are acted upon and care plans are updated. There are records which show the measures in place which help prevent pressure damage, wound care, moving and assisting, catheter care, continence promotion, nutrition and mental health condition which are completed, reviewed and updated monthly. Up to date information regarding changes in wound care is documented on a regular basis and regular reviews take place with residents’, their relatives and care managers to make sure the home is still meeting their needs. There are appropriate pressure relieving devices available to support the staff and residents. Due to their levels of need, most people living at the home need support to administer their own medicines, and designated staff therefore help in this area. The home has detailed instructions which gives staff direction about how they are to administer medication. Medicine is securely stored in a locked purpose made cupboard and records are in place for all medicines received, administered and disposed of. A check of medicines kept at the home showed no discrepancies although it difficult for staff to check where spare medicines have been added to with new prescriptions. There is a register of staff who are authorised to administer medication. People living at the home are treated with respect by staff who know them well. Examples include locking their bedroom doors, receiving their mail, being addressed by their preferred name and being able to go wherever they wish inside and where possible, outside of the home. Relationships between people and with staff are relaxed, friendly and informal which helps them to feel comfortable. People appeared to be relaxed and happy with the support they get from staff. Nursing and care staff meet at the start of each shift where they talk to each other about peoples needs so that they remain up to date, work well as a team and remain consistent. One person who lives at the home said, “You could not complain about how attentive the staff are. They have really motivated me and I feel I have been very well supported.” Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 14 People who live at this home have excellent support when they are at the end of their lives. Peoples care plans record their wishes about dying (if they want to say) and the arrangements they want after death. The families, Palliative care specialist nurses and consultants are also involved in their support. Care and nursing staff have been trained to follow care pathways for end of life care to make sure that peoples dignity, comfort and choice is promoted. Staff have also received training in use of specialist pain control and information about pain control is available. The Medication Administration Records and Controlled Drug records show that staff make sure that pain relief is given when people need it. So that effective end of life care can take place, the homes nursing staff work closely with General Practitioners and Consultants who make decisions about how peoples treatment is to take place. All of the staff are caring, supportive and sensitive to the needs of both the residents and their families at a very difficult time. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are encouraged and supported by the staff to lead fulfilling lives with their rights as individuals being respected and to eat healthily which supports their physical and emotional wellbeing. Contact with family members and friends are supported where possible so that people keep up links with those outside the home. EVIDENCE: The home has an activity person who organises events both inside and outside of the home. The staff also help people who live at the home with social and recreational activities. Activities are displayed in the hallways of the home. The activity person keeps records of all events that people have taken part in. Care plans contain information about people so that staff can make sure their likes and dislikes are known. On the day of the inspection people enjoyed, visits from relatives, visits to a nearby shopping centre and watching films on television. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 16 People living at the home and their relatives said that there was always something going on to keep them entertained. There are photographs on display, which show events that have taken place throughout the year. Examples of activities include, The mobile library visits regularly, There is a day centre at a nearby home on the same site which people can attend if they wish, Race Nights, Film Nights, Bingo, Entertainers, An Easter Bonnets Competition, A performance by a local Dance School, Chair based exercises. One person said they liked to be on their own and did not join in any events and they staff respected these wishes. People living at the home are encouraged to be in control of their lives as far as possible. For example, people are encouraged and supported to regularly visit the relatives and friends so that they are able to keep their social links and contacts with life outside of the home. Several people had visitors throughout the inspection. Staff spent time with them and shared information about their relative if necessary. Information about advocacy is available for anyone who needs impartial support and people at the home and their relatives again said that they were confident that the manager would sort problems out if they had any. All of the people living at the home are encouraged to bring items and keepsakes with them to making their own bedrooms homely and personalised. There are dining rooms on both floors, both are pleasantly decorated and furnished. The dining tables were attractively set with cutlery, crockery, napkins and condiments. People living at the home are encouraged to make choices about their diet. Most people said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen asking people about their choice of meal, size of portion to make sure that they always had their choice of meal. Comments from some of the people living at the home were, “I usually like the meals but if I don’t I know they will cook something else for me.” Staff are available during meals to offer support and assistance where needed and this makes meal times a relaxed and unhurried experience. The cook has a Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 17 good knowledge of peoples preferences and makes sure that the only good quality ingredients are used to prepare meals. Menus are usually available which detail the variety of meals available which give people a balanced diet and refreshments are available throughout the day and night. But on the day we visited the menus are not available so that people couldn’t read them in advance or at the time of their meal which would have helped them to make choices about their meal. Where people need it food supplements are available to help people to maintain their health for example if people have diabetes or have difficulty maintaining their weight. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people from being harmed which helps to promote their safety and security. EVIDENCE: There is a clear complaints procedure in place at the home, which tells people how to complain, and the length of time a response will take. Observations of the staff’s day-to-day practices show that they ask for the views of people living at the home all of the time and help people to make real choices and decisions. People who live at this home assert their views and preferences and were clearly empowered to say what they thought. There is a record kept at the home of all complaints, which includes details of any investigation and the outcome. No one has approached the Care Quality Commission (CQC) or its predecessor the Commission for Social Care Inspection (CSCI) because they have been unhappy with the way that the home has managed their complaint. One person living at the home said, “If I want anything done because I am unhappy I just go the manager, I know she will sort it out.” Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 19 A relative said, “Jean (the manager) is very approachable and easy to talk to if you have a complaint.” The homes has an adult protection procedure which is robust and complies with the Public Disclosure Act and the Department of Health Guidance. In the last 12 months, there have been no instances where staff and the manager have needed to taken direct steps to protect a person who they has suspected had been abused. There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed and all staff spoken to are knowledgeable and vigilant. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, clean and comfortable environment, which promotes their privacy, independence and comfort during their stay at the home. The home is clean, pleasant and hygienic which supports the health and lifestyles of people living there. EVIDENCE: All communal areas and some of the bedrooms were viewed during the inspection. The home has had recent repairs and the manager confirmed that there is ongoing maintenance and redecoration taking place in response to residents’ requests. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 21 The home has been designed so that all the people who live there can have safe access to the areas where they live. Everyone is able to lock their bedroom doors so that they can have privacy and there are areas where people can meet and talk in private. There are garden areas which are accessible to everyone and popular when the weather is good. The bedrooms are pleasant areas, which have a useful range of comfortable furniture and fittings. Most people have decorated their rooms with their items, photographs and keepsake’s. There are enough toilet and bathrooms available, all of which have been designed to help people who have mobility needs to use them. The home is kept clean by staff who take effective steps make sure that there are no unpleasant smells. There are laundry facilities are in place to make sure that that peoples clothing and linen is hygienically cleaned and the risks of passing on any infections is reduced. Arrangements are in place to make sure that clean clothing is always returned to their owner and mistakes are avoided. The home is inspected by the Fire Prevention Authority, the local council and the Health and Safety Executive (HSE) to make sure that the building and safety systems are suitable for the protection of those who live and work there. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff working at the home to meet the needs of the number of people who presently live there and most staff have been trained to make sure that their care and nursing practice is good. EVIDENCE: The manager has organised the home so that overall there are sufficient staff available to meet the needs of the people who currently live there. Nursing and care staff support each other and their manager both in their practice and also in their willingness to remain flexible about their working hours so that people who live at the home will benefit. Staff show that they know a great deal about the needs of the people who live at the home and can describe these in detail; they get on well together and with people who live at the home and promote an inclusive and supportive structure at the home. Staff work in teams and they have structured ways of working so that people get consistent support. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 23 Staff spend time with people who live at the home, listening to their opinions and experiences and taking part in discussions and laughing together which creates a happy atmosphere at the home. Staff turnover at the home is low which gives people who live there and staff the opportunity to get to know each other. For example some of the staff have worked at the home for over 10 years. One person living at the home said, “The staff work very hard to keep us entertained.” Another said, “They have to work hard to help people who can’t do things for themselves but they always have time to talk to me.” There are qualified nurses at the home who have taken further training to update, improve and review their skills. As well as this almost all of the care staff team have now achieved National Vocational Qualification awards in care at level 2 or above. The remaining staff are either working towards either Level 2 or higher levels. There is a plan in place which describes the training which staff are to undertake based on the needs of the home and their personal training requirements. Records showed that all staff have received fire, food hygiene, infection control, moving and assisting and COSSH training. The manager makes deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links, which helps to ensure that people are confident with the way in which they are supported. Examination of files for staff newly appointed in the home confirm that rigorous checks are carried out before they are employed to work in there. This includes receiving appropriate references and completing the necessary criminal record check to make sure that staff are suitable to work with people who are vulnerable. Staff files contain employment history, records of training and any training certificates. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 24 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32,33,35 and 38 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, organised and efficient; and people are asked for their views about the quality of the care they receive. All of which gives people who use this agency the confidence that they will continue to have their needs met by staff who support their best interests. EVIDENCE: The registered manager has worked at the home for 10 years and has been the manager for the last six years. She has completed a Registered Managers Award (RMA) and a National Vocational Qualification (NVQ) at level 4 in Care. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 25 She is a qualified in Dementia Mapping and has overall management responsibility for the home. There is also a Level 1 Qualified Nurse Manager at the home who oversees and makes clinical decisions about the nursing practices which take place at the home. The home is well organised by the manager who makes sure that staff get the support and guidance from senior staff and herself to make sure people get good quality nursing and personal care. The owners European Care Ltd oversee the manager’s work and the running of the home. Senior managers visit the home at least once a month to check that the staff and the manager are working well and that the quality of personal and nursing care remains high. The manager collects the views of service users, families and friends so that she can check to see if the service is meeting the needs of all parties. There are a number of meetings held at the home and other informal occasions where the manager is able to check that people are satisfied with the service. This helps the manager to monitor progress and develop the service. There were no significant hazards at the home throughout the inspection and arrangements are in place to minimise risks for people living at the home and staff. For example, Staff have had training in safe working practices. There is a fire prevention risk assessment which helps to make sure that people living and working at the home are protected and staff know what to do in the event of a fire. Accidents are clearly recorded and the manager completes monthly accident analysis to examine and track any trends. The manager confirmed that risk assessments for the safe use of bedrails have been carried out but these now need to be updated to make sure that people who use them are protected from accidental injury. In house health and safety checks are carried out weekly. Water temperatures are recorded to ensure temperatures of 44 C is not exceeded. External contract certificates are up to date. The home is also subject to inspections by the Fire Authority and local authority environmental health officers to make sure that the home is safe. People living at the home said, “People who live here are asked what they think about the way the home is run.” Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 26 “The manager is approachable.” The manager makes sure she is available if people living at the home or their families need to talk to her. Through out the inspection numerous people came for advice, direction, comfort and support. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 27 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 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 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 4 3 3 X 3 X X 3 Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 28 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. 2. 3. 4. 5. Refer to Standard OP7 OP9 OP15 OP19 OP38 Good Practice Recommendations The manager should complete the review and transfer of care planning documents to the new system introduced by the management organisation. The manager should improve the way loose medication that is carried forward from one prescription period to another is recorded to make it easier to check. Menus should be available at each mealtime so that people can male choices about the meals they would prefer. The planned redecoration of the home should continue to take place. Risk assessments which reduce the risks to people who use bedrails should be updated in line with best practice and current Department of Health Guidance. Birchwood Court Residential Care Home DS0000071053.V375256.R01.S.doc Version 5.2 Page 29 Care Quality Commission North Eastern Region Citygate, Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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