Care Home: Birds Hill

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What the care home does well All the residents spoken with were very complimentary of the care they received and the friendly nature of management, medical and care staff. Residents are only admitted to the home following a full assessment of their needs and having confirmed that the home can meet those needs. Staff at the home support resident`s rights to privacy in care routines and residents spoken with confirmed they are able to enjoy the privacy of their rooms when they choose without interruption. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made very welcome. Residents are helped to exercise choice and control over their lives as far as possible. The complaints procedure can reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff can easily follow. The home is well run and a competent and committed staff aid the Registered Providers in this. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. Staff are generally well trained, which helps to ensure that a good standard of care is given to residents. A robust quality assurance system is in place to ensure that the home is run in the best interests of the residents. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at the home. What has improved since the last inspection? The home`s refurbishment programme has been ongoing ensuring that residents live in a comfortable environment. The training programme for all staff continues to develop so that staff have ample opportunities to increase their knowledge, which enables them to deliver a good standard of care to residents. What the care home could do better: As a result of this inspection only three recommendations of good practice have been made. There are some shortfalls in recording within the care documentation, realistic goals should be set and care given monitored effectively. The home should replace the metal boxes they keep medicines in the fridges with plastic lockable boxes. A programme of the activities should be given to each resident so that they will be aware of what is going on and can make a decision about whether to join in with the activities available. The Registered Providers confirmed that they intend to produce a newsletter on a regular basis and this will be made available to residents. CARE HOMES FOR OLDER PEOPLE Birds Hill 25 Birds Hill Road Poole Dorset BH15 2QJ Lead Inspector Amanda Porter Key Unannounced Inspection 3rd & 10th December 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birds Hill Address 25 Birds Hill Road Poole Dorset BH15 2QJ 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) 01202 671111 01202 660808 matron@birdshill.co.uk/ office@birdshill.co.uk Mr B Seewooruthun Mrs S Seewooruthun, Mr R Seewooruthun, Miss S Seewooruthun Mrs Soussan Seewooruthun Care Home 72 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (26), Mental disorder, excluding learning of places disability or dementia (2), Mental Disorder, excluding learning disability or dementia - over 65 years of age (26), Old age, not falling within any other category (46), Physical disability (2) Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Merlin and Starling units can accommodate a maximum of 46 persons who need general nursing care. The Nightingale unit can accommodate a maximum of 26 persons who need mental nursing care. A maximum of two service users, between the ages of 40 and 65, may be accommodated at the home at any one time. 5th January 2007 Date of last inspection Brief Description of the Service: Birds Hill cares for 72 predominantly older people in a purpose built care home. It is set on a hill near the town centre and Poole General Hospital. The home is on four floors, with the three upper floors being used for the accommodation of the residents. There are two passenger lifts to all levels. Each floor houses a different unit. Nightingale is on the 1st floor, Merlin is on the 2nd and Starling is on the 3rd. Nightingale is the unit that is home to the residents with mental health problems and dementia. There are a variety of aids and adaptations around the building to allow residents to move about more independently. There are two double bedrooms on each floor. The rest of the bedrooms are single. Most of the rooms have ensuite facilities and there are communal bathrooms and toilets on each floor. There are attractive wheelchair accessible gardens at the front of the building. There is also an enclosed balcony area on the Nightingale Unit with views out on to Poole harbour. The current weekly charges range between £575 and £950. Additional charges are made for hairdressing and chiropody. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two day on the 3rd and 10th December 2007. On the first day the inspector was accompanied by an ‘expert by experience’ who focused on speaking to residents and staff to obtain their opinions of the home, which are included in this report. The purpose of the inspection was to review the requirements and recommendation made at the last inspection and assess all of the key standards. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment completed by the home. • 4 questionnaires completed by residents, 10 by relatives and visitors, 1 by a care manager, 1 by a health professional, 3 by visiting GPs and 16 by members of staff. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. • Two hours were spent observing the care being given to a small group of residents. The care of two people was looked at in depth when comparisons with the observations were made with the homes records and the knowledge of the care staff. During the course of the inspection a number of residents and members of staff were spoken with and asked their views on the service provided at the home. Comments received in surveys and through discussion included: “My relative has been a resident for nearly 3 years and I can go home knowing she is in very capable hands. Giving me peace of mind.” “They treat the residents with respect and genuine care.” “We have a good communication system.” “The relationship of the owners and staff is very kind and friendly.” “I have met with the management regarding implementations for staff and service users. These are always carried out. Reports from colleagues and other agencies are similar.” “Overall the care is reasonable.” “I couldnt be in a better home.” Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 7 The home’s refurbishment programme has been ongoing ensuring that residents live in a comfortable environment. The training programme for all staff continues to develop so that staff have ample opportunities to increase their knowledge, which enables them to deliver a good standard of care to residents. 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. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 8 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 Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure enables prospective residents, and/or those acting on their behalf, to make informed decisions about admission to the home and ensures that only residents whose needs can be met by the home are offered places there. EVIDENCE: The files for residents who had recently moved into the home were inspected. These showed that the home has a good procedure in place. Prior to anyone moving to the home the director of nursing or a senior member of the nursing staff assesses his/her needs. Sufficient information was obtained so that a care plan could be drawn up and made available to staff. The home confirmed in writing that assessed needs could be met. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 10 Residents spoken with confirmed that either they or a family member were encouraged to visit prior to making a decision about whether to come and stay at the home. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The care files for six residents were reviewed. Files contained a variety of assessments and this information was used to formulate care plans. The care plans seen gave the information needed to care for each resident. However there were some shortfalls in the documentation seen, for example, the goals for care that were set were not always measurable nor did they always give realistic expectations; generally the daily written statements in the care files lacked detail about what sort of day the resident has had, how they have been occupied and whether they were in a state of wellbeing. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 12 Medicines were properly stored. However it is recommended that the storage boxes in the fridges are plastic rather than metal. Records were kept of the receipt, administration and disposal of medication and examination of these showed that all was well recorded and there was a clear audit trail available. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, the district nurse, nurse specialists, dietician, chiropodists and opticians. Three GPs completed surveys and all were satisfied with the service provided at Birds Hill. Residents spoken with were happy with the care they received and staff treated them with respect and were supportive and kind. The time spent observing residents daily life and staff care practices found staff were very patient, always took time to ask residents questions rather that deciding for them and some people were encouraged to be active, but could also sit quietly if that was their wish. In response to the question in the survey “Do you feel that the care home meets the needs of your friend/relative?” 7 people said “Always” and 3 people said “Usually”. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are supported to maintain their life skills and are encouraged to make choices as far as possible. Social, cultural and recreational activities meet the needs of some residents. EVIDENCE: At the time of inspection the home employed one member of staff specifically to organise activities with residents. In addition a second member of staff is due to start in the New Year to help with activities. Activities include: • Games and quizzes • Musical entertainers • Massage • Reminiscence sessions • Gentle exercise Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 14 Residents spoken with confirmed that they could choose how they spent their time but they were not provided with an activities programme, which would have told them what to expect and made planning their routines easier. Residents confirmed that they could receive their visitors in private and that they were always made very welcome. Observation took place over one lunchtime and residents appeared to enjoy the food provided. The home offers a choice of food at any meal and staff are aware of residents dietary preferences. Comments ranged from superb to good, but a little lacking in imagination. During the meal some people needed assistance and these residents received friendly and helpful attention from the staff, who were patient in administering medicine, drinks and food to the people in their care. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 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 able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. EVIDENCE: The home has a clear complaints procedure available to everyone. Residents spoken with during the inspection said that if they had any concerns they would feel confident about talking to the managers, knowing that they would listen to them. The home has not received any complaints since the last inspection. The home has a robust policy and procedure to respond to suspicion or evidence of abuse or neglect and staff have received training in this. In discussion they appear to have a general understanding of local procedures. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment at Birds Hill is good providing residents with an attractive, homely and safe place to live. EVIDENCE: The home has a programme of ongoing maintenance and the home provides a comfortable environment in which to live. All of the dining rooms and a number of bedrooms have now been completely redecorated and refurbished and the Nightingale corridor has been redecorated. Records show that a variety of outside agencies have attended the home to undertake the routine maintenance of: • Fire safety equipment • Gas installation Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 17 • • Lift Hoists All communal areas both inside and out were easily accessible. All areas of the home were clean and bright and there were no unpleasant odours. The laundry was well managed and adequate supplies of clean linen were seen to be available. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient nursing and care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can give a good standard of care to the residents living at Birds Hill. EVIDENCE: At the time of inspection staff rosters demonstrated that there are sufficient staff on duty at that time. During the inspection staff were on hand to meet the needs of the residents. Four people responded to the question “Are staff available when you need them?” Three said “Usually” and one said “Sometimes.” The home has an ongoing training programme, which includes NVQ level 2 and 3 in care and over 50 of the care staff hold the minimum of a level 2 award in care. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 19 Five staff recruitment files were reviewed. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Training files demonstrated that staff were receiving induction training. Staff confirmed that the management team had encouraged them to take up a number of training opportunities provided including: • Protection of vulnerable adults • First aid • Dementia care • Moving and handling • Infection control • Promoting mobility levels • Principles of care • Nutrition • Mental capacity act Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the daily management and running of the home centres round the care of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: Residents and visitors said that all the staff were very approachable and if they had any concerns they would be happy to talk to them knowing that they would be listened to. Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 21 There is a quality assurance and quality monitoring system in place. The home takes steps to review its performance regularly and resident surveys are conducted and results analysed. The management team confirmed that residents have representatives to deal with their finances and this is frequently another family member. The home does not hold any monies on behalf of residents. Records showed that staff had received recent training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and analysed and appropriate action was taken as necessary. Birds Hill DS0000020510.V355249.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Birds Hill DS0000020510.V355249.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 OP7 Good Practice Recommendations Goals for care should be measurable and achievable and daily care records should demonstrate whether the resident is in a staff of well or ill-being so that staff can monitor how effective the care given is. The home should replace the metal boxes they keep medicines in the fridges with plastic lockable boxes. Residents should be provided with a copy of the activities programme. 2. 3. OP9 OP12 Birds Hill DS0000020510.V355249.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Birds Hill DS0000020510.V355249.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. 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. 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