Care Home: Birkdale

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What the care home does well This home provides a comfortable, clean and very well maintained environment which is homely. There is good information for people considering moving into the home. This includes a detailed website with photographs of the home, staff and people who live there. People are consulted so that their needs and preferences are known and care plans provide staff with relevant information so that they can provide the right support to each person. People are supported to receive appropriate health care and to follow a healthy lifestyle. People are protected by the home`s arrangements for the storage and administration of medication. People choose how they spend their days. There is a variety of suitable activities and outings. Visitors are welcomed to the home. There is a good variety of food and menus suit the people in the home. There are good arrangements for making sure that the food is prepared in a safe way. There are good arrangements for handling complaints and comments and for protecting people who live in the home. There is a staff team made up of people who receive ongoing training so that they are competent. The system for assuring the quality of the care takes account of people`s comments about the service they receive. The manager is committed to maintaining high standards and to making improvements where possible. What has improved since the last inspection? The last report identified areas of excellence and there was only one requirement. This has been met so that there is a more robust system for the recruitment and selection of staff. Managers and staff have received more training in adult protection, so that people are better protected. The home has developed a new website, which provides good, detailed information about the home, so that people have better information when choosing the home. Staff are now better trained in caring for people. They have received additional training in areas such as toenail management, nutrition, dementia and exercise, so that they can provide better care for the residents. There is now a wider range of activities for people living in the home, including outings. The home has purchased more equipment for activities and crafts. There are better arrangements for infection control, including hand gel at the door. There are improved arrangements for maintaining staff information and supporting staff so that staff turnover has reduced. This provides greater consistency for the people who live in the home. What the care home could do better: There are no requirements following this report. The manager has identified several areas where the service could be further improved. These include recruiting volunteers to assist with activities and outings, more widespread publicity of the home`s website, inviting residents and their families to join in with abuse training and inviting audits from relevant parties, making the improvements that they recommend. These developments should help the home to further improve the service to people who live there. Key inspection report Care homes for older people Name: Address: Birkdale Station Hill Oakengates Telford Shropshire TF2 9AA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Christine Lancashire     Date: 1 5 1 2 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 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. 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 Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Birkdale Station Hill Oakengates Telford Shropshire TF2 9AA 01952620278 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Keepings Ltd care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care Home with personal care only to service users of either gender, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. Dementia - Code DE. Date of last inspection Brief description of the care home Birkdale is owned by The Keepings Ltd and registered to provide accommodation and personal care for up to 29 Older People with or without dementia care needs. The home, which was converted by the previous owners, is located in a wellestablished residential area of Oakengates, convenient to all local amenities and within easy access to Telford Shopping Centre. Accommodation is provided over two floors. Communal areas include a lounge, dining room, conservatory and activities room. The Care Homes for Older People Page 4 of 27 2 1 1 0 2 0 0 8 0 0 Over 65 29 29 Brief description of the care home passenger lift provides access to the first floor for people who have difficulties with their mobility. The grounds are accessible and ample car parking facilities are provided at the front of the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited this home on a weekday without telling anyone that we would be arriving. The purpose of the visit was to see how the home is meeting key National Minimum Standards and to make sure that the requirement made in the previous report had been addressed. Before the visit we sent an Annual Quality Assurance Assessment form (AQAA) to the manager for her to complete. This asks for details about the running of the home and the plans for future development. This information arrived when we asked for it and was completed in a helpful way, with plenty of detail. We also sent questionnaires to people who live in the home to ask them about their experiences. At the inspection we spoke to the owner, the manager, several members of the staff team and several people who live at the home. We looked round the communal areas of the building and into several bedrooms. We sampled three people who live in the home and looked at their records. We looked at other records which the home is required to keep and these Care Homes for Older People Page 6 of 27 include records about peoples needs and preferences, safety, menus, staff rotas, medication, staff recruitment and training, complaints and minutes of meetings. We looked at the systems which the home has for monitoring its performance. We looked at the homes website. We used this information to write this report. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The last report identified areas of excellence and there was only one requirement. This has been met so that there is a more robust system for the recruitment and selection of staff. Managers and staff have received more training in adult protection, so that people are better protected. The home has developed a new website, which provides good, detailed information about the home, so that people have better information when choosing the home. Staff are now better trained in caring for people. They have received additional training in areas such as toenail management, nutrition, dementia and exercise, so that they can provide better care for the residents. There is now a wider range of activities for people living in the home, including outings. The home has purchased more equipment for activities and crafts. Care Homes for Older People Page 8 of 27 There are better arrangements for infection control, including hand gel at the door. There are improved arrangements for maintaining staff information and supporting staff so that staff turnover has reduced. This provides greater consistency for the people who live in the home. 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. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 are considering moving into this home are provided with good information so that they can make an informed choice. Assessments and visits to the home ensure that people know, before they move in, that their needs can be met by the home. Evidence: The home has a Statement of Purpose which contains relevant information describing the home and the services provided. There is also a website which provides detailed information about the home and the staff. We saw that this includes photographs of the home and the staff as well as people living in the home enjoying various celebrations and activities. People confirmed in their responses to the questionnaire that they had been provided with good information to enable them to make a choice about moving in. The manager told us that people who are considering moving into the home are encouraged to tour the home at any time without an appointment. They are provided Care Homes for Older People Page 11 of 27 Evidence: with information about the home and the website address. We sampled three files for people in the home. We saw that relevant assessments had been carried out prior to them moving into the home, to make sure that the home could meet their needs. These assessments contain details of peoples past lives as well as their needs and preferences. They include a brief life history, the persons medical needs and their likes, dislikes, phobias and fears. Additional information had also been gathered through observation over the first week after the persons admission. The assessments had been used to form the basis of the care plans which help the staff to know how to care for each person in te most appropriate way. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 health, personal and social needs are set out in a care plan so that they can be met by staff. People are treated with respect and their privacy and dignity are maintained. They are protected by the homes practices in relation to the storage and administration of medication. Evidence: We sampled three peoples records and found that all contained plans for staff to follow giving details of how each person needs and prefers to be supported. We saw signatures to indicate that people had been involved in the preparation of these plans and had provided information about their preferences. This shows that people are consulted about how their care is provided. We saw risk assessments which cover relevant areas and the measures which staff need to take to make sure that each person is kept safe. Staff keep daily notes to show the progress which people are making. The files which we examined contained details of peoples health and the support needed from staff in this area. They also show contact details and records of visits to Care Homes for Older People Page 13 of 27 Evidence: and from a range of health professionals such as nurses, chiropodists, dentists, opticians and physiotherapists. The medication currently prescribed is also listed. Changes made by the GP are recorded. We looked at the storage facilities for medication in the home, the records of medication which had been administered by staff and the records of medication which had been received into the home and returned to the pharmacy. These were appropriately completed and up to date. Staff who adminisnter medication are trained to do so. This shows that people are protected by the homes arrangements for storing and administering medication. We saw that people in this home are helped to maintain a dignified appearance. We saw people moving freely around the home and some had chosen to spend time in their room. The bathing facilities and WCs are large enough for staff to support people whilst maintaining their privacy. People told us that staff ask them how they like to be supported and take notice of what they say. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 lifestyles in the home match their preferences and suitable activities are arranged. People are encouraged to maintain significant relationships with people in the community and they receive a choice of nutritious meals which meet their needs and take account of their preferences. Evidence: The homes website contains pictures of people engaging in a variety of activities. The manager told us that all staff act as activity workers and the home has its own transport. We saw photographs of people on trips to various places of interest, including Stapeley Water Gardens and the canal. In house activities include exercises, craft work and a pantomime. We saw collages and Christmas decorations which people had made. Staff are helping people to make life story books, to help them to remember significant times in their lives and to provide staff with extra information about them. People living in this home had a lively appearance and were chatting to each other and the staff. Some were walking from room to room and others came to the office to chat to us. All told us that they liked living in this home. The homes literature states that visitors may arrive at any time. The files which we sampled contained details of the social contact which people have with friends and Care Homes for Older People Page 15 of 27 Evidence: family outside the home and staff told us that there are many visitors. The records which we sampled showed that there are nutritional assessments and people are weighed on a regular basis. Peoples needs and preferences in terms of food are clearly recorded. We looked at the menus and they show a choice at each meal. The meals are varied. The records show that people are able to make choices and if they do not want the choices offered, they are provided with an alternative meal. The cook demonstrated a good knowledge of peoples needs and preferences and said that people are involved in planning the menus. When people have very specific preferences, they are helped to plan their own personal menus and we saw examples of these. The choices which people have made are recorded, so there is a record of what people have eaten. Several people told us that they like the food. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this 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 good arrangements to ensure that people are protected, including the arrangements for handling complaints. Evidence: The home has policies and procedures for handling complaints. The details of how to make a complaint are in the Statement of Purpose and service user guide to the home and are displayed around the home on notice boards. They are also on the homes website. People confirmed that they would know how to make a complaint should the need arise. All expressed confidence that the manager would put things right should they bring anything to her attention. The records show that there has only been one complaint since the last inspection and this was resolved appropriately. There have been no issues regarding Adult Protection at the home, and the Manager stated they would refer to the local Multi Agency Guidelines for the Protection of Vulnerable Adults, should an issue arise, to ensure all the relevant authorities are notified. The training records show that staff have been trained in the protection of vulnerable adults. We sampled the staff records, including those for staff who had most recently been employed. There are standard procedures for the recruitment and selection of staff. These are robust and the appropriate checks are carried out prior to each person commencing employment. This provides protection for the people living at the home. Care Homes for Older People Page 17 of 27 Evidence: We saw that people living at the home have access to their personal money and there is a system to monitor and record financial transactions ensuring an accurate account is kept and enabling an audit trail to be maintained. These arrangements mean that people living in this home are well protected. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 safe environment which meets their needs. Evidence: We looked round that communal areas of the building and found that all areas looked clean and were free from unpleasant odours. There is a choice of seating and dining areas and people were moving between these. The conservatory is substantial and was warm even though we visited on a cold day. Several people told us that they were pleased with the conditions and they liked their bedrooms. We looked at several bedrooms and found that they contained personal items and were individual in style to reflect the personalities and preferences of the people using them. Bedrooms have wash hand basins and bathroom and toilet facilities are close to the bedrooms. There is good access to the garden from home. The garden has a patio as well as a seating area and sheltered sitting area. The banks around it are steep and have recently been tidied, to provide a more pleasant outlook. We saw procedures for making sure that infection is controlled. The manager told us that there have been improvements in this area. Staff are trained in infection control and they confirmed that they have easy access to gloves and aprons when necessary. We saw that hand washing areas have liquid soap and paper towels. There are also instructions about how to reduce infection. There is a supply of hand gel at the Care Homes for Older People Page 19 of 27 Evidence: entrance and in the bathrooms. The mattresses have recently been sanitized and the waste bins have been replaced. We saw risk assessments for the building, people and activities and use is made of an outside company to advise in this area. These measures mean that there are good arrangements to make sure that people using the building are kept safe and infection is well controlled. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in this home receive care and support from appropriate numbers of staff who are suitably trained. The recruitment practices help to make sure that people are safe and protected. Evidence: The records show that staffing levels are well maintained to meet the needs of the people living at the home. We sampled three staff files and found that when staff are recruited, there is a standard procedure which is robust and includes taking up references and checks through the Criminal Records Bureau. New staff undergo a suitable induction programme and work with a more experienced staff member until they feel confident to work on their own. The records show that the staff are very well trained and have access to NVQ and other relevant courses. Over 70 per cent of staff have achieved NVQ level 2 or above. Staff are enthusiastic about training and request to go on training courses on a regular basis. These are diverse and include training in areas relevant to the needs of the people in the home as well as the areas covered in basic training. The staff present as friendly and caring. We observed good relationships between people in the home and the staff. The records show that staff receive regular supervision as well as appraisals. They also Care Homes for Older People Page 21 of 27 Evidence: have questionnaires to check their knowledge and understanding of their role, the Home and policies and procedures. There is a New Ways of Working folder in the office with leaflets, information and training in it accessible to all staff. The homes website also has useful links for staff to access additional information, including up to date legislation and guidance. The manager told us that the staff files are currently being replaced by new files which are more robust and contain dividers. In addition to the paper files, the home also has a secure website where the staff files and all their information regarding holidays, absences and training can be recorded. The manager told us that she holds counseling sessions with staff if there are issues to be resolved, so that nothing escalates to become a concern if this can be avoided. The manager has worked hard to praise staff where possible and to reduce the staff turnover over the past year. There has been no use of agency staff during the past year. This shows that people receive care from familiar staff, who can provide consistency. People who live in the home told us that the staff are good at meeting their needs. One told us, they couldnt do more for you. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 well managed home which is run in their best interests and where there are good systems for maintaining the quality of care. Peoples financial interests are safeguarded and their health, safety and welfare is promoted and protected. Evidence: The manager of the home is well qualified and experienced to run the home and has the Registered Managers Award. She attends regular training courses and seminars and demonstrates that she continually seeks out new information which will help to improve the quality of life for the people who live in the home. The owners take an active interest in the home, making frequent visits, and they know the people and staff well. There are good arrangements for making sure that the home maintains high standards and continues to meet the needs of the people who live there. These include regular checks on records and visits from the owner, questionnaires for staff, people who use the service and visiting professionals. We saw the results of this years Care Homes for Older People Page 23 of 27 Evidence: satisfaction surveys and the manager had analysed these to identify areas where the home could improve. This information had been used as the basis of the homes annual business development plan. The manager also maintains a striving for excellence book, in which she notes ideas for making further improvements to the home. We discussed the arrangements for the management of finances with the manager and procedures appeared satisfactory. People are provided with lockable storage facilities and records are available for the finances held. Two signatures are obtained for all transactions and regular audits are undertaken. People living at Birkdale are well safeguarded by the health and safety procedures in place. There are certificates for the servicing of equipment. The manager supplied us with the dates of safety checks and we sampled these. There are risk assessments in relevant areas, including manual handling, nutrition, tissue viability, falls and fire. There is a contingency plan for swine flu. We saw that staff complete reports of accidents involving residents and take appropriate action to ensure good outcomes for the person concerned. Staff receive training in these areas. We saw good arrangements for making sure that food is prepared safely and the home told us that the Environmental Services are pleased with these arrangements. This means that people who use the building are kept safe. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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. 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. 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