Care Home: Silver Birches

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What the care home does well Silver Birches is like a small, family owned hotel. Everyone is very friendly and they make visitors feel very welcome. The manager of the home is also one of the owners; she works there along with members of her extended family. The owners of the home, and their family pets, live on the premises. The home is well managed and run in the best interest of the people living there. People are always assessed before they move in, this is to make sure that their needs can be met at the home. There is plenty of information for people to take away giving details about the service provided. All of the staff know people very well. They have a good understanding of individual needs and care is carefully and thoughtfully provided on a personalised basis. People are positively encouraged to follow their own routines and relatives and friends are welcome to visit at any time. The home provides a very good standard of care. People have confidence in the service provided and said they were satisfied with the care and support they receive. People said the food is good and there is plenty of choice on the menu. Staff recruitment procedures are good, all staff are checked before starting work to ensure that they are suitable and people people living there are safe. We asked people to tell us what the home does well. These are some of the comments we received: "They look after me very well" "They give a good homely feel, always friendly" "There is a friendly homelike atmosphere" "Great food, friendly staff" "It is a valued resource in our community, very well thought of" "They cater for my every need. I want for nothing" What has improved since the last inspection? The owners continue to maintain good standards of decoration throughout all parts of the home. What the care home could do better: The service continues to meet the needs of the people living there. People have told us they are extremely satisfied with all aspects of the service provided. In the surveys we asked people to tell us what the service could do better. These are some of the comments we received: "I have no concerns, excellent service" "I don`t feel able to say what could make the service better" "The home could do nothing better" "As far as I am concerned-nothing!" "I don`t know, I am very content". Key inspection report Care homes for older people Name: Address: Silver Birches 70 Erringden Road Mytholmroyd Hebden Bridge West Yorkshire HX7 5AR     The quality rating for this care home is:   two star good 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: Lynda Jones     Date: 2 8 0 7 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 26 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 26 Information about the care home Name of care home: Address: Silver Birches 70 Erringden Road Mytholmroyd Hebden Bridge West Yorkshire HX7 5AR 01422882804 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: peteandmar@talktalk.net Mrs Marcia Hurst,Mr Peter Hurst care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Silver Birches is registered to provide personal care for ten older people. The house is in a quiet residential area of Mytholmroyd, off the main road but within easy reach of the main bus route and railway station. Shops and other local amenities are a short walk away. In the Statement of Purpose, which gives information about the home and is available on request from Silver Birches, it says that the home caters for people with low to medium dependency levels. Some people suffer from some short-term memory loss but, in most cases, physical frailty has been the reason why people have moved into the home, in the main most people need only minimal support from staff. Many of the people who live at Silver Birches are from the Mytholmroyd and Hebden Bridge area. Accommodation is provided in ten single bedrooms, six have en suite facilities. Bedrooms are at ground and first floor level. The bedrooms on the first floor can be accessed by a stair lift. On the ground floor there is a comfortably furnished lounge and adjoining conservatory, which overlooks the garden, the dining room is Care Homes for Older People Page 4 of 26 Over 65 10 0 Brief description of the care home adjacent. The house is decorated and furnished to a high standard throughout. There is ramped access to the house and the well stocked garden. The proprietors live on the premises and, with other members of their extended family, they are very much involved in the day to day running of the business. The current charge is 450 pounds per week. This includes all meals and accommodation. People pay extra for their hairdressing and for any personal newspapers or magazines. Care Homes for Older People Page 5 of 26 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: two star good 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: The quality rating for this service is two stars. This means that people who use the service experience good quality outcomes. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the service since the last inspection, as well as a visit to the home. The owner of the home completed a self assessment form and we have used some of the information provided to us in this report. Surveys were sent to the people who live there and eight were returned to us; some people had help from relatives in order to complete them. We also sent surveys to health care professionals who visit the home regualrly such as district nurses, doctors and pharmacist. We received three responses from them. The surveys provide an Care Homes for Older People Page 6 of 26 opportunity for people to share their views of the service with us, information received in this way is shared with the home without identifying who has provided it. We have used some of the comments we received in this report. During the visit we spoke to people living at the home and to the staff on duty. We spoke to the owner/manager of the home, observed staff delivering care, looked at various records and looked around the home. 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. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The service continues to meet the needs of the people living there. People have told us they are extremely satisfied with all aspects of the service provided. Care Homes for Older People Page 8 of 26 In the surveys we asked people to tell us what the service could do better. These are some of the comments we received: I have no concerns, excellent service I dont feel able to say what could make the service better The home could do nothing better As far as I am concerned-nothing! I dont know, I am very content. 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 26 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 26 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. Everyone is fully assessed before moving in, this makes sure that staff are confident that they can meet peoples needs. People are given information about the home before they move in this helps them to decide if it is suitable for them. Evidence: The Statement of Purpose and Service User Guide are available on request from the home. These documents give people a lot of information about the facilities and service that is offered. The Statement of Purpose says that the home caters for people with low to medium dependency levels. Many of the people who live at Silver Birches are from Mytholmroyd and the surrounding area. People told us they chose to move into the home because they knew people who were already living there. Two people said the home has a very Care Homes for Older People Page 11 of 26 Evidence: good reputation in the area. People who completed the surveys said they had enough information about the home to decide if it was the right place for them to choose and they confirmed that they had been given a contract outlining the terms and conditions of residence; this is important because it tells people about their rights and responsibilities and about those of the owners of the home. The manager told us that everyone is assessed before any decision is made about moving in. We confirmed this by looking at an assessment for one person who moved in four months ago and another one for an individual who intended to take up residence a few days after our visit. Staff confirmed that they always encourage people to have a look round and meet other people who live there, although relatives sometimes do this. This gives people the opportunity to see the home and decide if it is suitable for them. The home does not provide intermediate care. Care Homes for Older People Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met and health care professionals are consulted when necessary. Evidence: Everyone has an individual care plan which is written in plain language and is easy to understand. The plans cover each persons health, personal and social care needs. We looked at two of the plans and found them easy to follow. Peoples health care needs are being met. There was evidence that GPs, district nurses and other health care providers were seeing people when necessary. Everyone who returned a survey said they always receive the care and support that they need. They told us the staff listen and act on what they have to say and the home makes sure that people get the medical care that they need. We received a survey from a GP and a District Nurse who visit the home on a regular basis. They said in their opinion peoples health and social care needs are always Care Homes for Older People Page 13 of 26 Evidence: properly monitored and reviewed. They said the home is good at noticing new symptoms, managing dificult behaviour and illness and the staff contact us if they need support or advice and are willing to follow advice on care and treatment. Medication practices in the home are safe. The medication is stored securely and all staff have received training in the administration of medication. We looked at the medication administration records and we could see that people are receiving the medication prescribed for them at the correct times. The pharmacist told us medication is ordered appropriately and they ring us for advice when needed. Care Homes for Older People Page 14 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People choose how they want to spend their time and these choices are respected by staff. The menus offer plenty of choice; meals are of good quality and are enjoyed by everyone. Evidence: There is a relaxed, family atmosphere at the home. The manager of the home is also one of the owners; she works there along with members of her extended family. The owners of the home (and their family pets) live on the premises. In the surveys people said there is a good homely feel, everyone is always friendly and there is a friendly & homelike atmosphere. There is nothing prescriptive about life at Silver Birches, people do exactly as they wish, following their own preferred daily routine. Some people like to spend time in their room, others prefer to sit together in the lounge. The staff regularly call on people who are in their rooms, to offer drinks, make sure everyone is alright and to ask if they need anything. We saw evidence of this during our visit. Care Homes for Older People Page 15 of 26 Evidence: In the surveys we asked people whether any activities were arranged for them to take part in. The response was always or sometimes. No one specified which activities they took part in. When we asked about this people told us they prefer to organise their own time, whether that was reading the paper, watching TV or sitting talking. Meals are a seen as a social occasion, where the majority of people sit and eat together in the well-appointed dining room. Everyone said they really enjoyed the food.When we asked what the home does well, people said excellent food and great food. One person said the meals and the table are always nicely presented. Care Homes for Older People Page 16 of 26 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. The complaints procedure is well publicised and people are confident that any concerns will be listened to, taken seriously and acted upon. People are protected by the policies, procedures and practices in the home. Evidence: The people who completed surveys said they knew about the complaints procedure, they knew how to make a formal complaint and who to speak to if they were unhappy about anything. They also said the staff listen to them and act on what they say. The relatives who completed surveys said they knew how to complain and they knew who they would speak to if there were any issues they wanted to discuss . They said the owner of the home is very approachable and always available if they had any concerns. The home has not received any complaints and no concerns have been raised with us. The home has an adult protection policy and staff have received adult protection training. Staff on duty said they are aware of the procedure they need to follow if they felt there were any practices in the home that they felt were not in the best interests of the people living there. The manager needs to ensure that staff receive regular training updates in this area to keep their practice up to date. Care Homes for Older People Page 17 of 26 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 excellent 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 safe, clean and comfortable home that is well maintained. Evidence: Silver Birches is a detached property set in a quiet residential area of Mytholmroyd, off the main road but within easy reach of the main bus route and railway station. Shops and other local amenities are a short walk away. There is ramped access to the house and the well stocked gardens. The gardens are well maintained and there is an outside sitting area for people to use in the good weather. There are ten single bedrooms at ground and first floor level. The bedrooms on the first floor can be accessed by a stair lift. Six have en suite facilities; the other bedrooms are near to toilets and bathrooms. People said they were very pleased with their rooms, they said they have everything in them that they need. They are large enough to accommodate a sitting area so that people can comfortably watch TV or entertain visitors. All of the bedrooms are decorated to a good standard. The home is spotlessly clean and free from any odours. All of the people living at the home said the home was always clean and fresh. Care Homes for Older People Page 18 of 26 Evidence: In the surveys people said its always clean and tidy and smells fresh excellent cleanliness and the garden is beautiful The home is very well maintained and decorated to a high standard throughout. Every area of the home is comfortable and looks cared for. There are pictures on the walls; lots of well tended plants and lots of books, newspapers and magazines around for everyone. The lounge and adjoining conservatory are both very comfortably furnished and as they look out over the garden both areas are bright and airy. Care Homes for Older People Page 19 of 26 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. There are sufficient staff on duty at all times to meet peoples needs. Evidence: The home is adequately staffed at all times to meet the needs of the people living living there. People who completed surveys said the staff were always available when they were needed. The home owner said there are always two members of staff on duty until 9.30 pm, the staff rota supports this. If anyone requires assistance during the night, a call bell system will alert the owners who live on premises. If anyone is ill, the owner said night time support would be provided. We know that this has been arranged in the past when one of the people living there was unwell and needed care during the night. Silver Birches is predominantly a family run business, there is very little turnover of staff. No new staff have been appointed since the last inspection. People see this a very positive aspect of the service. One of the relatives said they keep staff for years and another comment was most of the staff have worked there for a long time-this gives good continuity of care and stability to the residents. The homes recruitment policy is clear. The manager confirmed that new staff would Care Homes for Older People Page 20 of 26 Evidence: not start work at the home until all of the required checks have first been carried out. This is to make sure that new staff are suitable and to keep people living at the home safe. Care Homes for Older People Page 21 of 26 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. The home is well managed and run in the best interests of the people living there. People are consulted about the service and asked if it can be improved in any way. Work practices promote the health, safety and welfare of people who live there. Evidence: The owner/manager is experienced and is highly competent to run the home and meet its stated aims and objectives. She worked with older people in the community for a number of years before setting up Silver Birches in 1997. She has completed NVQ level 4 and the Registered Managers Award. The home is run in the best interests of the people living there. The home owner is always available at the home, she talks to people each day and she is open, approachable and welcomes comments on the service provided. People were very positive in their comments about the whole staff team and said they would talk to Care Homes for Older People Page 22 of 26 Evidence: them if they had any concerns. There is a written health and safety policy. One of the home owners takes responsibility for maintenance and health and safety issues. The home has a comprehensive set of policies and procedures which are regularly reviewed, and they have support from a specialist health and safety company which provides advice and annual inspection of related records. The home does not hold personal money on behalf of individuals. People usually get support from relatives to manage their finances. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 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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