Archived: Birch Abbey

Updated 23 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’

The inspection of Birch Abbey took place on 10 & 11 April 2018. The inspection was unannounced on the first day and announced on the second day.

On the first day of the inspection the inspection team comprised of an adult social care inspector, an assistant inspector and an 'expert by experience'. On the second day of the inspection two adult inspectors attended. An 'expert by experience' is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed the information we held about the home. This included notifications we had received from the provider such as incidents which had occurred in relation to the people who lived at the home. A notification is information about important events which the service is required to send to us by law. We also requested and received the Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Due to the nature of the service people were not always able to share their views about the service. To help us we therefore used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager, two nurses (including the clinical lead), three care staff, and a chef, a member of the domestic team, an activities organiser and a regional manager of an external organisation who support the service. We also spoke with two people at the home and nine relatives. Following the inspection received feedback from two external health professional who had regular contact with the service.

During the inspection we spent time reviewing a number of records. These included the care records of four people who used the service, three staff personnel files, staff training matrix, medication administration records (MARs), audits (checks), complaints, accidents and incidents and other records relating to the management of the service. Over the course of the two days we undertook general observations of the home. This included the general environment, décor and furnishings, bathrooms and bedrooms of some of the people who lived in the home. We also had lunch with people in the dining area/bistro.

Updated 23 May 2018

The inspection took place on 10 & 11 April 2018 and was unannounced. The last inspection of the service was 6 & 7 January and 14 April 2016 and the rating for the service following this inspection was Good.

Birch Abbey is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Birch Abbey is a care home providing personal and nursing care. It can accommodate up to 60 older people. At the time of the inspection 58 people were living at the home. The service specialises in caring for people with dementia.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

At this inspection we found a breach of regulation. People’s plan of care lacked information around care and support. This meant there was a risk staff did not have the information they needed to meet people’s care and support needs effectively and in accordance with individual need and preference. Governance arrangements to asses and monitor standards in the care home were not always effective to ensure the service was managed safely. Record management needed to improve as some information was difficult to locate.

The environment was maintained and subject to service contracts and safety checks of obvious hazards. Not all of these were current though the registered manager took immediate action to rectify this.

Staff sought consent from people before providing support. When people were unable to consent, the principles of the Mental Capacity Act 2005 were followed in that an assessment of the person's mental capacity was made. Sixteen people were being supported on a Deprivation of Liberty (DoLS) authorisation. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests.

Staff understood the concept of safeguarding knew how to report any concerns. Records indicated that safeguarding referrals to the local authority had been made appropriately.

Medicines were administered safely to people. Staff received medicine training and had been deemed competent for their administration.

Risks to people safety and wellbeing were recorded to enable staff to support people safely whilst promoting their independence. Staff recorded actions to maintain people’ safety.

Accidents and incidents were recorded and analysed to look for patterns and trends.

People at the home were supported by the staff and external health and social care professionals to maintain their health and wellbeing.

Staff were deployed in sufficient numbers to keep people safe and meet their needs.

The registered manager obtained required checks before an employee's commencement in post to ensure staff were suitable to work with vulnerable adults.

Staff received training and support to care for people in accordance with their individual needs. This included more specialised training to support people with dementia.

Our observations showed good interaction by the staff with people they supported. Staff were attentive, kind and respectful in their approach.

Staff were aware of their responsibility to treat people equally and respect their diversity and human rights.

Relatives told us the staff respected their family member’s rights to privacy and dignity and staff looked after people well.

Our discussions with staff confirmed they had a good knowledge and understanding of the people they cared for. We saw care being provided in accordance with individual need.

People’s dietary needs were managed with reference to individual preferences and choice. Pictorial menus were available for people to help choose their meal.

A new social activities programme was in place to help people engage with hobbies they enjoyed and to provide some structure and normality for their day.

Staff were positive about the management and leadership of the home. Staff told us they were able to share their views openly.

A complaints’ procedure was in place and relatives we spoke with were aware of how to raise a concern.

Birch Abbey had a clean environment and we observed good adherence to the control of infection.

Relatives and visitors were welcomed at the home and kept up to date about their family member.

There was a system in place to get feedback from people and/or their relatives so that the service could be developed with respect to their needs and wishes. These included meetings and satisfaction surveys.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with our statutory notifications. The ratings from the previous inspection were on display in accordance with requirements.

You can see what action we took at the back of this report.