Background to this inspection
Updated
2 February 2017
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.
This inspection took place on 13 and 15 December 2016 and was unannounced.
One inspector and an expert by experience undertook this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert by experience at this inspection had expertise in caring for older people.
Before the inspection, the provider completed a Provider Information Return (PIR). This 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. We also reviewed three previous inspection reports and notifications received from the registered manager. A notification is information about important events which the service is required to send us by law. We used all this information to decide which areas to focus on during our inspection.
We 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 looked at care records for three people, medication administration records (MAR), monitoring records, accident and activity records. We also looked at five staff files, staff training and supervision records, staff rotas, quality feedback surveys, audits and minutes of meetings.
During our inspection, we spoke with 11 people using the service, six relatives, the registered manager, a representative of the provider who was also on shift as a registered nurse, two senior care assistants, two care assistants, the chef and kitchen assistant. Following the inspection, we contacted a GP and a Community Psychiatric Nurse (CPN). They consented to share their views in this report.
Birch Trees Nursing Home was last inspected in September 2014 and there were no concerns.
Updated
2 February 2017
The inspection took place on 13 and 15 December 2016 and was an unannounced inspection.
Birch Trees Nursing Home provides accommodation and nursing care for up to 22 older people. At the time of our visit, there were 20 people in residence. The home is situated in a rural location, close to the town of Midhurst. Accommodation is provided over two floors and is accessible by a lift and stair lift. Communal areas include a dining room and lounge on the ground floor. There is a large garden accessible to people at the back of the home.
The service has a registered manager. 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.
People and relatives spoke positively about the service. They said that it was welcoming and that people received a high standard of care. There was a regular team of staff who knew people well. Staff were supported by the registered manager and representative of the provider who were regularly in the home. Feedback was welcomed and the registered manager was proactive at trying new ideas and making improvements to the care that people received.
People felt safe at the service and there were enough staff to respond to their needs. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed. People received their medicines safely.
People had developed good relationships with staff and had confidence in their skills and abilities. They told us that staff were kind and that they treated them respectfully. Staff had received training and were supported by the management. Staff were able to pursue additional training which helped them to improve the care they provided to people.
People were involved in planning their care and in making suggestions on how the service was run. Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).
People enjoyed the meals at the service and were offered choice and flexibility in the menu.
Staff responded quickly to changes in people’s needs and adapted care and support to suit them. Were appropriate, referrals were made to healthcare professionals, such as the GP or Community Psychiatric Nurse (CPN), and advice followed.
A variety of activities were provided, both in the form of group and individual interests.
There was strong leadership within the home. The registered manager and representative of the provider monitored the delivery of care and regularly assisted staff in supporting people. They had a system to monitor and review the quality of the service and were prompt in taking action if improvements were identified.