Birtley House Nursing Home

Updated 29 June 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Birtley House Nursing Home 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This was an unannounced, comprehensive inspection.

What we did before the inspection

Before the inspection we reviewed the information we held about the service. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used all this information to decide which areas to focus on during our inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with four people and spent time observing the care and support people received. We also spoke with two relatives of people living at the home. We spoke with the provider’s Chairman, a director who is also the nominated individual, the registered manager, the marketing manager, a registered nurse, the nurse clinical lead, two care staff, the menu assistant and activities staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. These included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures, were reviewed.

After the inspection

We sought more information after the inspection and the registered manager sent us the staff training plan, staff supervision plan, staffing rotas and the complaints log.

Updated 29 June 2019

About the service

Birtley House Nursing Home is a residential care home providing personal and nursing care for up to 47 older people in one adapted building. At the time of our inspection, 33 people were living at the home. The home is also registered to provide personal care for eight independent living flats, however, none of these people were receiving a regulated activity at the time of our inspection.

People’s experience of using this service and what we found

People said they felt safe living at the home. Their risks were identified and assessed, with guidance for staff on mitigating risks. Staff followed this guidance. Staffing levels were enough to meet people’s needs. One person commented, “My feeling is that staff come promptly. I need to ring the bell at night-time because I use a bed pan and staff come quickly”.

Medicines were managed safely. One person said, “Yes, I receive my medicines and staff explain any side effects to me”. The home was clean and smelled fresh. Staff had been trained in infection prevention and control. Lessons were learned if things went wrong.

People were positive about the training and experience of staff who supported them. One person said, “They all treat you as if you are a friend; that’s very important”. Staff had regular supervisions and an annual appraisal. One staff member said, “The whole environment is so lovely to work in, so homely. Everyone is nice and friendly”.

People were supported to have a healthy diet and with their nutrition and hydration needs. The lunchtime meal was a sociable occasion. Special diets were catered for. People had access to a range of healthcare professionals and support. Premises were suitable and comfortable and met people’s needs. A relative said, “She’s comfortable here and gets the attention she needs”.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were looked after by kind and caring staff who knew them well. People were encouraged to be involved in decisions relating to their care and were treated with dignity and respect.

People received personalised care that was responsive to their needs. Activities were organised according to people’s preferences and interests. People were encouraged to go out if they wished and had access to the gardens and grounds of the estate. Many activities involved people from the local community. People spoke highly of the activities on offer. A relative said, “I looked at 21 different places and this was head and shoulders above the rest, down to how Christmas, Easter, theme nights and the seasons are celebrated”.

People could spend the rest of their lives at the home, if their needs could be met and this was their wish.

People considered the home was well-organised and commented on the pleasant working atmosphere amongst staff. People appreciated the community feel at the home. The directors of the provider and the registered manager provided a visible presence at the home. People were encouraged in their involvement and development of the home and their feedback was encouraged.

Staff felt well supported in their roles. Staff meetings provided opportunities to reflect on people’s care and anything that might be done differently.

A system of audits monitored and measured all aspects of the home and were used to drive improvement. There were strong links with the community, for example, people with a learning disability worked in the grounds to produce vegetables and flowers which people enjoyed. The home worked proactively with the NHS and Social Services.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was requires improvement (published 2 July 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Birtley House Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.