The Care Quality Commission
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Archived: Birch Court Care Home

Overall: Requires improvement read more about inspection ratings

Egerton Street, Howley, Warrington, Cheshire, WA1 2DF

Provided and run by:
Bupa Care Homes (CFHCare) Limited

Important: The provider of this service changed. See new profile

All Inspections

7 October 2016

During an inspection looking at part of the service

We undertook a focused inspection of Birch Court on 7 October 2016.

At the previous inspection of this service in August 2015 we found the service had been rated as inadequate in relation to the effective section and an action plan had been provided to evidence how this would be addressed.

This focused inspection was carried out to look at concerns raised anonymously with regard to staffing levels especially on one specific unit of the home.

This report only covers our findings in relation to the Safe section.

You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Birch Court on our website at www.cqc.org.uk.

Birch Court Nursing and Residential Home is split into five separate single story houses: Brook House; Moss House; Fern House; Bank House; and Waterside House. Each house has the capacity to accommodate 30 people. All bedrooms are single and are located on the ground floor. The home is located in the Howley area of Warrington and is within easy access of local amenities including shops, social and educational facilities. At the time of our visit there were 23 people living in Brook House, 24 people living in Fern House, 18 people in Moss House, 22 People in Waterside House. Bank House was currently unoccupied.

A manager had recently been appointed to Birch Court and had submitted her application to the Care Quality Commission to become the registered manger. 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.

We found that since our last inspection the previous registered manager had left the service. We also found the staffing levels were a cause for concern. We were aware that concerns had been raised by Warrington Council regarding the staffing levels throughout the home.

At time of our visit we found that there were insufficient staff on Moss House to ensure the safety and well-being of people living there. This was a breach of Regulation 18 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we took at the back of this report.

5th and 6th August 2015

During an inspection looking at part of the service

This focused inspection took place on the 5 and 6 August 2015. The inspection was unannounced. The last inspection was a comprehensive inspection which took place in February 2015, when the registered provider was found to be meeting all the requirements for a service of this type with an overall rating of Good.

Birch Court provides nursing and personal care for a maximum of 150 people across five units. Personal care is provided for up to 30 older people living with dementia in Brook House. Nursing care for up to 30 older people living with dementia is provided in Waterside House. Nursing care for up to 30 older people is provided in Moss House and Fern House. At the present time Bank House is empty. All bedrooms are single and are on the ground floor. There are no en-suite facilities.

There was a registered manager 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.’ The registered manager was on annual leave at the time of our inspection and the home was being managed by the deputy manager a qualified nurse who was also known as the clinical services manager.

Although people told us they had enough to eat and drink, monitoring and recording of food and fluid intake was ineffective, which meant vulnerable people were at risk of dehydration and malnutrition.

We found that the registered provider did not provide the people who lived in the home with the protection afforded by the Mental Capacity Act 2005. The unit manager on the Waterside unit and staff did not have a thorough understanding of the deprivation of liberties safeguards and the conditions upon which they had been granted. This lack of knowledge resulted in people’s human rights not being protected.

Staff lacked basic knowledge and skills on the management of challenging behaviour and  there was a risk that the medicine was being given unnecessarily and not in line with the prescribers directions. 

We identified breaches of the relevant regulations in respect of person-centred care, need for consent, safe care and treatment, records and staff training. You can see what action we told the provider to take at the back of the full version of the report.

To Be Confirmed

During a routine inspection

The inspection was unannounced and took place on the 26 February 2015.

The last inspection took place on the 12 November 2013 when the home was found to be meeting the regulatory requirements looked at and which applied to this category of home.

One of the conditions of registration for the home was that it must have a registered manager. At the time of our inspection although there was a manager in place they had not registered with the Care Quality Commission. 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. Records show that the current manager is awaiting his registration with CQC.

Birch Court provides nursing and personal care for a maximum of 150 people across five units. Personal care is provided for up to 30 older people living with dementia in Brook House. Nursing care for up to 30 older people living with dementia is provided in Waterside House. Nursing care for up to 30 older people is provided in Moss House and Fern House. At the present time Bank House is empty. All bedrooms are single and are on the ground floor. There are no en-suite facilities.

There were 90 people living in the home at the time of our inspection.

We asked people using the service if they felt safe at Birch Court and they said that they did. Comments included; “There always appears to be enough staff around to help. If anyone needs something the carers are right there for them”, “I feel really safe here and staff do their best to help us” and “I’m very happy here. The carers knock on your door and ask if you are alright”.

Visitors we spoke with told us, “I am happy to leave mum here and know that she is safe”, “I hope she is safe, we have not had any problems here but sometimes I think there could be a few more staff around” and “It is not a bad place, the security seems OK and there is always someone around if you need them”.

The service had a safeguarding procedure in place. This was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.

Staff files showed that the appropriate checks had been made to ensure that new employees were suitable to work with vulnerable adults.

We asked staff members about training and they all confirmed that they received regular training throughout the year and that it was up to date.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff told us they had received training in these areas to ensure they could provide for the protection of people who were no longer able to make a decision for themselves usually because of an illness such as dementia.

There was a flexible menu in place which provided a good variety of food to the people using the service. The menus offered variety and choice and provided a well-balanced diet for people living in the home meeting specialised diets and personal likes and dislikes.

Care plans we looked at all explained what each person’s care needs were. Records showed that the plans were reviewed monthly so staff would know what changes, if any, had been made. This enabled staff to provide care that was appropriate to any changing need.

Meetings for the people using the service were arranged monthly. However records showed that these meetings were not well attended and as a consequence we were unable to access any recent minutes. However people told us that all need to know information was cascaded verbally and they “always knew what was going on”.

Staff members we spoke with were positive about how the home was being managed. Throughout the inspection we observed them interacting well with other staff and the people who lived in the home.

12 November 2013

During a routine inspection

The people we spoke with and who could tell us said that they felt involved in their care and that they were not forced to do anything that they did not want to do. Relatives spoken with said "I have nothing but praise for the staff,their attitude is very good"," staff are very good 'I can't fault any of them but they are stretched' 'they are excellent' and 'I don't think you could find better care anywhere'.

We spoke with people who said " I like living here" " staff are lovely." 'it's lovely here staff keep you clean and well fed' and 'good nurses in here-you can have a laugh with them'

One person told us that the food was "very good food' and '"the food is nice." Relatives spoken with said " my relative likes the food and can always choose something different if they don't like what is on offer.' and 'my relative has put on weight since they came in here'

One person commented 'There always seems to be enough staff.' People said "staff are lovely" and "I think the staff are wonderful"

26 February 2013

During a routine inspection

People spoken with said 'I can get into bed when I want.' One resident who was in for respite said "a worker takes me for walks'. Visitors spoken with they told us they were happy with the care their relatives received. Comments such as "our relative would not be alive today if it was not for the care that have received here'" I can not fault the care in this home, all the staff are fabulous and appear to know what they are doing" "really pleased with the way my relative is looked after" "nothing is too much trouble"and "my relative always looks clean and is dressed well" were made.

Comments from people spoken with were "I have porridge but I can have egg and bacon if I want' 'food good' 'for supper usually sandwiches and a drink, whatever you want' 'you can ask for different food if you want'.

Staff told us that the manager of the home was "very approachable and you can speak to her about anything" and that they enjoyed being part of the staff team at Birch Court Nursing and Residential Home. Comments from staff such as "I love it here"; "this is a great place to work " and " we get plenty of training and feel supported in our role" were made.

The people we spoke with said that they had no complaints about the service and they could not think of anything that needed to be changed.

3 May 2012

During an inspection looking at part of the service

The purpose of this visit to was assess the improvements made within the service following our last visit.

No comments were received from the people living at Birch Court in relation to the outcome area we assessed during our visit.

11 January 2012

During a routine inspection

We spoke with people who live at Birch Court and residents who were able to converse were 'happy with their care' and that' the food was basic but was good.'

One relative said that they were very happy with their relatives care and said that 'The staff are good with communications should anything need to be referred to a relative.'

Other comments from relatives were' I feel my relatives care is good,' 'the care is good' 'my relative is being looked after as best they can ' ' I am happy with the care'.