We carried out a review of the data available to us about Birchwood Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Birchwood Residential Care Home, you can give feedback on this service.
Birchwood Residential Care Home is a residential care home providing personal care to 44 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 43 people using the services.
Birchwood Residential Care Home is purpose built to accommodate 44 people. The service is on 2 levels with 5 separate units. Each unit has separate adapted facilities. There are dining and common areas on each unit and adapted bathrooms.
People’s experience of using this service and what we found
Since our last inspection, the registered manager had taken action to improve staffing level. The service had enough appropriately skilled staff to meet people's needs and keep them safe. People and relatives were happy with staffing level. They told us staff were kind and caring. The provider had a safe staff recruitment process in place. This ensured that staff were properly checked and supported with induction and training. People received their medicines as prescribed and medicines were managed safely. The service was clean, and people were protected from the risk of infection.
Risks to people were assessed and systems put in place to ensure people were safe. Staff knew how to identify and report incidents of abuse.
There was a positive culture at the service and people benefited from being supported by happy staff which was reflected in the atmosphere at the service. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. Staff told us they enjoyed their job and making a positive difference to someone's life.
Governance and auditing processes had been implemented to enable the register manager and provider to monitor the service and drive improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
At the last inspection the service was rated Requires Improvement (published 28 November 2019) and there were breaches of Regulation 18 (staffing) and Regulation 17 (good governance). 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
We carried out an unannounced comprehensive inspection of this service on 19 and 20 September 2019. Breaches of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall 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 Birchwood Residential Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Birchwood Residential Care Home is a residential care home providing personal care to 43 people aged 65 and over at the time of the inspection.
Birchwood Residential Care Home is purpose built to accommodate 44 people. The service is on two levels with five separate units. Each unit has separate adapted facilities. There are dining and common areas on each unit and adapted bathrooms.
People’s experience of using this service and what we found
People and staff did not always feel there were enough staff available and we observed incidents where staffing levels could impact on people’s safety. Systems in place to monitor the quality of the service were not always effective and had not identified this shortcoming we found during the inspection.
People told us they felt safe. Systems were in place to protect people from abuse and the service had notified local safeguarding teams in a timely manner.
People told us they were happy with the care and support provided. When asked about the service one person said, “It’s relaxing and the staff are kind to you.”
Risk assessments were completed to identify and manage risks to keep people safe. Staff were trained to support people to take their medicines and measures were in place to protect people from the spread of infection.
Pre-employment checks were carried out to ensure staff were suitable to support people. There were procedures for responding to accidents and incidents.
The service carried out assessments of people’s needs prior to admission to the service to ensure they could meet their 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 supported to eat and drink enough to meet their needs. Staff had completed required training to perform their roles effectively and felt supported in their role. The service worked with other agencies to promote people’s health, safety and well-being.
People were included in decisions about their care, including their wishes and preferences at the end of their life. People received care and support from staff who were caring and compassionate. One person told us, “They [staff] are looking after me very well.”
Staff treated people in a respectful manner maintaining their dignity and encouraging independence. Systems were in place to protect people’s right to confidentiality. The service was respectful of people’s equality diversity.
Care plans were person centred and included the individual needs of people. Care plans were reviewed monthly to reflect people’s changing needs. Complaints procedures were in place and people told us they knew how to make a complaint.
People and staff told us they found the registered manager approachable and supportive. Staff were positive about the culture of the service.
Rating at last inspection
The last rating for this service was good (published 13 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. The provider has taken action to mitigate the risks.
Enforcement
We have identified breaches in relation to staffing and leadership of the service at this inspection.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Birchwood provides care to a maximum of 44 people. The service is split into five separate communities. Hollywood and Woodland are residential communities located on the ground floor whilst Rosewood and Mayfair are located on the first floor. Penthouse is also on the first floor and accommodates people living with dementia. On the day of our visit there were 38 people using the service.
At the time of our inspection, there was a registered manager in place. 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 told us they felt safe at Birchwood and that they were treated with dignity and respect by polite and caring staff. They felt if they raised any concerns they were promptly rectified. They were aware of the complaints process which was displayed in several communal areas within the service. They were able to feedback at monthly ’resident’’ meetings, through the comments and suggestions box at any time they felt the need to talk with the registered manager.
Staff were aware of the safeguarding processes in place and had attended training on safeguarding adults. They were aware of how to recognise and report abuse and where to locate the safeguarding policy.
Incidents and accidents were investigated and managed appropriately. Staff were aware of recent incidents and any identified learning was shared during handovers and team meetings.
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and the policies and systems in the service supported this practice.
Risk assessments were completed to ensure any identified risks were mitigated. Risks identified included falls, choking, and reduced mobility.
Medicines were managed safely by staff who received appropriate support and training.
Staff completed a comprehensive induction and received regular supervisions and yearly appraisals. This ensured their skills and competence were up to date and enabled them to support people safely.
People were supported to eat and drink a balanced diet that met the cultural, religious and personal preference. Where people were identified as at risk of malnutrition, appropriate referrals were made to enable them to maintain a healthy lifestyle.
Care plans were individual and reflected people’s current likes and dislikes. People were encouraged to participate in activities as they wished and had a lot of choice or communal or individual activities.
There was an open and honest culture where people, their relatives and staff felt they could approach management and discuss any issues and concerns.
There were effective quality assurance in place including seeking and acting on people’s feedback in order to improve the service.
The inspection was unannounced and took place on 3 November 2015. There were no breaches of any legal requirements at our last inspection in December 2013.
Birchwood Home provides accommodation and support with personal care for up to 44 older people some of which may have a physical disability or may be living with dementia. On the day of our visit there were 41 people living at the service.
The service had a manager in place who had started on 19 October 2015 and was in the process of completing the relevant steps to become 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 told us they felt safe and that staff were kind and compassionate. We observed people were treated with dignity and respect and their privacy was respected.
Staff were aware of the procedures to follow in response to allegations of abuse, reporting incidents, medical emergencies, fire and had attended appropriate training. Staff were supported by means of regular supervision, annual appraisals and regular meetings. In addition continuing professional development by means of gaining vocational qualifications was also supported.
People told us that there were enough staff to meet their needs most times although they told us over the summer where there had been shortages. Staff and management confirmed that there had been shortages in July and August. However, there had been a big recruitment drive and all vacancies had now been filled. We checked staff files and found appropriate recruitment checks had been completed.
People were supported to maintain a balanced diet and given choice. Staff were aware of the Mental Capacity Act 2005 (MCA) and the need follow appropriate procedures to ensure that people who lacked capacity to make certain decisions were only deprived of their liberty when it was in their best interests to do so.
People told us that staff were considerate and kind. We observed compassionate interactions between staff, people and relatives. Staff had attended equality and diversity training and were able to demonstrate how to apply this in practice.
Although care plans had an element of describing people’s individual needs, they were not always updated to reflect the current needs of people.
People thought the management were approachable and visible. There were clear management and reporting structures in place and staff were aware of the vision and values of the service.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of the report.
We found that care was planned and delivered by experienced staff who understood the needs of the people. There was a choice of menus and people were supported during mealtimes. We found that the staff interacted well with the people. "We are happy here; very very wonderful staff", said one person who spoke to us.
The service had a complaints procedure and it was kept in a folder in the entrance hall. People told us that they were able to raise their concerns with the manager who would deal with the issue satisfactorily. People felt safe in the home and we found that the staff had regular training, including on safeguarding and manual handling. Clinical staff such as the general practitioner, the district nurse and the dentist visited the home as required to provide care and treatment.
The residents and their relatives were surveyed during the year and they responded that they were happy with the home.
People told us they liked the food, and that they were offered choices. People also told us they were given enough food and drink. One person said "the food is all right, they don't keep you short or anything." We observed the lunchtime period to be relaxed and unhurried, and people appeared to enjoy their meal. Kitchen staff had a good understanding of people's individual dietary needs.
We found that medications were stored securely, and administered in line with prescribing instructions. The service had a complaints procedure in place. People told us they had not had to make a complaint, but that they knew who to complain to if they did want to. We found that checks were carried out on staff before they began working at the service including Criminal Records Bureau checks and employment references.