Birch Avenue

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always treated people with kindness, empathy and compassion and respected their privacy and dignity. We observed some positive and meaningful interactions between staff and people using the service. Staff demonstrated a kind approach, and they took time to engage with people in a respectful manner. People were treated with dignity and respect. We saw staff knocking on doors before entering rooms, addressing people by their preferred names, and offering reassurance and encouragement where needed. People said staff treated them with respect and ensured their dignity was maintained. Relatives spoke highly of the staff describing them as kind and caring. Comments included, “I know [loved-one] is one hundred percent in safe hands and is happy.” And “Staff are certainly kind, there are a couple of staff here, who really took to [loved-one] and know them well.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Although we saw some ways in which people were treated as individuals, there were some changes needed to improve people’s potential experiences of care. Staff knew people well, which enabled them to provide support that met people’s basic needs and wishes. However, because detailed, full and accurate information was not always recorded, it was not always possible to support people in a way that fully reflected their preferences, communication styles and daily routines. Staff adapted their approach based on their own knowledge, but this was not consistently supported by robust documentation. At the time of our assessment, the service was adapting people’s care records to ensure more person-centred information was included, which reflected what was most important to the people they supported. Bank staff we spoke with lacked knowledge about people’s needs and preferences. Therefore, new processes around providing personalised care and support required embedding into the culture and practices across the service.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. At the time of the assessment, care plans and associated risk assessments did not always detail people’s needs and preferences or include information around what people could do independently. Feedback from people and relatives told us people had choice. A person said, “No one tells you to get up or go out. I can go to bed or get up when I want to.” A relative also commented, “They know what [loved-one] likes and staff understand them from the noises they make.” We saw people being visited by loved-ones. However, people were observed to be lacking choices around daily activities and there wasn’t sufficient stimulation in place to enhance people’s independence. A relative commented, “I have not seen a great deal of activities, there’s nothing structured.” And, “They had an external singer for an afternoon at Christmas time. Every other month, the singer comes in for an hour. I haven’t seen them play games. They could do with more activities; people need more stimulation.” We also observed doors being locked from the outside, to help prevent people going into other people’s rooms. However, we had some concerns around people having the choice to re-enter their rooms if their doors were locked, or whether this would have an impact on any emergency situations within the service. This information was passed onto the local fire service to address any potential risks.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. We observed staff responding to people’s needs in a timely manner. For example, at dinner time, 1 person’s blood sugar levels were assessed as being high, so they were offered an alternative type of dessert of their choosing. We observed when sensor equipment was alerted, staff responded to people promptly. Daily handovers were in place which allowed staff to initiate discussions about people’s immediate needs, a relative told us, “The staff nurses keep me updated, they ring and let me know if anything has happened. They ring if [relative] is ill, or anything significant.”

The provider cared about and promoted the wellbeing of their staff. Staff told us they enjoyed working at Birch Avenue and felt supported in their roles. Since having a new manager, staff told us “We have been trying our best despite staffing challenges and leadership issues. But [manager] has been trying very hard to improve things and put appropriate measures in place to improve the home.” Records showed staff received regular supervision and an annual appraisal, as these had previously not been carried out regularly. A staff member told us, “Yes, I have a supervision today with the nurse. I find them useful and it is good to have them in place again." A professional told us, “I hope the service now have a staffing model which allows them to give safe care to the residents, who often have complex and highly challenging needs. These staff shortages have had a serious impact on the mental health of the staff.”