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Inspection Summary


Overall summary & rating

Good

Updated 2 June 2018

Birkdale Park 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. Birkdale Park is registered to provided accommodation, nursing and personal care for up to 36 adults. The home admits older people with general nursing care needs. It is a large detached house on a main road leading to Southport town centre. There were 26 people accommodated at the time of the inspection. The home was last inspected in April 2017 and was rated ‘Requires Improvement’ at that time.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; Safe, Effective, Responsive and Well-led to at least good.

This inspection was conducted on 30 April and 3 May 2018 and was unannounced on the first day.

A registered manager was in post, and the ratings from the previous inspection were displayed as required. 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.

At our last inspection in April 2017 we identified a breach of regulation because audit processes had failed to identify a number of concerns and omissions that were picked-up by the inspection team. Following the inspection the provider submitted an action that detailed how the necessary improvements would be made and sustained. At this inspection we found the audit processes at Birkdale Park were extensive and covered a wide range of safety and quality indicators. The provider had made and sustained the necessary improvements in accordance with their action plan and was no longer in breach of regulation regarding audits.

We saw evidence that managers at Birkdale Park used information from audits, accidents, incidents and feedback to learn and develop. There was evidence that the management team at Birkdale Park were making good use of external resources, guidance and partners to measure performance and drive quality improvements.

At our last inspection in April 2017 we identified a breach of regulation because records relating to the administration of medicines contained anomalies which meant it was not clear if the medicines had been given as prescribed. Following the inspection the provider submitted an action plan which detailed how the home would improve practice. As part of this inspection we checked to see if the necessary improvements had been made and sustained.

Medication was safely administered and the provider was no longer in breach of regulation regarding the safe administration of medicines. However, some records and systems were difficult to navigate and could be further improved. We made a recommendation regarding this.

People and their relatives told us they felt safe living at Birkdale Park. People were kept safe because staff had been trained in adult safeguarding and understood indicators of abuse and what action to take. Risk was fully considered as part of the assessment and care planning process. The care records that we saw showed that risk had been assessed and reviewed in relation to a number factors including; falls, skin integrity and weight-loss.

As part of the inspection we checked the operation of fire doors and found that some did not close fully. This meant that they may not have been effective in the event of a fire. We reported this to the registered manager who arranged for each door to be checked and adjusted as required before the end of the inspection.

Staff were recruited safely in accordance with requirements. Staff were deployed in sufficient numbers to keep people safe and meet their needs. However, people living at Birkdale Park and staff commented that the allocation of staff overnight meant that people were sometimes kept waiting for care.

Prior to the inspection we received information of concern which indicated that people were not given sufficient fluids to maintain a safe level of hydration. As part of the inspection we checked the availability of fluids and the monitoring of consumption. We found that the people had appropriate access to fluids and were supported to drink.

Staff had completed a programme of training in relevant subjects such as; food safety, health and safety, moving and handling and safeguarding. Staff told us that they felt well-supported by the provider. Staff were given regular formal supervision and could access additional support at any time.

The home operated in accordance with the principles of the Mental Capacity Act 2005 (MCA). Applications to deprive people of their liberty had been made appropriately and were subject to regular monitoring.

We saw evidence that people were supported to access healthcare in a timely manner as required. Documentation in care records showed that people had made use of GP’s, opticians and dieticians amongst others.

Parts of the building had been adapted to meet the additional needs of people. For example, a stair-lift and a passenger lift had been installed to help people move around the building and high-contrast paint schemes had been used on hand-rails to make them easier to see.

Prior to the inspection we received information of concern which indicated that staff did not always treat people with respect. As part of the inspection we spoke with people living at Birkdale Park, relatives, visitors and staff to gather their views. Each of the people that we spoke with was positive about their relationship with staff and the quality of care that they provided. Staff knew people well and interacted with them in a relaxed, caring and supportive manner. Staff took time to speak with people and offer information and re-assurance as required.

Staff were clear about their responsibility to protect people’s right to privacy and dignity in the provision of care. They explained how personal care was given in people’s bedrooms or in locked bathrooms. Each of the people that we spoke with confirmed that staff treated people with respect in the provision of personal care.

Following the last inspection in April 2017 we made a recommendation to improve practice in relation to the monitoring of people’s care. As part of this inspection we looked in detail at four care records. Each of the four records was sufficiently clear and well-detailed to instruct staff how to provide safe, effective care.

People’s need regarding equality and diversity were assessed and recorded. We saw and heard of examples relating to people’s culture, faith and sexuality. Staff were aware of people’s different needs and reflected them in the provision of care.

Birkdale Park employed an activities coordinator who engaged with individuals and groups. The home had a programme of activities and events including; seed planting, gentle exercise, hair day, scented activity and songs of the war. We spoke with the coordinator and observed them providing activities. It was clear that they knew people and their preferences well. The people that we saw were fully engaged and appeared to enjoy the activities available.

Birkdale Park increasingly provided end of life and palliative care to people. The registered manager recognised the additional requirements of this model of care and was in the process of sourcing specialist training for care and nursing staff.

Inspection areas

Safe

Requires improvement

Updated 2 June 2018

The service was not always safe.

Improvements had been made since the last inspection, but practice and records relating to the administration of medicines required further development.

Staff were recruited safely and deployed in sufficient numbers to meet people’s needs.

Risk was appropriately monitored and people were protected from abuse and neglect by trained staff.

Effective

Good

Updated 2 June 2018

The service was effective.

Improvements had been made following the last inspection meaning staff acted in accordance with the principles of the Mental Capacity Act 2005.

Records indicated that staff were well-trained and supported through regular supervision.

We saw people’s dietary needs were managed with reference to individual preferences and choice.

Caring

Good

Updated 2 June 2018

The service was caring.

Staff knew people well and provided care in accordance with their individual needs and preferences.

People’s privacy was respected and staff were careful to ensure people’s dignity was maintained when providing care.

Responsive

Good

Updated 2 June 2018

The service was responsive.

Assessment records and care plans contained sufficient detail for staff to provide person-centred care.

The home employed an activities’ coordinator who facilitated a wide-range of group and individual activities.

Well-led

Good

Updated 2 June 2018

The service was well led.

There was evidence of improvements being made and sustained following the last inspection.

The governance framework was clear, and we saw evidence of involvement and oversight at provider level.

There was evidence of partnership working and monitoring of performance against recognised standards.