We carried out a review of the data available to us about Birchwood House Rest 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 House Rest Home, you can give feedback on this service.
We found the following examples of good practice.
People were well supported by staff to have telephone and internet contact with their family and friends. The service facilitated in person visits in a manner which minimised the risk of infection spread, including outside visits, and visits using patio doors for ground floor rooms. Visitors were asked screening questions and to wash their hands with soap and water when they arrived.
Plans were in place to isolate people with COVID-19 to minimise transmission. The service had good supplies of personal protective equipment (PPE) that were readily available at stations throughout the service.
Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and residents were regularly tested for COVID-19.
The building was clean and free from clutter.
Staff ensured people’s well-being had been maintained and they had sufficient stimulation, such as activities.
Birchwood House Rest Home can accommodate up to 38 people. The service has 32 single bedrooms and usually only accommodates 32 people unless couples request shared accommodation. There were 23 people living at the service at the time of our inspection. People had varied communication needs and abilities. Most of the people could talk with us about their experiences.
At our last inspection we rated the service as Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
At the last inspection in August 2015, we recommended that the provider identified training for staff in ancillary roles to ensure that they could support people living in the service. At the inspection, we found that the provider had acted on our recommendations and ancillary staff were able to access additional training.
People were protected from the risk of harm. Staff had received safeguarding training and there were effective safeguarding procedures in place.
The provider and registered manager had good oversight of the service. The registered manager operated and promoted an open and transparent culture. Staff felt their views were considered about how the service operated.
Staff were kind and caring and treated people with dignity and respect. They had taken the time to get to know each person well and provide the care they wanted in the way they preferred.
People and their relatives had been asked about their views and experiences of using the service. One person told us “Amazing and I know I’ve picked the right home, it feels family orientated when you walk in, no regrets I’m very happy.”
Individual risks associated with people's care and support had been identified and risk assessments were in place to help manage these effectively. Risk assessments provided staff with detailed information on how to mitigate risks where possible.
Safe recruitment practices were followed to help ensure potential staff were of good character. There were sufficient numbers of staff deployed to meet people's needs in a timely way.
Staff received regular support which included individual supervisions and team meetings. Staff felt supported in their roles. Staff completed an induction when they commenced work at the service and had access to a range of on-going training. Staff were positive about the training they received.
Peoples medicines were managed safely. People received their medicines in the ways their healthcare professionals had prescribed and in a way that best suited their needs. People were offered a balanced diet of food they liked.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The registered manager had informed CQC of significant events that had happened at the service, so that we could check that appropriate action had been taken. They had learnt from these events and made improvements to the service.
Services are required to prominently display their CQC performance rating. The provider had displayed the rating in the entrance hall. The rating can be found on their website.
Further information is in the detailed findings below.
The inspection was carried out on 24 and 26 August 2015 by two inspectors and an expert by experience. It was an unannounced inspection. The service provides personal care and accommodation for a maximum of 38 older people. The service has 32 single bedrooms and usually only accommodates 32 people unless couples request shared accommodation. There were 32 people living at the service at the time of our inspection. People had varied communication needs and abilities. Most of the people were able to talk with us about their experiences.
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 supported by a deputy manager and a team of senior carers to ensure the daily management of the service.
People lived in a clean and well maintained environment. Staff had a thorough understanding of infection control practice that followed the Department of Health guidelines, which helped minimise risk from infection. The premises had not been designed to meet the needs of people living with dementia. We have made a recommendation about this.
Staff training was up to date and was renewed annually, and staff had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular supervision sessions and were scheduled for an annual appraisal to ensure they were supporting people based on their needs. Some staff in housekeeping and catering roles had not completed training appropriate to their roles. We have made a recommendation about this.
Staff communicated effectively with people and responded to their needs promptly. Staff treated people with kindness and respect, some language used by staff did not reflect the values of the service. We have made a recommendation about this. We observed frequent friendly engagement between people and staff and staff responded positively and warmly to people. People were satisfied with how their care and treatment was delivered.
Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm.
Accidents and incidents were recorded and monitored to identify how risks of re-occurrence could be reduced.
There were sufficient staff on duty to meet people’s needs. Staff had time to spend supporting people in a meaningful way that respected individual needs. Staffing levels were calculated according to people’s needs and were flexible to respond to changes in need.
There were safe recruitment procedures in place. These included the checking of references and carrying out disclosure and barring service checks for prospective employees before they started work. All staff were subject to a probation period and disciplinary procedures if they did not meet the required standards of practice
Staff were trained in the safe administration of medicines and kept relevant records that were accurate.
Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed before they moved into the service and were continually reviewed. This ensured that the staff knew about their particular needs and wishes when they moved in.
The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS). All care staff and management were trained in the principles of the MCA and the DoLS and were knowledgeable about the requirements of the legislation.
The building was warm and welcoming. People lived in a clean environment. People’s own rooms were personalised to reflect their individual tastes and personalities.
The service provided meals, in sufficient quantity that were nutritious and well balanced. People were offered hot drinks and snacks throughout the day. Staff knew about people’s dietary preferences and restrictions.
People were involved in their day to day care. People’s care plans were reviewed with their participation or their representatives’ involvement.
Clear information about the service, the management, the facilities, and how to complain was provided to people and visitors. A brochure and service user guide were available and menus and information regarding activities were displayed.
People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.
People’s individual assessments and care plans were reviewed twice a year with their participation or their representatives’ involvement. People’s care plans were updated when their needs changed to make sure they received the care and support they needed.
A range of activities was provided. Information about people’s hobbies, interests and skills was not always used to plan how they were supported to spend their time. We have made a recommendation about this.
The service took account of people’s complaints, comments and suggestions. People’s views were sought and acted upon. People’s relatives were asked about their views when they visited the home and when people’s care plans were reviewed. The service sent annual questionnaires to people’s relatives or representatives and analysed and sought to act upon the results of the surveys.
The service notified the Care Quality Commission of any significant events that affected people or the service and promoted a good relationship with stakeholders.
The registered manager kept up to date with any changes in legislation that may affect the service, and participated in monthly forums with other managers from other services where good practice was discussed. The registered manager and deputy manager carried out comprehensive audits to identify how the service could improve. They acted on the results of these audits and made necessary changes to improve the quality of the service and care.
We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.One person told us, "They always ask me if it is all right to do this or that, and they wait to make sure I agree. If I say no then they respect what I say".
People were made aware of the requirements for them to pay for their care, treatment and support and the expected costs. One relative told us, "The agreement of residency and the fees are very clear from the start".
We found that people's needs were assessed and reviewed regularly. Care was planned and delivered in line with individual care plans. One relative told us, "The care is really very good here. When our Mum became ill we were kept informed every step of the way and they took excellent care of her".
There were effective recruitment and selection processes in place. The manager checked the staff had relevant qualifications, knowledge, skills and experience to carry out their role.
There was a complaint policy and procedures in place, and people who lived in Birchwood and their relatives knew the steps to follow should they wish to complain. People told us, "We are not afraid to speak up, we talk with the staff and the manager and things get done".
People told us that they always had a choice of meals and that they enjoyed the food. One person said 'It's always lovely and hot'. We saw that people were offered choices and were given the support they needed to eat their meals. We heard people telling staff that their meal had been "very nice".
We found that people's nutritional needs had been assessed and a plan written for how these were to be met. In some cases people needed additional support or nutritional supplements and we saw records that showed that this was being provided. Staff had a good understanding of people's needs. They had recently completed training in diet and nutrition to help them support those at risk of poor nutrition. Record keeping had been improved and we could see that the records were being used to assess, plan and monitor people's nutritional needs.
We found that the manager had taken action to review people's experiences in the evening and during the night to check that there were enough staff on duty to meet their needs. The records showed that people were satisfied with the support they were receiving. People we spoke with told us they felt there were enough staff on duty to meet their needs.
The inspection team was led by a CQC inspector joined by an Expert by Experience (people who have experience of using services and who can provide that perspective).
We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
All of the 10 people with whom we spoke gave us generally positive feedback about the service. One of them said, "Overall, I've been happy with coming here. I think that most of the staff are genuinely kind and caring and I've always been treated with kindness and had all my needs met. The food's okay most days and the place is clean."
We found that the location was not compliant with the regulations relating to three outcomes. We saw that some people's nutritional needs had not been reliably assessed, recorded and met. Some staff did not have all of the knowledge and skills they needed to support people's nutritional needs. Also, some records not being kept in a way that supported staff to care for people and their nutritional needs.