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Archived: Birchwood - Newbury Requires improvement

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Reports


Inspection carried out on 8 May 2017

During an inspection looking at part of the service

This inspection took place on 8 and 9 May 2017. This was a focused responsive inspection, to concerns that had been raised through a recent safeguarding referral to the local authority.

The home had a registered manager who had been in post since July 2016. 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.

Birchwood – Newbury is a care home with nursing that is registered to provide support to a total of 60 people across three floors. At the time of the inspection, we were advised that the ground floor had been closed, to allow staff to be deployed to the other two floors. A total of 46 people were being provided support and care at the service.

Staff knew how to keep people safe by reporting concerns immediately. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. However, the service required using agency staff as there were a number of vacancies within the service. This ensured sufficient staff were deployed to keep people safe.

There was a rolling training programme in place for all staff. This ensured that when any training was due to expire, this was arranged and booked for staff to attend, keeping staff equipped with knowledge.

People had comprehensive care plans in place, that informed staff how they wanted to be kept safe. This required further evaluation in the form of risk assessments. We found that whilst the risks had been assessed for some people, there were no written guidelines in place to inform staff how people should be kept safe. For example, one person was at high risk of falls, this was identified, however no care plan was written up specific to this.

Records were not maintained accurately to illustrate that people were receiving the appropriate level of support and care in line with their care plan. For example we looked at records for people who required 2:1 support and found that the daily records did not illustrate that the appropriate level of staff were supporting. We also found that from the records we were unable to distinguish if male or female staff were helping people, even when this had specifically been highlighted in the care plan.

Inspection carried out on 16 February 2016

During a routine inspection

This inspection took place on 16, 17 and 18 February 2016.

Birchwood – Newbury is a care home that provides services over three floors. The ground floor, with ten beds is predominantly for people with low level care needs. The first floor offers accommodation for a maximum of 25 people and the second floor provides nursing care to a maximum of 25 people. Each floor is managed by a ‘unit manager’ who oversees the care provided.

The home is required to have 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. The home has been operational without a registered manager since June 2014, which is an offence under section 33(b) of the HSCA 2008. A manager was appointed in November 2015, who was in the process of applying to the CQC as a registered manager. However she ceased employment on 11February 2016. Measures to support the service had been implemented. This included an interim service manager, as well as support from the regional manager and director, until a manager is appointed.

Staff knew how to keep people safe by reporting concerns promptly. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. Staff had the relevant training and experience to manage people’s needs.

We observed good caring practice by the staff. People and relatives of people using the service said they were happy with the support and care provided. All people spoken with said they thought they were treated with respect and staff preserved their dignity at all times.

People were supported with their medicines by suitably trained, qualified and experienced staff. Medicines were managed safely and securely, with correct reference being made to the medicine administration records (MAR) when administering medicines.

People who could not make specific decisions for themselves had their legal rights protected. People’s support plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests. Care plans and risk assessments were updated in conjunction with people’s changing needs. This meant that care was responsive and met people’s care needs.

The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The DoLS provide legal protection for vulnerable people who are, or may become, deprived of their liberty. Applications had been made as required, and were recorded on the provider’s computer system.

We found that quality assurance audits and governance of documents were completed by the service. This therefore allowed assessment and changes to be made where the service felt necessary.

People received care and support from staff who had received induction and shadowing from experienced staff. Staff stated they did not always feel supported by the management. They said they were not always consulted or listened to if they raised concerns, specifically in relation to staff deployment. It was found that supervisions and appraisals took place infrequently. This potentially affected the level of support staff had to carry out their duties. We found this was linked to the lack of consistent management of the service.

Inspection carried out on 22 August 2013

During a routine inspection

We found that people�s consent was obtained wherever possible. Relatives of people who used the service told us that staff listened to people and families and respected their choices.

We found that people were well cared for in the way they preferred. We saw staff responding to people�s requests for assistance promptly and in a patient and professional way. People told us that they were '' treated very well'' they said, ''it�s very nice here, very nice indeed''.

People were provided with fresh, varied and nutritious food in ways that met their individual needs. People told us,''the food is as good as you get at home''.

The home was clean, hygienic and well maintained. Relatives told us that the home was always clean and tidy. Staff had been trained in how to prevent the spread of infection.

The home took health and safety seriously and made sure people were kept as safe as possible.

We found that staff were appropriately trained and supported to give the best possible care to the people who lived in the home. People described care staff as, ''very kind'' and ''lovely''. Relatives told us that staff were ''very respectful, patient, courteous and kind''.

The home had ways of making sure that they checked the quality of care being given to people. They listened to the views of the people who lived in the home, their relatives and staff. Relatives told us,''the manager always listens and takes any actions necessary, immediately''.

Inspection carried out on 14 February 2013

During an inspection looking at part of the service

This was a follow up inspection to check that the home was compliant in specific areas. We did not speak with people who used the service on this occasion.

The home recorded and investigated any bruising or minor injuries and took action to try to prevent any repetition. The home had developed ways of helping people who may sometimes have harmful or distressing behaviour.

The service looked carefully at all incidents of unexplained bruising, accidents and falls. They made sure they took action to try to reduce risks to people who lived or stayed there to keep them as safe as they could.

Inspection carried out on 23 October 2012

During a routine inspection

We found that the home involved people in decisions about their care and made sure that they could make choices about their daily life. People told us that they were always treated with respect and dignity. People told us that they were ''very well looked after '' and that it was a '�very nice place to live.'' They told us that they felt ''very safe'' in the home. However, we found that there were no records to show that the home had tried to find out what had caused unexplained bruising and minor injuries to people. All staff had received safeguarding of vulnerable adults training and were clear about their responsibilities to protect the people in their care. People told us that there were always staff available to help them, if necessary. Staff told us that they answered call bells within minutes and that there were enough staff to look after people safely. The home had a system to assess and monitor the quality of service it provided but this had failed to identify and investigate the cause of the large number of falls that had occurred since the beginning of the year. People told us that the home always listened to their views and took action, as necessary. People told us that they had no complaints about the quality of care the service provided.

Inspection carried out on 2 August 2011

During an inspection in response to concerns

People said that the home was a very nice place to live, staff were �great� and they always felt safe and well looked after.

Families of people who live in the home said they were very pleased with the quality of care their relatives received.

Reports under our old system of regulation (including those from before CQC was created)