Archived: Birkenhead Court

The home is a three storey purpose built building in Bidston offering single accommodation of an excellent standard. The ground and first floors were split into four units for people who lived in the home. The top floor was used for kitchen laundry and staff areas. Each bed room was ensuite with a shower wet room and there were additional communal bathing facilities for people who lived at the home to use if they preferred a bath. On each unit there was a communal lounge, quiet lounge and dining area decorated to a high dementia friendly standard.

The home required 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. There was a registered manager in post from August 2013.

People who lived at the home were protected from the risk of potential abuse because staff had undertaken safeguarding training, to recognise and respond to potential signs of abuse. Staff had a good understanding of what safeguarding meant and how to report it.

People's medicines were handled safely and were given to them in accordance with their prescriptions. People's GPs and other healthcare professionals were contacted for advice about peoples health needs whenever necessary.

We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had been adhered to in the home. The provider told us that some people at the home lacked capacity and that a number of Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority in relation to people’s care. We found that in applying for these safeguards, peoples’ legal right to consent to and be involved in any decision making had been respected.

The provider offered a wide range of both group and individual activities that were meaningful to to the people who lived in the home and which had a positive impact on their lives. Visiting was unrestricted and people's relatives told us they felt included in the care of their family members. Staff had gone above and beyond the call of duty to fulfil some people's wishes and dreams. The vision and values of the staff team were imaginative and person-centred and made sure people were at the heart of the service. They looked at innovative ways of including people in planning their care, gaining their views and in choosing activities.

Staff enjoyed working at the service and felt well supported in their roles. They had access to a wide range of training which equipped them to deliver their roles effectively. The registered manager was an excellent role model and there were robust systems in place to develop staff and promote reflective practice. Staff were proud to work at Birkenhead Court and felt valued and empowered to deliver high quality care.

People benefitted from living in a well organised, forward thinking home where their needs were always put first. The culture of the home was open and people felt confident to express their views and opinions.

The registered manager provided clear leadership and direction to staff and was committed and passionate about the quality of care provided. The skills of the registered manager had been recognised when staff nominated them for 'Manager of the Year' were they became a finalist. They also actively sought out and developed partnerships with community groups that can benefit the people who live at the home. Learning was shared from within and outside the organisation and community contacts were well established.

End of life care was exceptional with the service consistently going the extra mile to meet people's final wishes and ensuring their final days were lived comfortably surrounded by the people who knew and cared for them.

The provider regularly checked the quality of care at the home through visits and audits. These showed the home was performing well in all aspect of care. People’s care records were maintained to a good standard and staff had access to policies and procedures to guide their practice.

As part of this inspection we spoke with a number of representatives of the local authority, the registered manager, 14 staff, 15 people who lived at the home and four of their relatives.

We started our unannounced inspection after 9 at night-time and carried out two further unannounced visits to the home during day time hours. On each occasion we found that there were enough trained, skilled and experienced staff to meet the needs of the people who lived at the home.

We found that the people who used the service received safe and appropriate care, treatment and support. Their individual needs had been established with their involvement and the support of their relatives and health and social care professionals. Care plans had been developed which were centred on them as an individual and considered all aspects of their individual circumstances and needs.

People we spoke with during this inspection praised the staff for their kindness, care and dedication. We asked them whether they felt that there was always enough staff on duty. They told us that they did not have to wait for support and overall they were happy with the numbers of staff on duty.

We observed staff engaging people in conversation frequently, listening to them, and responding to their request with kindness and consideration. This provided for a positive environment where people were acknowledged and included in the day to day comings and goings of the home.

People were safeguarded from the risk of abuse because the provider had taken steps to ensure that staff had the skills to recognise and respond promptly and effectively to any evidence or suspicion of abuse. The people who used the service told us that they felt safe and well cared for and their relatives told us that they had confidence in the manager and staff. Representatives of the local authority told us that the manager and staff had worked in partnership with them to ensure that the people who lived at the home were safeguarded from abuse and the risk of them receiving unsafe or inappropriate care and support.

The people we spoke with confirmed the staff kept them involved with any appointments. One friend told us 'The staff are always getting my friend hearing aids and glasses but he always ends up losing them. It's no fault of the staff'. We saw adequate involvement of healthcare professionals.

We saw there were sufficient numbers of staff who were well trained. The people we spoke with told us 'I can't fault the staff', 'The staff give care really well' and 'The staff are very encouraging'.

'The attitude of the staff has really improved over the last few months.'

'The staff are very supportive of my relative and very patient.'

We looked at the care records of four people who used the service. We found them to be person centred and to provide detailed information about the health and care needs of people.

Records showed policies and procedures such as the disciplinary and complaints procedures were adhered to.

There were systems in place to monitor the quality and safety of the service provided at Birkenhead Court.

Records showed that where there was a concern about a person's health needs such as their risk of falls, mental health or pressure area care the advice of healthcare professionals was sought.

We spoke with members of the staff team who could described how they would ensure the welfare of vulnerable people was protected through the whistle blowing and safeguarding procedures.

The nutritional care plans and risk assessments of two people who used the service did not reflect their needs and did not identify risks leaving them at risk of not receiving appropriate care and support.

We looked at staff records and found the service did not manage their disciplinary procedure and systems in a consistent manner. This meant people who used the service could be at risk of being supported by people who did not have the necessary skills to support vulnerable adults.

The service had a complaints policy and procedure in place however this was not being applied in a consistent manner.

We found care records were not being effectively reviewed and amended to reflect the changing needs and wishes of the people who used the service.