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Birch Court Care Home Requires improvement

The provider of this service changed - see old profile


Inspection carried out on 7 October 2019

During a routine inspection

About the service

Birch Court Nursing and Residential Home is split into five separate single -storey houses: Brook House; Moss House; Fern House; Bank House and Waterside House, each with the capacity to accommodate 30 people who need nursing, dementia, palliative, respite or residential care. The service is provided by HC-One Oval Limited. At the time of our visit Bank House was not in use and there were 112 people living at the service.

People’s experience of using this service and what we found

People living at Birch Court and their relatives shared mixed views, but the majority were positive about the staff being caring and kind. We received mixed comments regarding staffing levels, use of agency staff and activities.

We noted several concerns regarding how staff were recording and administering medications using the current electronic system. We identified a breach of regulation regarding safe care, treatment and management of medications.

We have made a recommendation about the clarification of some job roles with regards to medication.

People living at the service and visiting relatives were unsure how many staff they could expect to see on duty each day. The registered manager advised they were recruiting and advertising posts and were also recruiting more activities organisers. We identified a breach of regulations relating to staffing.

Quality assurance processes were regularly carried out to show actions and improvements to the service in the last 10 months. However, concerns regarding the management of medications and of the deployment of safe staffing needs further review by the provider.

The home was clean and staff used appropriate techniques to prevent the spread of infection. Two corridors had an unpleasant smell and staff took action to improve these areas.

People told us they enjoyed the food and drink provided. We observed mealtimes and saw that people had a choice of meals. Mealtimes were noisy at times with staff busy in various departments. Staff could be heard

carrying out their work, while dining room and small galley kitchen doors were left open.

We have made a recommendation regarding the environment and activities.

We saw that people were supported with various activities including occasional trips out, visiting entertainers and the forming of a Birch Court choir. Whilst some people enjoyed the activities others felt they didn't see much going on as they didn't have an activities organiser on their unit.

Care plans and risk assessments were in place and generally contained the correct level of information in relation to the support people needed. Some areas of recording needed updating for one plan.

People could express their views in a variety of ways. Regular meetings were held, annual surveys were carried out and there was a complaints procedure in place. We saw that complaints had been recorded and responded to in line with this policy. We received four complaints from residents and relatives which we passed to the registered manager to review in line with their complaints policy. Some concerns were around the use of agency staff.

Staff and visitors noted improvements to the service since the registered manager commenced in post.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. Policies and systems in the service supported this practice.

Staff had received training and were knowledgeable about how to protect people from abuse. Staff felt supported and listened to. Staff received the training, support and supervision they needed to carry out the roles they were asked to do.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was ‘good’ (published 6 April 2017.)

Why we inspected

This was a planned inspection based on the previous rating.


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Inspection carried out on 8 March 2017

During a routine inspection

The inspection took place on 8, 9 March 2017 the first day being unannounced.

This was the first inspection of Birch Court since it had been re-registered with The Care Quality Commission in January 2017. The re-registration had taken place as a business entity to reflect changes to the providers named responsible people. This did not create any changes to the overall registration of the home.

Birch Court Nursing and Residential Home is split into five separate single -storey houses: Brook House; Moss House; Fern House; Bank House and Waterside House, each with the capacity to accommodate 30 people who need nursing, dementia, palliative, respite or residential care. The home is situated in the Warrington suburb of Howley, within a quiet residential setting. At the time of our visit Bank House was not in use and there were 20 people living in Moss House, 20 people living in Waterside House, 25 people living in Fern House and 26 people living in Brook House.

There was a registered manager in place. 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.

People were well cared for at Birch Court. People told us they were happy with the care and support provided and that staff were kind and caring. Staff maintained people's privacy and dignity ensuring that any care or discussions about people’s care were carried out in private. We saw that interactions both verbal and none verbal between staff and people who used the service were caring and respectful with staff showing patience, kindness and compassion. External health and social care professionals told us that the standards of care appeared to be very high.

Arrangements were in place to protect people from the risk of abuse. We spoke to staff about their understanding of safeguarding and they knew what to do if they suspected that someone was at risk of abuse or they saw signs of abuse. People who lived in the home and their relatives told us that they felt that staff provided safe and supportive care.

Relatives told us they were made to feel welcome and staff and managers were considerate to them and ensured they felt looked after and valued. They were kept informed of any changes and had open dialogue with staff about concerns or changing needs.

Staff were recruited through a rigorous procedure and attend mandatory training as part of their induction and continuous personal development. The registered manager ensured that staff had a full understanding of people's care and support needs and had the skills and knowledge to meet them.

Staffing provision was responsive to the numbers of people living in each house and their changing needs. We saw that staff on duty in one house were quite rushed around the lunchtime as a meeting had been arranged for one staff member to attend and they were therefore unable to assist with the care and support provision. However we noted that an extra staff member quickly joined the staff team to ensure that there were sufficient staff around to provide needs led care.

People’s nutritional needs were met and they had access to a range of professionals in the community for advice, treatment and support.

People received their medicines as prescribed by their GP. The home had a medication policy in place and a range of associated procedures which included arrangements for the administration of homely medicines. Medicines were managed safely to ensure people received them in accordance with their health needs and the prescriber’s instructions.

The service had a complaints policy details of which were provided to all of the people who used the service and their relatives. One person told us they had raised a concern and it was quickly dealt with. Other people told