Archived: Birchwood Grange Nursing Home

We observed the care provided and the interaction between staff and people who used the service. We spoke with 12 people, seven staff and a relative of a person who used the service.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People told us they felt safe. We observed that staff were supervising people to ensure they were safe. People were treated with respect and dignity. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. Care records contained risk assessments which provided guidance to staff on action to take to keep people safe. CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLs) which applies to care homes. While no applications had been submitted, appropriate policies and procedures were in place. When speaking with staff we found most had an understanding of the Mental Capacity Act (MCA) 2005 and the DOLs and how it applied to the people they were providing care and support to on a daily basis.

Is the service effective?

Assessments had been carried out regarding the needs of people, which included details about each person's preferences and needs. People's health and care needs were assessed with them, and they were involved in writing their plans of care. Risk assessments had been carried out and recorded. Where risks had been identified measures were in place to minimise the risk. We saw that reviews of people's needs were carried out and noted that changes to the care plans had been made when people's needs had changed.

Is the service caring?

People told us that staff were pleasant and took good care of them. We saw that staff were constantly supervising people and attentive towards them. One person told us, 'I love it here because they look after you.' We observed that people who used the service were well cared for. Those who were not able to speak with us showed signs of well-being. For example they smiled to us and were well dressed. People's preferences, interests, aspirations and their diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We observed that staff responded immediately when people needed attention. One person who used the service told us, 'Staff respond to the call bell very quickly, even if it's a glass of water.' We saw that the provider had responded positively to feedback from other stakeholders and had put in place systems to ensure staff were regularly supervised and appraised.

Is the service well-led?

The home did not have a registered manager. At the time of this inspection, the current manager had submitted an application for registration with the Care Quality Commission (CQC). We were told that the provider had contacted the previous manager to submit an application for de-registration. This was evidenced by records we looked at. At this inspection we found that the current manager was knowledgeable about their role and responsibilities. There were arrangements in place for monitoring the quality of care provided. Records showed that any identified shortfalls were addressed in a timely manner. For example, the provider had put in place an audit system to monitor response time to call bells.

Staff were aware of the need to protect people from abuse or the risk of abuse. They were aware of the safeguarding and whistleblowing policies and had received training about safeguarding people.

Overall we were not satisfied that people experienced safe and appropriate care. We looked at several plans of care. We noted that the care needs of people had been assessed but, in several cases, the actions for minimising potential risks had not been indicated.

The provider sent us information that showed there were enough qualified, skilled and experienced staff to meet people's needs.

We did not see evidence of regular supervision or appraisals as stated in the provider's action plan.

We observed care reflected needs as identified in care plans with relevant forms such as weight monitoring or fluid charts completed as appropriate.