Birchmere House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect. Some interactions were task‑focused, and some people reported limited access to showers, having a choice in gender of the staff that supported them and activities due to the complexity of their needs and ongoing staffing pressures. This led to variable experiences of person-centred care.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

On the first day of inspection, some mealtime support was task‑focused, with staff standing over people or talking to colleagues rather than engaging with them; this improved on later inspection days. A small number of residents felt their dignity was compromised, including concerns about being supported with personal care by staff of a gender they were uncomfortable with. A staff member shared that some staff members felt uncomfortable attending to certain residents which sometimes impacted on the fulfilment of gender preference. The provider shared that they asked for preferences when the initial assessment took place and this was detailed on the assessment form. However, it seems whilst the question was asked, these preferences were not always followed. One resident described feeling “objectified and ignored”, as those supporting did not engage well in conversation. Although staff were observed to knock before entering rooms, they did not always wait to be invited in, which impacted people’s privacy and dignity. Experiences were also less consistent when agency staff were involved, as they did not always know people well or introduce themselves.

However, we observed many staff who were warm, smiling and enthusiastic. Most interactions observed across the inspection were caring and compassionate, and daily notes showed staff offering empathy and reassurance when people were distressed. Relatives told us staff went out of their way to make people feel valued, for example, arranging a special meal for residents’ birthdays. The chef contacted families in advance to check dietary preferences and was already aware of people’s favourite foods. One resident said they felt very welcomed on arrival, receiving flowers and a personalised welcome card. People described permanent staff as respectful, friendly, understanding and polite, with one person saying, “Staff here are first class, they are respectful and very polite”.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

Several residents told us they were unable to have showers as often as they would like, particularly those with more complex mobility needs. One person said, “I very rarely have a shower… I would like to be able to have a shower more often.” Another person commented, “I would like to have a shower sometimes, but I don’t want to have a shower with a man watching me.” Others said staff sometimes arrived late in the evening to support with their care needs, which disturbed them, and they would prefer staff to attend earlier. Staffing pressures also affected personalised activities. A relative told us their family member was unable to attend activities they enjoyed because there were not always enough staff available to support them to be ready in time.

However, despite these concerns, people generally felt respected and said staff knew them well. We saw examples of staff recognising when someone was distressed and offering reassurance, showing an understanding of people’s individual needs and emotions.

The provider supported people’s independence, choice and control, offering personalised opportunities that enabled people to pursue activities that were meaningful to them.

The home offered a diverse and engaging activities programme. Information boards and in‑room handouts helped people choose what they wanted to do. Relatives told us staff “popped their head in” throughout the day to invite people to activities. Staff showed determination and creativity in helping people achieve personal ambitions. For example, when a resident wanted to find an aircraft linked to a family member, the team supported them to locate it at the RAF Cosford museum, enabling the person to fulfil a meaningful objective. People told us staff knew them well and anticipated their preferences, “the first thing they do is bring us a cuppa.” Residents described feeling “awash with goodness,” enjoying regular exercise groups and faith‑based activities such as church services. Bedrooms were tidy, comfortable and highly personalised, with layouts that supported orientation and independence. One family member highlighted the benefit of a “differentiated area for night and day,” which helped their relative. People said they felt “at home” and valued having familiar belongings around them.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Some residents told us they waited longer than they felt was acceptable for assistance, particularly when using their call bell. One person said, “When I’m waiting for a long time for my buzzer to be answered or if I’m waiting for a long time to go to the loo, I feel like there’s not enough staff.” Whilst another person shared, “There is not as many staff as there were. I have to wait more often now”, and another commented, “I would like another coffee but there’s no one to ask and so I have to wait.” This meant that people’s immediate needs were not always met promptly, contributing to variable experiences of being listened to.

However, staff described how they monitored people’s wellbeing and responded when they noticed someone was distressed or uncomfortable. One member of staff told us, “If a person is distressed or uncomfortable, I ask them why… I document everything I notice and hand it over so we can see if it has happened before and if we need to contact the GP or social worker.” The manager also told us they planned to ask people about their call bell experience during ‘resident of the day’ checks to identify where further improvements could be made.

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff told us, “I enjoy my job,” and “It is a lovely place to work.” We saw that staff birthdays were celebrated, a wellbeing newsletter was displayed, and staff had access to regular recognition schemes such as ‘employee of the month’ and ‘Thank you Thursdays,’ where treats like chocolate were offered. One member of staff described how they received flowers from the regional manager in appreciation of the additional responsibilities they had taken on during the absence of a registered manager.

The organisation also offered a wide range of wellbeing support through the ‘We Care’ programme, including a confidential support line, same‑day virtual GP appointments, referrals to people’s own GP’s, financial and marital support, and virtual dental appointments. Staff described strong teamwork and a culture of supporting one another, telling us, “We always pull together as a team.”

However, morale was not always strong across the team. Some staff told us they were tired and felt stretched, with one staff member saying, “Everyone is really tired and so no one will pick up extra shifts as we are spread too thin …shifts are exhausting.” This showed that although wellbeing initiatives were in place, staffing pressures were affecting staff resilience and wellbeing.