Archived: The Birches Residential Home

During our inspection on 24 April 2014 we set out to answer five questions. These were whether the service is caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who used the service and the staff that supported them. We also spent time looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People were cared for in an environment that was clean, safe and well maintained. Many areas had been decorated. New carpets and flooring had been fitted and there were new chairs being delivered on 6 May 2014. Support staff had received the training necessary to support people safely.

We found that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People told us that they were happy with the care that they received and that their needs had been met. Care plans were written in a way which reflected people's choice and preferences. Staff asked for people's consent before providing care and support.

We saw that the risk assessments and support plans had been reviewed monthly and where needed, updated to reflect the person's current needs. We looked at the care notes for people whose plans we had viewed and saw that care was delivered in accordance with the plans.

Is the service caring?

People told us that care and support was delivered in a way in which the liked and they were involved in the planning of their care. One person told us, 'I get everything I need.' Another person told us, 'Staff are nice.'

We observed staff interaction with people who used the service and staff appeared to know people well. There was conversation and banter between people and staff that made for a relaxed, friendly atmosphere. Staff we spoke with spoke fondly of people they were supporting and people who they were assisting responded with smiles and gratitude.

Is the service responsive?

We found that the service responded to issues identified through their own monitoring systems. This enabled them to monitor trends in areas such as incidents, falls, infections and complaints. Any trends identified were responded to and actions for minimising any reoccurrence were put in place.

The service had responded to the previous compliance action set by the Care Quality Commission by to ensuring that the appropriate standards were met. All of the staff we spoke with were aware of this and what corrective action had been taken.

Is the service well led?

People told us that they knew how to make a complaint and we noted that the management had responded appropriately to complaints made by people who used the service.

The service carried out regular audits on care plans, medication and health and safety. We saw that where an audit identified an issue, an action plan was developed and there was a record of actions being completed.

Surveys were sent out annually to people who used the service, their relatives and staff. The manager was taking steps to address any issues identified and make the suggested changes that were made in these surveys.

People said they were satisfied with the care they received from staff at The Birches. We observed positive interactions between people and staff. For example, staff were attentive to people and treated them with respect and dignity. People looked relaxed in the company of staff. A person who used the service said, 'Staff are kind and lovely.'

We found that people were supported to have adequate food and hydration. This meant that people were provided with sufficient quantities of food to meet their needs. A person who used the service said, 'The food here is excellent and well cooked. We have at least two choices."

The systems in place to reduce the risk and spread of infection needed to be improved to ensure that people were protected against the risk of exposure to a health care associated infection.

The provider had systems in place to ensure that people's medicines were handled appropriately. However, they were not consistently followed.

We found that the premises were not safe and adequately maintained. This meant that people were not protected against the risks associated with unsafe or unsuitable premises.

Recruitment processes were robust to ensure appropriate checks were undertaken before staff began work.

We observed and talked with staff who were very knowledgeable about the people who lived at The Birches and were able to understand their needs. Care records and the training offered by the provider enabled staff to meet people's health and care needs.

We found that people's privacy and dignity was compromised as there were no blinds or curtains at the bathroom windows throughout the home.

People we spoke with told us the care they received was satisfactory and their needs were met. One person said, "The carers are excellent". Another told us, "I'm very happy here. This is my home.' Each person was called by their preferred name and people said that staff treated them with respect. People were supported to make choices in all aspects of their daily lives and encouraged to be as independent as possible. ".

People told us they felt safe at this home and they would be happy to talk to the manager if they wanted to discuss any concerns. People we spoke with, and the staff, had mixed views about whether there were enough staff on duty.