Birch Grove Nursing Home

Updated 19 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

An inspector and an Expert by Experience carried out this inspection on both days. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Birch Grove Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the CQC. The former registered manager had resigned in January 2019 and a new manager was immediately appointed who had remained in day-to day-charge of the care home since. The new manager is in the process of applying to be registered with us. This means they will be legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This two-day inspection was unannounced on the first day. Inspection activity started on 7 January 2020 and ended on 13 January 2020.

What we did

Before our inspection, we reviewed all the key information providers are required to send us about their service, including statutory notifications and our Provider Information Return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We spoke with 10 people who lived at the care home and two visiting relatives who were able to tell us about their experiences of the service provided. We also talked with various managers and staff, including the relatively new manager, the deputy manager, two nurses, seven care workers, two activities coordinators, the cook, two domiciliary workers and the maintenance person. In addition, we observed the way staff interacted with people using the service throughout out the inspection, including at mealtimes. Records we looked at included six people’s care plans and multiple samples of medication administration records, staff recruitment, training and supervision files, and various other records relating to the management of the service.

Updated 19 February 2020

About the service

Birch Grove Nursing Home was providing nursing and/or personal care to 46 older people at the time of our inspection. The service can accommodate and support up to 50 people in a single five-storey building, each floor with their own separate unit with suitably adapted facilities. Most people using the service were living with dementia. The service also supports people with a range of other care and support needs, including those associated with complex health conditions and mental ill health.

People’s experience of using this service

At our last inspection we found the provider had failed to ensure people were helped to move and transfer safely. We recommended at the time the provider seek advice and guidance from a reputable source about how to move and transfer people with mobility needs safely. At this inspection we found staff followed relevant national guidelines in relation to supporting people with mobility needs to move and transfer.

We also observed at our last inspection people who required assistance to eat and drink were not always supported to do so in a dignified or respectful manner. At this inspection we observed staff who were assisting people to eat and drink did so in a dignified, patient and respectful manner.

At this inspection it was clear staff had received most of the training they needed to effectively perform their working roles and responsibilities. However, we found some gaps in staff's knowledge and skills. We have made a recommendation about staff training on the subject of positive support for people whose behaviour might challenge the service at times, to help staff prevent or manage such incidents more effectively.

Staff had opportunities to reflect on their working practices and professional development through regular individual supervision meetings with their line manager. However, records showed staff had not had their overall work performance appraised for well over 12 months. We discussed this issue with the manager who agreed to ensure all staff had their work performance routinely appraised. Progress made by the provider to achieve these stated aims will be assessed at their next inspection.

People lived in a reasonably well decorated care home that met their needs. However, we saw the service’s environment was not particularly ‘dementia friendly’ and most communal areas lacked any easy to understand pictorial signage. We discussed this matter with the manager who agreed to make the care homes communal areas more suitable for people living with dementia. Progress made by the provider to achieve these stated aims will be assessed at their next inspection.

Most people told us they remained happy with the standard of care and supported they received at this care home.

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. People received their medicines safely and as prescribed. Staff continued to undergo all the relevant pre-employment checks to ensure their suitability and fitness for the role. The premises remained clean and staff followed relevant national guidelines regarding the prevention and control of infection.

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; the policies and systems in the service supported this practice. People were offered well-balanced meals that meet their dietary needs and wishes and were supported to stay healthy and well.

People were treated equally and had their human rights, diversity and privacy respected. People were encouraged to make decisions about the care and support they received. People were supported to be as independent as they could and wanted to be.

People had their own individual care plans for staff to follow. People’s communication needs and preferences continued to be respected and met. People were aware of the providers’ complaints policy and how to raise any concerns or complaints they might have. When people were nearing the end of their life, they continued to receive compassionate and supportive palliative care.

People, their relatives and staff all spoke positively about the leadership approach of the relatively new management team. The manager demonstrated a good understanding of the importance of quality monitoring and analysing and learning lessons when things went wrong in order to continuously improve the care home. The managers and staff involved people and staff in the running of the care home. They also worked in close partnership with community professionals and groups.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was good (published 26 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Birch Grove Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.