We carried out a review of the data available to us about Birch Grove Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Birch Grove Nursing Home, you can give feedback on this 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.
At the last inspection on 28 April 2015, the service was rated ‘Good’. At this inspection we found some areas of practice that need improvement, however the overall rating for Birch Grove Nursing Home remains as ‘Good’. We will review the overall rating at the next comprehensive inspection, where we will look at all aspects of the service and to ensure the improvements have been made and sustained.
A registered manager was not in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. The registered manager had left the service approximately four months previously, and day to day management of the service was carried out by a new manager who had applied to register with the CQC.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. Special dietary requirements were met, and people’s weight was monitored, with their permission. However, improvement was needed to the mealtime experience for people in some parts of the service.
Staff continued to feel fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. One member of staff told us, “If you asked for extra training, they’d be happy to get going on that”. Another member of staff said, “We get supervision quite regularly”. People felt staff were skilled to meet their needs and provide effective care. One person told us, “As far as I’m concerned I think they perform their job well, I’ve no reason to doubt them”. However, we identified some areas of moving and handling practice that needed improvement.
We have made a recommendation in relation to moving and handling practices.
People told us they felt the service was safe. One person told us, “I’d tell any of those in a purple coats [referring to staff in uniforms], actually I’d tell any of them not just those”. Another person told us, “It’s difficult to be anything but safe here”. People remained protected from the risk of potential abuse because staff understood how to identify and report it.
The provider continued to have arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicines safely when they needed it. Healthcare remained accessible for people and appointments were made for regular check-ups as needed.
Staff considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make specific decisions had been assessed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).
People remained encouraged to express their views and had completed surveys. Feedback received showed people were satisfied with the overall care, and felt staff were friendly and helpful. People said they felt listened to and any concerns or issues they raised were addressed.
The service had a relaxed and homely feel. Everyone we spoke with spoke highly of the caring and respectful attitude of the staff team which we observed throughout the inspection. One person told us, “They look after me so well here, they are terribly kind”. Another person said, “They [staff] do everything they can to make you happy”.
People’s individual needs were assessed and care plans were developed to identify what care and support they required. People continued to be consulted about their care to ensure their wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.
People and staff told us the management team continued to be approachable and professional. A relative told us, “[My relative] has only been here a week, but the manager has taken the time to ring us and also speak to us to check everything is going alright. We’ve been very happy”.
Further information is in the detailed findings below.
The inspection took place on 28 April 2015. Birch Grove Nursing Home was last inspected on 12 April 2013 and no concerns were identified. Birch Grove Nursing Home is located in Brighton. It is registered to support a maximum of 60 people. The service provides personal care and support to people with nursing needs, some of whom were living with dementia, and many who had complex health needs and required end of life care. The service is set over five floors. On the day of our inspection, there were 40 people living at the service.
There was a registered manager in post. 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 happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. A relative told us, “I wanted somewhere safe for my wife. We’ve never looked back”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place.
Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately, including the administration of controlled drugs.
People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).
Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.
Staff had received essential training and there were opportunities for additional training specific to the needs of the service, such as wound management, and palliative (end of life) care. Staff had received both one to one and group supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People were advised on healthy eating and special dietary requirements were met. People’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.
People chose how to spend their day and they took part in activities in the service and the community. People and their relatives told us they enjoyed the activities, which included singing, exercises, films, arts and crafts and themed events, such as reminiscence sessions. People were encouraged to stay in touch with their families and receive visitors.
People felt well looked after and supported. We observed friendly and genuine relationships had developed between people and staff. A relative told us, “Such a lovely place. She is well looked after and they are very obliging”. Care plans described people’s needs and preferences and they were encouraged to be as independent as possible.
People were encouraged to express their views and completed surveys, and feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed. A relative said, “We raised a formal complaint with the hospital and would do the same here, but we’ve had no need to”.
Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where managers were always available to discuss suggestions and address problems or concerns.
The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.
During our inspection we spoke with four people who used the service. We also spoke with four staff members; these were the interim manager and three care workers. We also took information from other sources to help us understand the views of people who used the service, which included meeting minutes.
The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us 'I think it's alright here, it's always nice and clean'. Another person who used the service told us 'It suits me living here'. A care worker we spoke with told us 'We try our maximum to give the residents good care'.
We saw that the service had systems in place to gain and review consent to care and treatment from people who used the service. The overall appearance of the service was clean and we saw that they had appropriate systems and policies in place in respect to cleanliness and infection control.
We spoke with three care workers during our inspection and were told that they felt valued and supported and that their training needs had been met. We also saw that the provider had systems in place to monitor, respond and learn from complaints.
We also took information from other sources to help us understand the views of people living at the home to include surveys and resident meetings.
The people we spoke with told us they were happy with the care they received and with the staff team.
Staff we spoke with knew the people living at the home well and had a good understanding of their support needs.
Information shared with us under local safeguarding protocol raised concerns that the people living a Birch Grove had not been protected from abuse.