Silver Birch Care Home

Silver Birch is a residential care home providing personal care for up to 23 people. At the time of the inspection 13 people were living there.

People’s experience of using this service and what we found

We identified a number of issues in relation to the management of sharps. A sharp is a device that has sharp points or edges such as needles and syringes. We found some people did not receive their medication as prescribed with no recorded reason. We found some people receiving medicines on a when required basis (PRN) did not have a medical review.

We found improvements were required to ensure risk assessments were accurate and up to date following changes to people’s health conditions.

The provider had safeguarding systems and processes in place to keep people safe. Staff knew the risks to people and followed the assessments to ensure they met people's needs. People felt safe and were supported by staff who knew how to protect them from avoidable harm.

Staff were recruited safely and there were enough staff to meet people's needs. Staff followed the infection control procedures the provider had in place.

The provider did not have a registered manager in post. The provider's audits to monitor the quality of the service were not consistently effective in identifying and driving forward improvements. Audits of care records had not identified some risk assessments contained a lack of clear instructions or were not up to date.

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.

Staff spoke positively about working for the provider. They felt well supported and that they could talk to the management team at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.

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

Rating at last inspection

The last rating for this service was requires improvement (published 02 December 2019)

Why we inspected

The inspection was prompted in part due to concerns received about the management of safeguarding incidents. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to Regulation 12 (safe care and treatment) and Regulation 17 (good governance) at this inspection . The provider responded to the concerns on the day of the inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The last rating for this service was Inadequate (published 29 October 2018 ). Since this rating was awarded the registered provider of the service has changed the service to Silver Birch Care Home Ltd. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Silver Birch is a residential care home providing personal care for up to 23 people. At the time of the inspection 13 people were living there.

People’s experience of using this service and what we found

People were kept safe by staff who knew them well. Staff had a good understanding of keeping people safe and this included reporting concerns to other healthcare professionals and the local authority if they suspected abuse. People were supported by enough staff who were trained and recruited safely.

People care needs were assessed regularly and reviews considered the protect characteristics under the Equality Act. This ensured staff had updated information to support people safely.

People were supported to have food that met their current dietary and cultural needs.

People were supported by staff that were caring, kind and maintained people’s privacy, dignity and encouraged people to remain as independent as possible ensuring their health care needs were met

People were supported to undertake activities of their choice.

People and relative knew how to raise concerns and the provider used the information to improve the service for people.

People received their medication as prescribed and to maintain their health.

Staff sought peoples consent before providing care and support. People were to have maximum choice and control of their lives and staff supported them in the least restive way possible.

Staff had a good understanding of the Mental Capacity Act 2015 and deprivation of liberty safeguards.

Why we inspected

The inspection was a comprehensive planned inspection based on the previous rating.

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.

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