Archived: Birchdale Care Home

Updated 12 March 2015

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

We did not request a Provider Information Return (PIR) before we undertook the inspection, due to the late scheduling of the inspection. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

This inspection took place on 26 November 2014 and was unannounced. The inspection team consisted of two inspectors, an expert by experience and a specialist nursing advisor. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service for older people. The specialist advisor helped us to gather evidence about the quality of nursing care provided. We undertook general observations in communal areas and during mealtimes.

Due to their health conditions and complex needs not all of the people were able to share their views about the service they received. During the inspection we spoke with 10 people who lived at Birchdale, four relatives, the deputy manager, six support workers, the activities co-ordinator, two catering staff, the temporary manager and regional manager.

We observed care and support in communal areas and looked in the kitchen and six people’s bedrooms. We reviewed a range of records about people’s care and how the home was managed. We looked at care plans for six people, the recruitment, training and induction records for four staff, five people’s medicines records, staffing rosters, staff meeting minutes, meeting minutes for people who used the service and their relatives, the maintenance book, maintenance contracts and the quality assurance audits that the registered manager completed.

We reviewed other information we held about the home, including the notifications we had received from the provider about deprivation of liberty applications, safeguardings and serious injuries. We also contacted commissioners from the local authority and clinical commissioning group who contracted people’s health and social care. The local authority commissioners told us they had suspended the admission of people with nursing needs to the service from 18 July 2014 until 11 November 2014, as the service was not meeting its contractual obligations with regard to the provision of nursing care. We spoke with the local safeguarding team who had concerns the service had under reported safeguarding concerns before July 2014.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 12 March 2015

This was an unannounced inspection carried out on 26 November 2014.

We last inspected Birchdale in April 2013. At that inspection we found the service was meeting all its legal requirements.

Birchdale Care Home provides accommodation for up to 63 people who need support with their personal and health care. The home mainly provides support for older people many who are living with dementia. The home also provides general nursing support to some people. The home is a large, purpose built property. Accommodation is arranged over three floors and there is a passenger lift to assist people to get to the upper and lower floor. The home has 63 single bedrooms all with an en-suite facility. There were 26 people living at the home at the time of our inspection.

There was a registered manager in place, however the registered manager was not available at the time of inspection. A temporary manager was running the home. 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.

Although people said they felt safe and they could speak to staff. Comments included; “Safe, yes, the staff are so nice to me and pleasant.” Another person commented; “I feel very safe and if I was not happy I would let them know.” We found there were not always enough staff on duty to provide individual care and support to people and to keep them safe as staffing levels were not maintained.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

The necessary checks were carried out to ensure the building was safe and fit for purpose.

Staff knew people’s care and support needs but detailed care plans were not in place to help staff provide care to people in they wanted. They were also not available to give staff guidance to provide consistent care to people who displayed distressed behaviour. Information was not available for all people with regard to individual preferences, likes and dislikes. We found records did not all accurately reflect people’s care and support needs.

People said staff were kind and caring. Comments included; “Staff are very pleasant and helpful.” “The carers are very pleasant.” “Staff keep me up to date with the care and; “If I want anything doing they will do it.” Staff responded patiently to people’s requests for assistance. They spoke warmly to people and noticed when people needed any help.

Menus were varied and a choice was offered at each mealtime. Staff were sensitive when assisting people with their meals and the catering staff provided special diets which some people required.

Birchdale was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had received training and had a good understanding of the Mental Capacity Act 2005 (MCA) and Best Interest Decision Making, when people were unable to make decisions themselves. Staff were provided with other opportunities to receive training to meet people’s care needs.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the treatment they needed. People received their medicines in a safe and timely way.

People had the opportunity to give their views about the service. There was regular consultation with people and their family members and their views were used to improve the service. A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to. The provider undertook a range of audits to check on the quality of care provided.

We found two breaches of the Health and Social Care Act 2008(Regulated Activities) Regulations 2010 in relation to staffing levels and records.

You can see what action we told the provider to take at the back of the full version of the report.