Background to this inspection
Updated
5 August 2021
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
The inspection was carried out by two inspectors, an assistant inspector and an Expert by Experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this
type of service.
Service and service type
Birchmere Mews is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care
provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Prior to the inspection we looked at the information we held about the service to help us plan our inspection. We used the information the provider sent us in the 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 reviewed notifications we had received about events that had happened at the service, which the provider is required to send to us by law, for example about serious injuries. We contacted commissioners to
gather their views about the service. We used all this information to plan our inspection.
During our inspection we spoke with seven people who use the service and six visitors/relatives about their experience of the care provided. We spoke with four members of staff, the cook, the registered manager and
regional manager. 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.
We reviewed a range of records. This included five people's care records and multiple medication records. We also looked at records relating to the management of the home. These included systems for managing
complaints, checks undertaken on the health and safety of the home and staff training records.
Updated
5 August 2021
About the service
Birchmere Mews accommodates up to 63 people in a purpose-built building. It provides residential care to older people, younger adults, people with a mental health condition, dementia, a physical disability and
sensory impairment.
People's experience of using this service
People's needs were assessed before they moved into the home to make sure these could be met and it was the right place for them to live.
There was an effective system to identify risks associated with people's care. These were identified, recorded and regularly reviewed to keep people safe. Health professionals were contacted, where appropriate, to
support people's healthcare needs.
People felt safe and spoke positively of the staff and of living at the home. Staff understood what they needed to do to keep people safe. Where people lacked capacity, this had been identified and people were
supported with decision making where needed.
Staff were recruited safely and there were enough staff to meet people's needs. Staff received on-going support, training and supervision to be effective in their roles.
Staff knew people well and ensured people had access to social activities and stimulation to maintain their wellbeing in accordance with their preferences.
The environment was clean, and staff followed good infection control practice.
People received their medicines when they needed them, and medicines were managed safely by suitably trained staff.
People's nutritional and hydration needs were met. People were offered a choice of meals and snacks on a daily basis and staff understood and supported people's dietary needs.
Staff cared about people and were responsive to their needs. Care plans supported staff to provide personalised care. People had opportunities to maintain positive links with the community and there were
plans to further expand these.
People were supported to be independent. Signage and visual prompts were limited to support people to find their way around the home. Actions were in progress to review the environment to ensure this fully
supported people living with dementia.
Staff understood how to respect people privacy and dignity and people told us this was maintained.
People's end of life wishes were discussed with them as appropriate and specific decisions were documented to ensure their wishes were respected.
People and their relatives felt at ease to raise any concerns with staff and said any issues discussed with the registered manager were effectively acted upon.
Systems to monitor the quality and safety of the service were in place to ensure staff followed the required policies and procedures to keep people safe and meet their needs. People, staff and relatives had opportunities to voice their views of the service through planned meetings or quality questionnaires.
Feedback from people, their relatives and staff was welcomed to drive improvement.
Health and safety checks were carried out to make sure equipment and the environment was safe for people.
At this inspection, we found the evidence supported a rating of 'Good' in all areas.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This was the first inspection to this service under the new registered provider.
Why we inspected
This was a planned inspection for the newly registered service.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.