CQC report explained · a nursing home
What the CQC found at Birch Grove Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe moving and handling, suitable staffing, safe medicines systems and good infection control.
- Effective?
- Requires improvement
- Mealtime support had improved, but staff had gaps in knowledge and skills around positive support for behaviour that might challenge the service. Staff had also not had overall work performance appraisals for well over 12 months.
- Caring?
- Good
- People were treated with warmth, dignity and respect. Staff encouraged people to make choices and remain as independent as they could and wanted to be.
- Responsive?
- Good
- Care plans were personalised and included people's preferences, life histories and communication needs. People had access to activities, could raise complaints and received compassionate end of life care.
- Well-led?
- Good
- People, relatives and staff spoke positively about the management approach. The home used audits, action plans and people's views to monitor and improve care.
What inspectors found, February 2020
Rated Good overall; inspectors found safe, kind and person-centred care, but staff training and the dementia-friendly environment needed improvement.
Inspectors visited on 7 and 13 January 2020. The first day was unannounced. They spoke with people living in the home, relatives, managers and staff. They also observed care and checked care plans, medicines records, recruitment files and other records.
The home was rated Good overall. Safe, caring, responsive and well-led were rated Good. Effective was rated Requires Improvement. Inspectors found that moving and transferring people, mealtime support and medicines management had improved since the previous inspection.
The main weaknesses were gaps in staff training for behaviour that may challenge the service, staff appraisals not being completed for over 12 months, and communal areas not being particularly suitable for people living with dementia. The manager agreed to take action, and progress will be checked at a future inspection.
Safer transfers
Inspectors found that staff had corrected the previous problems with moving and transferring people. Staff used hoists safely and care plans included detailed moving and handling guidance.
“Staff followed relevant national guidelines in relation to supporting people with mobility needs to move and transfer safely.” from the report
Kind and respectful care
People appeared comfortable with staff. Inspectors saw staff respect privacy, ask permission before entering bedrooms and support people's independence.
“Conversations between people and staff were characterised by respect and warmth.” from the report
Personalised support
Care plans included people's likes, dislikes, life histories and care preferences. Staff offered choices about meals and activities and supported people to stay connected.
“People received care and support according to their individual assessed needs and preferences.” from the report
Safe medicines and staffing
Medicines were organised and given as prescribed. Inspectors found no recording errors in the medicines records they checked, and staff numbers appeared adequate during the visit.
“Medicines systems were well organised and people received their prescribed medicines when they should.” from the report
Gaps in behaviour support training
needs fixingNo staff had completed positive behavioural support training. Inspectors said this could leave staff less able to prevent or manage behaviour that might challenge the service.
“No staff had completed any positive behavioural support training in relation to preventing or appropriately managing behaviours considered challenging.” from the report
Overdue staff appraisals
needs fixingRecords showed staff had not had overall work performance appraisals for well over 12 months. The manager agreed to introduce an action plan.
“Records showed staff had not had their overall work performance appraised for well over 12 months.” from the report
Manager registration in progress
minorThe home did not have a manager registered with the CQC at the time of the inspection. A new manager had been in day-to-day charge since January 2019 and was applying to register.
“The service did not have a manager registered with the CQC.” from the report
- 01What positive behavioural support training have staff completed since the inspection?
- 02Have all staff now received their required work performance appraisals?
- 03What changes have been made to communal areas to support people living with dementia?
- 04Has the manager's application to register with the CQC been completed?
- 05How do you check that improvements to moving and handling and mealtime support are being maintained?
This was a planned, comprehensive inspection covering all five key questions, and the previous overall rating was also Good. This explanation was written from the published report of 19 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2017
Rated Good overall; inspectors found kind, responsive care, but the effective rating was Requires Improvement because mealtimes and some moving and handling needed improvement.
The inspection was unannounced and took place on 16 May 2017. Inspectors spoke with people living in the home, relatives and staff. They observed care, including lunchtime, and checked care records, staff files, medicines and management records.
The home was rated Good overall. It was rated Good for Safe, Caring, Responsive and Well-led. Effective was rated Requires Improvement. Inspectors found safe medicines systems, caring staff, personalised care plans and a good range of activities.
The main problems were the mealtime experience in one part of the home and some moving and handling practices. The home did not breach a regulation, but inspectors made a recommendation about moving and handling. A registered manager was not in post, although a new manager had applied to register.
Safe medicines and staffing
Medicines were administered, recorded, stored and disposed of safely. Inspectors also found that staffing levels were adjusted when people's needs changed.
“People continued to receive their medicines safely.” from the report
Kind and respectful staff
People and relatives spoke highly of the staff's kindness and friendliness. Inspectors observed respectful care and attention to privacy and dignity.
“Everyone we spoke with spoke highly of the caring and respectful attitude of a consistent staff team which was observed throughout the inspection.” from the report
Personalised care
Care plans described people's individual needs, preferences and routines. People and relatives were involved in care planning where possible.
“The care plans were detailed and gave descriptions of people's needs and the support staff should give to meet these.” from the report
Activities and choice
People could choose how to spend their time and were offered activities in the home and community. Staff also supported people to maintain their hobbies and interests.
“The provision of meaningful activities remained good and staff undertook activities with people both at the service and in the community.” from the report
Management monitoring
The home used audits, feedback and monitoring to identify problems and plan improvements. Staff and people said managers were approachable.
“Quality assurance audits were embedded to ensure a good level of quality was maintained.” from the report
Uneven mealtime experience
needs fixingIn one dining area, a staff member repeatedly left someone who needed help with eating. Their food became cold, and another person was not offered an alternative meal when they disliked lunch.
“However, our observation of the lunch service on the top floor (Stanmer) was not as positive.” from the report
Moving and handling practice
needs fixingInspectors saw wheelchair footplates or brakes not being used and staff assisting people in non-approved ways. The report says these examples had no direct impact on the care people received, but recommends improvement.
“We saw three examples of staff assisting people in non-approved ways, such as placing their hands under their armpits.” from the report
No registered manager
minorThe registered manager had left around four months before the inspection. Day-to-day management was being provided by a new manager who had applied to register with the CQC.
“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.” from the report
- 01What changes have you made to the mealtime service, especially for people who need help eating or who do not like the meal offered?
- 02What action have you taken following the recommendation about moving and handling?
- 03How do you check that staff consistently use the correct moving and handling methods?
- 04Who is currently responsible for managing the home, and what is the progress of their CQC registration?
- 05How do your audits show that improvements to mealtimes and moving and handling have been sustained?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating. This explanation was written from the published report of 23 June 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Birch Grove Nursing Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 15 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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