CQC report explained · a residential care home
What the CQC found at Birch House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2019
Rated Good; inspectors found safe, kind and personalised care, with minor management record issues.
This was an unannounced planned inspection on 11 June 2019. One inspector met all five people living there, observed care, spoke with staff, and reviewed care, medicine, recruitment, training and management records. Feedback was also sought from relatives and a health professional.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines, good risk management, a clean environment and appropriate support with health and nutrition.
Staff knew people well and treated them with kindness, dignity and respect. People were supported to make choices, stay active, maintain relationships and develop independence. The manager and provider used regular checks and feedback to monitor and improve the service.
The overall Good rating means the home met the characteristics of good care at this inspection. This was unchanged from the previous Good rating published on 28 December 2016.
Kind and respectful staff
Staff showed warmth and compassion and treated people with dignity. They noticed and responded to people's individual communication and body language.
“We saw that people were relaxed and comfortable around staff, people were smiling.” from the report
Personalised support
Care plans described what each person could do and where they wanted or needed help. Staff adapted support to individual routines, preferences and health needs.
“They delivered care and support specifically tailored to meet each person's needs.” from the report
Choice and independence
People were supported to make everyday choices, take part in household tasks, go out, learn new skills and maintain relationships.
“Staff promoted people's independence to maximize their potential.” from the report
Safe care and staffing
Inspectors found safe medicine systems, staff with relevant training, enough staff on duty and suitable arrangements for managing risks and emergencies.
“People received their medicines safely and in accordance with their preferences.” from the report
Quality monitoring
The manager and provider used regular audits, surveys and incident reviews to check the service and act on areas for improvement.
“These measures gave the provider an improved oversight of what was happening in the service and what improvements needed to be made to service delivery.” from the report
Manager registration pending
minorA manager was in post, but their registration with the CQC had not yet been completed. The application was being processed at the time of inspection.
“The manager was not yet registered with the Care Quality Commission.” from the report
Reference records
needs fixingInspectors said the home needed clearer records explaining when and why alternative staff references were used. The provider's human resources staff member agreed to implement this.
“We discussed the need for accurate recording of when and the reasons why alternative references were sought to provide a clear audit trail.” from the report
- 01Has the manager's registration with the CQC now been completed?
- 02How do you record and check alternative references when recruiting staff?
- 03How are medicines, including epilepsy rescue medicines, checked and kept safe now?
- 04How do you update care plans and risk assessments when someone's needs or behaviour changes?
- 05How do people and their relatives influence activity plans, care decisions and service improvements?
This was an unannounced inspection covering all five CQC questions, including the care provided and the premises; the previous rating was Good in all areas. This explanation was written from the published report of 1 August 2019 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, December 2016
Birch House was rated Good overall; inspectors found safe, kind and personalised care, with some medicine records needing improvement.
This was an unannounced comprehensive inspection on 16 November 2016. Inspectors observed care, spoke with one resident, three relatives and staff, and checked care plans, medicine records, staff files and management records. Most residents had limited verbal communication, so inspectors relied heavily on observation and feedback from relatives and staff.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, suitable training, person-centred care, support with health needs, and systems to monitor quality.
There were two medicine recording problems. One liquid medicine had not been dated when opened, and staff had not recorded that they had observed a person applying prescribed cream. The manager agreed to put these right. Inspectors also found that one care plan needed clarification about whether relatives had legal authority to consent to medicine support.
Safe staffing
Inspectors found staffing levels were planned around people's assessed needs. Staff recruitment included appropriate checks.
“The rota showed that staff had been identified to provide support to each person throughout the day to enable them to have their agreed levels of support.” from the report
Kind and dignified care
Staff were observed and reported to treat people with kindness. Privacy, dignity and confidential information were protected.
“People received support from staff who showed kindness and compassion.” from the report
Personalised support
Care plans described people's routines, likes, dislikes and communication needs. Staff used this information to support individual choices.
“People's care plans were centred on them as individuals and contained information about their likes, dislikes and preferences.” from the report
Independence and activities
People were encouraged to take part in household tasks, develop skills and enjoy hobbies they had chosen.
“This meant that people were doing activities they enjoyed and that helped them to develop skills.” from the report
Medicine records
seriousOne liquid medicine had not been dated when it was opened. Staff had also failed to record that they had observed a person applying prescribed cream.
“We found that one person had been prescribed a liquid medicine that had been used. This had not been dated when it was opened.” from the report
Consent records
needs fixingA person's parents had signed to consent to medicine support, but the home had not yet clarified whether they had the legal authority to do this.
“However, we found that in one person's care plan their parents had signed to consent to the person being supported with their medicine.” from the report
Family feedback
minorOne relative said they were not being given enough formal information about the person's progress. The home mainly relied on informal communication and care plan reviews.
“A relative told us, "I have not been asked for my thoughts on [person's] progress.” from the report
- 01How were the undated liquid medicine and missing cream records corrected, and how are medicine records checked now?
- 02How do you assess a person's capacity to consent to medicine support, and what evidence is needed when relatives make decisions?
- 03How will you give families regular formal updates about progress and changes in support?
- 04How often are resident meetings and other opportunities for people to give feedback held now?
- 05What training and supervision will staff receive to support each person's communication, routines and independence?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the service. This explanation was written from the published report of 29 December 2016 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 House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- October 2013
Registered with the Care Quality Commission on 25 October 2013.
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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39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.