CQC report explained · a residential care home
What the CQC found at Birches
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured that infection prevention and control measures, PPE, testing, visiting and COVID-19 vaccination checks were being managed safely.
- Effective?
- Good
- This area was not rated in this targeted inspection.
- Caring?
- Good
- This area was not rated in this targeted inspection.
- Responsive?
- Good
- This area was not rated in this targeted inspection.
- Well-led?
- Good
- This area was not rated in this targeted inspection.
What inspectors found, January 2022
Birches was inspected but not rated; inspectors were assured about infection prevention and control, visiting and COVID-19 arrangements.
This was an announced, targeted inspection on 11 January 2022. Inspectors looked at infection prevention and control, visiting arrangements and any staffing pressures linked to COVID-19.
Inspectors were assured that the home was using personal protective equipment safely, arranging testing, managing visitors and admissions safely, and following infection prevention guidance. They were also assured that visits were being supported in line with current guidance.
The report does not give an overall rating or ratings for the five areas of care. It says the home was inspected but not rated, so this report is not a full assessment of the quality of care.
Visitor infection checks
The home had checks and declarations for visitors to help reduce the spread of COVID-19 to residents and staff.
“There were robust systems to ensure visitors to the home would not spread infection to residents or staff.” from the report
Testing was risk assessed
The home used capacity and best-interest assessments when considering the distress that monthly testing could cause residents.
“There was an established staff COVID-19 testing system and the home had used Mental Capacity Act (MCA) and Best Interest (BI) assessments to risk assess the requirement to test residents monthly against the level of distress testing may cause.” from the report
PPE use
Staff were using the correct protective equipment when helping residents with daily activities.
“Staff wore appropriate PPE correctly when supporting residents with activities of daily living.” from the report
Infection control support
Managers had access to advice from infection control leads and a clinical lead nurse.
“Managers received advice and support with infection prevention and control(IPC) issues from IPC leads from the provider group and a clinical lead nurse from the primary care network.” from the report
Inspectors raised no specific concerns in this report.
- 01How have your COVID-19 visiting arrangements changed since the inspection on 11 January 2022?
- 02How do you assess the distress caused by testing for each resident, and how are best-interest decisions recorded?
- 03How do you manage staffing pressures when staff are absent because of COVID-19?
- 04How do you check that staff and visiting professionals meet the current vaccination or exemption requirements?
- 05What is the home's most recent full CQC rating for Effective, Caring, Responsive and Well-led?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not provide a full service rating. This explanation was written from the published report of 21 January 2022 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 2018
Rated Good; inspectors found safe, kind and personalised care, with some improvements still needed in staffing and best-interest decisions.
This was an unannounced comprehensive inspection on 8 November 2018. Inspectors looked at care records, medicines, staff training and recruitment, complaints, safety checks and how the home was managed. They spoke with relatives, staff and managers.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, supported by trained staff, given their medicines safely and helped to take part in activities and community life.
The home had improved since the previous inspection, when it was rated Requires Improvement and breached requirements about staff support and person-centred care. Inspectors found those breaches had been put right. They also noted some inconsistencies in best-interest decisions and asked the home to review them.
Personalised support
Staff knew people's routines, preferences and communication methods. Support plans helped staff provide individual care and encourage independence.
“People's support plans included important information about their preferences, routines and what was important to them.” from the report
Kind and respectful staff
Staff used calm, caring approaches and respected people's dignity, privacy and choices.
“People were supported by staff that treated them with kindness, dignity and respect.” from the report
Improved staff support
Staff received relevant training, regular meetings and opportunities to discuss development. Inspectors found the earlier shortfall in staff support had been addressed.
“This showed staff received effective support that equipped them to support people's individual needs.” from the report
Strong oversight
The new registered manager was described as experienced and supportive. The home used regular audits and improvement plans to monitor quality and safety.
“There was an open and inclusive, person centred approach with a clear vision and plan of how the service was to further develop.” from the report
Minimum staffing level
needs fixingInspectors did not agree that four staff was always enough for people's complex needs, particularly if physical intervention was needed. The home said after the inspection that it had increased staffing levels.
“We did not agree with this, due to the level and complex needs of people and the staffing required if physical intervention was required.” from the report
Best-interest decisions
needs fixingRecords and practice were not fully consistent when decisions were made for people who could not make particular decisions themselves. The management team agreed to review this, and inspectors said it had not negatively affected people.
“However, there were some inconsistencies in how best interest decisions were made.” from the report
End-of-life wishes
minorNo end-of-life plans were in place because they were not then required. The management team said people's wishes should be discussed during future care reviews.
“The management team told us they were aware that they needed to consult people about their end of life wishes and told us this would be discussed during reviews of people's care.” from the report
- 01What staffing level is now used for each person, and how is it increased when someone's needs or behaviour change?
- 02How do you make sure best-interest decisions are recorded consistently and reviewed?
- 03How are people's end-of-life wishes discussed and recorded during care reviews?
- 04How will you gather the views of a person who cannot communicate their experience directly?
- 05Which activities and community opportunities would be available for my relative, and how would their preferences shape them?
This was an unannounced comprehensive inspection covering all five CQC questions, including care, records, medicines, staffing, safety and management systems. This explanation was written from the published report of 5 December 2018 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 Birches
5 rated inspections over 3 years: the service has held its Good rating throughout.
- January 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Requires improvementstayed Requires improvementWell-led: Good
- September 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- December 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- September 2013
Registered with the Care Quality Commission on 6 September 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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