CQC report explained · a residential care home
What the CQC found at Birkenhead Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable risk assessments, safe recruitment, enough staff on the inspection days and safe medicines systems. Infection prevention and control arrangements were also considered effective.
- Effective?
- Good
- Staff had suitable training and support. People's dietary, health, communication and consent needs were assessed and included in their care plans.
- Caring?
- Good
- People and relatives spoke positively about the staff. Inspectors found that people were treated with kindness, dignity and respect, and were supported to make choices and remain independent.
- Responsive?
- Good
- Care plans reflected people's individual needs, likes and dislikes and were regularly updated. People could take part in activities, maintain relationships and raise complaints if needed.
- Well-led?
- Good
- Inspectors found approachable management, supportive teamwork and regular audits. The provider had acted on issues from the previous inspection and used incidents and feedback to improve care.
What inspectors found, January 2023
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
The unannounced inspection took place on 6 and 12 December 2022. Inspectors spoke with people living in the home, relatives and staff. They reviewed care plans, medicines records, recruitment files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff on duty, safe medicines systems, suitable risk assessments and care that respected people's choices and dignity.
The home mainly supports people living with dementia and can care for up to 60 people. At the inspection, 58 people were receiving support. The report says the provider had acted on the previous inspection and was no longer in breach of regulation.
Personalised care
Care plans described people's needs, wishes and preferences. Staff knew people well and supported them in an individual way.
“Care plans and risk assessments were person centred and they detailed how people wished and needed to be cared for.” from the report
Kind and respectful staff
People were supported patiently and respectfully. Relatives described staff as kind, considerate and supportive of people's independence.
“People received support in a caring, responsive and patient manner.” from the report
Safe systems
The home had systems for managing risks, medicines, accidents and infection control. Inspectors found enough staff on duty during the inspection.
“There were systems in place to learn lessons when things went wrong.” from the report
Good food and activities
People's dietary needs were recorded and staff supported specific diets where needed. The home offered activities and spaces such as a cinema room and pub.
“People were able to make choices about how they spent their time and were supported to take part in a range of social and leisure hobbies and interests.” from the report
Improved management
The provider had improved the service since the previous inspection. Audits and action plans were used to address identified issues.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulation.” from the report
Decision-making records
needs fixingSome records about relatives' legal authority to make decisions were still being updated. Ask how this has been completed and kept current.
“The registered manager was in the process of updating the documentation to reflect the evidence of this.” from the report
External areas
minorThe home had an improvement plan, including planned work to the external areas. Ask what work has been completed and what remains outstanding.
“There was an ongoing improvement plan within the home. There were plans for the external areas to be improved.” from the report
Busy staffing periods
minorAlthough inspectors found enough staff on duty, one person said staff were sometimes under pressure. Ask how staffing is managed during busy periods or absences.
“I have never seen a shortage of staff however there are times they are pushed.” from the report
- 01How many staff are usually on duty on each unit, and what happens when staff are absent or the home is busy?
- 02Have the records about relatives' legal authority to make decisions now been updated and checked?
- 03What improvements to the external areas have been completed, and what work is still planned?
- 04How are risks, accidents and incidents reviewed, and how are lessons shared with staff?
- 05How will you support my relative's personal preferences, communication needs, activities and independence?
This unannounced inspection covered all five CQC areas and included infection prevention and control arrangements, with visits on 6 and 12 December 2022. This explanation was written from the published report of 12 January 2023 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, November 2021
Rated Requires Improvement; inspectors found caring support but gaps in risk assessments, medicines records and management oversight.
This was an unannounced inspection on 26 October 2021. One inspector, a medicines inspector and an Expert by Experience visited the home. They spoke with relatives, staff and health and social care professionals, and checked care, medicines, recruitment and management records.
The home cared for 54 people living with dementia, with space for up to 60. Relatives described the care positively. Inspectors saw people who were comfortable and happy with staff, who were caring and patient.
Inspectors found that some health risks were not properly assessed. Some medicines guidance and storage temperature records were also incomplete. The home had systems for safeguarding, staffing, infection control, accidents and complaints.
The overall rating fell from Outstanding at the previous inspection to Requires Improvement. Safe and Well-led were rated Requires Improvement, while Responsive was rated Good. The report says the provider must send an action plan, and CQC will monitor progress and return for another inspection.
Kind and patient staff
Inspectors saw people who appeared comfortable and happy with staff. Relatives also gave positive feedback about the care.
“It was observed during the inspection that people were comfortable and happy in the presence of staff who interacted with them in a caring and patient manner.” from the report
Safeguarding and staffing
The home had systems to respond to abuse concerns. Recruitment checks were in place and inspectors saw an appropriate number of staff on duty.
“Staff were recruited appropriately with various checks in place to ensure their suitability for the role.” from the report
Infection control
Inspectors were assured about infection prevention, including the use of protective equipment, testing, cleaning and arrangements for visits.
“We were assured that the provider was making sure infection outbreaks could be effectively prevented or managed.” from the report
Activities and family contact
Activities had increased after being reduced during the pandemic. Relatives said staff helped them keep in touch with people living in the home.
“The people living in the home enjoyed events and took part in ongoing activities that the staff provided on a daily basis.” from the report
Missing health risk assessments
seriousSome people did not have risk assessments for conditions such as diabetes or kidney problems. This meant staff did not always have written guidance to recognise problems or provide safe support.
“There was a failure to robustly assess risks relating to the health, safety and welfare of people.” from the report
Medicines records
needs fixingSome people did not have written instructions for certain pain relief and behaviour-related medicines. Storage temperatures were not always recorded every day.
“Not all the people, who were administered pain relief medicines and medicines to manage behaviour had written guidance to administer these appropriately.” from the report
Management oversight
needs fixingAudits were in place but had not picked up all the risk assessment and medicines problems. There was no registered manager when inspectors visited.
“However, during the inspection we identified aspects of the care service needed to be improved such as identification of risk and some medication issues.” from the report
- 01What action has been completed since the inspection to assess risks linked to diabetes, kidney conditions and nutrition?
- 02Do all residents now have clear written guidance for pain relief and medicines used to manage behaviour?
- 03How are medicine storage temperatures recorded and checked every day?
- 04Has a registered manager now been appointed, and how are the interim and deputy managers supported?
- 05What did the provider's latest audits find, and how are outstanding improvements being checked?
This was a focused inspection prompted by concerns about medicines and service delivery, mainly examining Safe and Well-led; other key questions were not inspected and some ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 25 November 2021 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 Birkenhead Court
3 rated inspections over 4 years: the service has slipped, from Outstanding to Good.
- January 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2021Requires improvementSafe: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- October 2018OutstandingSafe: GoodEffective: OutstandingCaring: GoodResponsive: OutstandingWell-led: Outstanding
- May 2021
Registered with the Care Quality Commission on 6 May 2021.
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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