CQC report explained · a residential care home
What the CQC found at Silver Birch Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, November 2021
Rated Requires Improvement; inspectors found medication, risk assessment and management oversight problems, although people were generally supported by caring and sufficient staff.
This was an unannounced inspection on 09 September 2021. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care records, medication records, staff files and management records.
The home was not always safe. Inspectors found problems with sharps, medicines and some risk assessments. Two people did not receive medicines as prescribed, with no recorded reason. One person’s regular use of sleeping medicine had not led to a medical review.
The home was also not consistently well-led. Audits had not found some problems with medicines or care records, and there was no registered manager. The overall rating was Requires Improvement. This means some aspects were not always safe and there was limited assurance about safety.
Safeguarding awareness
The provider had safeguarding systems, and staff understood how to protect people from abuse and avoidable harm.
“The provider had safeguarding systems in place and staff had a good understanding of what to do to make sure people were protected from avoidable harm or abuse.” from the report
Staffing
Inspectors found enough staff to meet people’s needs. Recruitment checks had been completed.
“There were sufficient numbers of staff on duty to meet people's needs.” from the report
Infection control
Inspectors were assured that the home had effective infection prevention measures, including safe use of protective equipment and arrangements for visits.
“We were assured that the provider was using PPE effectively and safely.” from the report
Positive staff culture
Staff said they felt supported and valued. They had regular supervision and opportunities to raise concerns and suggestions.
“Staff told us they felt valued and their views were respected.” from the report
Medicine safety
seriousInspectors found unsafe sharps storage and disposal, missed medicines without recorded reasons, and a lack of medical review for regularly used PRN sleeping medicine.
“We found two people did not receive their medication as prescribed with no recorded reason.” from the report
Out-of-date risk information
seriousSome risk assessments and care plans were not updated after changes in people’s health. One catheter care plan did not clearly explain the required care.
“We found improvements were required to ensure risk assessments were accurate and up to date following changes to people's health conditions.” from the report
Weak quality checks
needs fixingAudits did not identify problems with medicines or care records. The home also needed better analysis of incidents to find recurring themes.
“The provider's audits to monitor the quality of the service were not consistently effective in identifying and driving forward improvements.” from the report
No registered manager
needs fixingThere was no registered manager in post at the time of the inspection. The provider said an application would be submitted for the acting manager.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01What changes have you made to ensure medicines are given as prescribed and any missed doses have a recorded reason?
- 02How are sharps containers now stored, checked and disposed of?
- 03How do you make sure risk assessments and care plans are updated after a person’s health changes or hospital admission?
- 04Who is currently responsible for managing the home, and what is the progress of the registered manager application?
- 05How do your audits now check medicines, care records and accident or incident trends?
This was an unannounced inspection focused on Safe and Well-led; the report gives ratings only for these two questions. This explanation was written from the published report of 16 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.
What inspectors found, December 2019
Requires Improvement; inspectors found safe, kind and responsive care, but the home still needed to improve its environment and management systems.
This was an unannounced, comprehensive planned inspection on 10 and 11 October 2019. Inspectors spoke with people living in the home, relatives, staff, the manager and the provider. They also checked care, medicines, recruitment and management records.
The home was rated Good for Safe, Caring and Responsive. Inspectors found people were protected from abuse, supported by enough staff and given their medicines safely. Staff knew people well, treated them kindly and supported their choices, activities and cultural needs.
Effective and Well-led were rated Requires Improvement. Building improvements had started but were not finished, and new management systems were not yet fully established or tested. The overall rating means the home had improved since the previous Inadequate rating, but further improvement was still needed.
People felt safe
Staff understood how to recognise and report abuse. Risks were recorded, reviewed and used to guide people's care.
“People were kept safe by staff who knew them well.” from the report
Kind and respectful care
Inspectors saw patient and compassionate interactions. Staff respected privacy, dignity and people's preferred ways of being addressed.
“Staff were patient, they listened to what people said and demonstrated kindness and compassion.” from the report
Personalised support
Staff knew people's needs and preferences. The home supported activities, cultural meals, spiritual choices and involvement in care planning.
“People were supported to undertake activities of their choice.” from the report
Improved direction
The new provider and manager had started making changes. Staff said they felt more involved and supported.
“All staff spoken with told us the way they were working now was better because they were involved and had a sense of direction.” from the report
Building work was unfinished
needs fixingThe home was safe, but inspectors found that much work was still needed to bring the environment up to the expected standard. Renovation and decoration were ongoing.
“The new provider had a lot of work to do to bring the environment up to the required expected standard.” from the report
New checks were not embedded
needs fixingNew management systems had been introduced but had not yet been fully tested to show that they identified and addressed problems effectively.
“New systems had been implemented but were not fully embedded to assess their effectiveness.” from the report
Some dining arrangements needed attention
minorPeople eating in the lounge were not offered salt and pepper during the inspection. This was a small but specific gap in meeting people's meal preferences.
“People who remained in the lounge area to eat their meals were not offered salt-and-pepper.” from the report
- 01What work has been completed since the inspection to improve the building, decoration and furniture?
- 02How do you now check that the new quality and care-record systems are working effectively?
- 03How do you make sure people are offered the meal choices and items they prefer when eating in different areas of the home?
- 04How are people's care plans and assessments being updated on the new provider's system?
- 05What changes have been made since the previous Inadequate rating, and what improvements are still outstanding?
This was a comprehensive inspection covering all five key questions; it was the first inspection of the newly re-registered service under the new provider. This explanation was written from the published report of 3 December 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.
Every inspection of Silver Birch Care Home
7 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- November 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2019Requires improvementup from InadequateSafe: GoodWell-led: Requires improvement
- June 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2018Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2017Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- April 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2019
Registered with the Care Quality Commission on 29 April 2019.
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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