CQC report explained · a residential care home
What the CQC found at The Birches
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments were individual to each person and regularly reviewed. Medicines were managed safely overall, but inspectors found several low-level administrative errors in medicines records.
- Effective?
- Good
- Staff had training, supervision and appraisals, and people received support from health professionals. The home had improved its work under the Mental Capacity Act since the previous inspection.
- Caring?
- Good
- Staff were familiar with people and were observed providing kind, respectful and compassionate care. People were supported to make choices and remain as independent as possible.
- Responsive?
- Good
- Activities were based on people's interests and were mainly provided one to one. Care records could have included more detail about people's life experiences, backgrounds and interests.
- Well-led?
- Good
- Quality checks, audits and action plans were used to monitor and improve care. Inspectors received positive feedback about the management and communication at the home.
What inspectors found, September 2019
The Birches was rated Good; inspectors found safe, kind and well-managed care, with some low-level medicines errors and mixed views about staffing.
This was an unannounced, planned inspection on 29 August 2019. One inspector reviewed information held by the CQC, spoke with staff, one person and relatives, and checked care records, recruitment files, medicines records and management documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from avoidable harm, received personalised support, and were treated with kindness, dignity and respect.
There were some issues, but they were not judged to change the overall rating. Inspectors found low-level administrative errors in medicines records, mixed feedback about staffing numbers and a need for more detailed information in some care records. The manager acted on the medicines errors during the inspection.
Safe recruitment
Staff had pre-employment checks, including checks through the Disclosure and Barring Service. Inspectors found recruitment procedures to be safe.
“Safe recruitment procedures continued to be in place. All staff were subject to pre-employment and Disclosure and Barring System (DBS) checks.” from the report
Kind and respectful care
Inspectors saw staff treating people with kindness and respect. People were supported with privacy, dignity, choice and independence.
“Staff interacted and engaged with people in a kind and friendly way. It was clear that positive relationships had developed between staff and people receiving support.” from the report
Activities matched interests
People received support with activities chosen around their likes and interests. Staff also helped people stay active and involved in the community.
“Activities were tailored around people's likes, preferences and interests.” from the report
Quality monitoring
The home used audits, checks and action plans to monitor care and address improvements.
“Effective quality assurance measures were in place. Audit tools and checks were regularly completed, these helped to ensure the quality and safety of care provided was well maintained.” from the report
Mixed feedback about staffing
needs fixingStaffing appeared well managed during the visit, but relatives gave mixed views about staff numbers. The manager said recruiting the right staff had been difficult and was a priority.
“Although staffing levels appeared to be well-managed at the time of the inspection, we received mixed feedback from relatives about the levels of staff who were employed.” from the report
Medicines record errors
minorInspectors found several low-level administrative errors in medicines administration records. The manager investigated them and took immediate action to strengthen procedures.
“We identified a number of low-level administrative errors when we checked medication administration records (MARs).” from the report
More detail in care records
needs fixingAlthough staff knew people well, inspectors said records needed more information about people's life histories, backgrounds and interests. The manager said this would be addressed.
“However, we identified that care records could have contained more detailed information in relation to people's life experiences, backgrounds and interests.” from the report
- 01How many staff are on duty for each shift now, and how do you adjust this for each person's support needs?
- 02What checks were introduced after the low-level errors in medicines administration records?
- 03Have care records been updated with each person's life experiences, background and interests?
- 04How are one-to-one activities planned, and how are people's choices recorded?
- 05What changes have been made since the previous inspection, when Effective was rated Requires Improvement?
This was an unannounced, planned inspection that looked at the overall service, including all five CQC questions, the premises and the care provided. This explanation was written from the published report of 24 September 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, March 2017
Rated Good overall; inspectors found kind, safe and personalised care, but the home needed to improve capacity assessments.
Inspectors visited on 2 March 2017 without telling the home in advance. This was the first inspection. They observed care, spoke with people, staff and professionals, and checked two care records and other service records.
The home supported seven people with an acquired brain injury, with three people living there at the time. Inspectors found people were safe, treated with kindness, supported to make choices and helped to remain independent. Staff understood people's needs and there were enough staff to provide support.
The main shortfall was in the Effective area. Some capacity assessments had not been completed for specific decisions, including decisions about medicines. The overall rating was Good, with Safe, Caring, Responsive and Well-led rated Good, and Effective rated Requires Improvement.
Enough staff
Inspectors found there were enough staff to support people safely and help them do what they wanted. Staff were not rushed and spent time with people.
“There were sufficient staff to provide support to people.” from the report
Kind and respectful care
People were treated as adults and staff adapted their communication and support to individual preferences. Privacy and dignity were also respected.
“People were treated with respect and their privacy and dignity were promoted.” from the report
Personalised activities
People were supported to enjoy different activities and experiences, both in the home and outside it. Plans were flexible and based on what people wanted.
“People were supported to explore different experiences and staff recognised people's diverse interests.” from the report
Quality checks
The provider and manager had systems to check the quality of care and record improvements when concerns were found.
“The provider and registered manager carried out quality checks on how the service was managed.” from the report
Capacity assessments
needs fixingFor some decisions, the home had recorded that people lacked capacity but had not completed an assessment for that specific decision. Inspectors recommended seeking advice on best practice.
“However, a capacity assessment had not been completed to establish whether they had capacity to make this specific decision.” from the report
- 01How are capacity assessments completed for each specific decision a person may need help with?
- 02How do you make sure decisions made in a person's best interests are recorded and reviewed?
- 03How are medicines managed when a person may lack capacity to consent to them?
- 04How will you keep activities and weekly plans matched to the person's changing interests and wishes?
- 05How will you involve people and families in the planned annual quality review?
This was an unannounced first inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 31 March 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 The Birches
2 rated inspections over 2 years: the service has held its Good rating throughout.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2015
Registered with the Care Quality Commission on 12 December 2015.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Staffordshire
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 £1,230 a week. 85 can care for a couple. 10 years' experience on average.
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
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.