CQC report explained · a nursing home
What the CQC found at The Birches Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People said they felt safe and there were enough staff. However, inspectors found that legionella risks, water temperatures and flushing of water outlets were not properly assessed, checked and recorded.
- Effective?
- Good
- Staff had suitable training and supervision. People were supported with healthcare, food and drink, consent, and their individual needs.
- Caring?
- Good
- Staff built positive relationships with people and treated them with kindness, dignity and respect. People were involved in their care and encouraged to remain independent.
- Responsive?
- Good
- Care plans gave staff guidance about people's routines, needs and preferences. Activities were available, but inspectors found that social and emotional needs were not always covered in enough detail in care plans.
- Well-led?
- Good
- The home had approachable management, quality checks and an open culture. Inspectors found that feedback was gathered, although discussions with people and staff were not always formally recorded and staff meetings were not frequent.
What inspectors found, February 2020
Rated Good overall; inspectors found kind, responsive care, but safety needed improvement because water risks were not fully managed.
This was an unannounced inspection on 22 and 24 January 2020. Inspectors spoke with seven people, six relatives, eight staff members and a visiting professional. They reviewed care records, medicines records, staff files and management records.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. People and relatives described caring staff, enough staff, good food and support that respected people's choices and dignity.
Safe was rated Requires Improvement. Inspectors found that risks linked to legionella and water management had not been assessed and monitored properly. The provider acted after the inspection by bringing in a water company. Inspectors also found smaller gaps in medicines records, room temperature checks, bathroom bins and social and emotional care planning.
Caring relationships
Staff knew people well and treated them warmly and respectfully. Inspectors observed positive and friendly interactions.
“All the interactions we observed between people and staff were positive and friendly.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Staff responded promptly and were not rushed.
“There were sufficient staff to meet people's care needs.” from the report
Staff training
Staff completed relevant training, induction and supervision. People and relatives felt staff had the skills needed for their roles.
“People were supported by staff who had completed a range of training to develop the skills and knowledge they needed to meet people's needs” from the report
Choice and activities
People had choices about food and were offered activities such as music, quizzes, arts and crafts and pampering.
“Activities were planned for the month and included, arts and crafts, music, quizzes and pampering and outside entertainers.” from the report
Water safety checks
seriousThe home had not completed a legionella risk assessment or water testing. Water temperatures and flushing of outlets were also not consistently checked and recorded.
“Improvements were needed to assess and identify risks relating to the management of legionella within the service.” from the report
Medicine records
needs fixingSome opened liquid medicines and insulin pens did not have their opening dates recorded. The room temperature for medicine storage was also not recorded.
“We did find a small number of opened liquid medicines and insulin pens with no date of opening recorded.” from the report
Social and emotional care planning
needs fixingCare plans contained people's life histories, but this information did not always become a clear plan for their social and emotional wellbeing.
“There was a lack of focus on how peoples social and emotional needs might be met” from the report
Infection control details
minorNot all bathroom bins had closed lids, although the manager said new bins had been ordered after the inspection.
“However, we found not all bins in the bathrooms had closed lids in line with best practice for infection control.” from the report
- 01Has the legionella risk assessment now been completed, and can you show us the latest water testing results?
- 02How are water temperatures and flushing of outlets checked and recorded now?
- 03How do you make sure opened liquid medicines and insulin pens have their opening dates recorded?
- 04How are each resident's social and emotional needs recorded and reviewed in their care plan?
- 05How often are staff meetings held, and how are suggestions or concerns recorded and followed up?
This was an unannounced planned inspection covering all five CQC key questions; Safe had fallen from Good at the previous inspection, while the other four ratings remained Good. This explanation was written from the published report of 26 February 2020 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, July 2017
Rated Good; inspectors found safe, kind and responsive care, with a window safety problem fixed during the inspection.
This was an unannounced inspection on 10 and 11 July 2017. The inspector and an expert by experience spoke with people, relatives, staff and health professionals. They also reviewed care records, staff files, audits, surveys and other records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines arrangements, person-centred care plans, good support with food and health needs, and kind and respectful care.
Inspectors found that window restrictors on the first and second floors were not all safe on the first day. This created a risk of serious injury from a fall. The provider acted immediately and sent evidence that robust restrictors had been fitted. The home had also acted on the previous inspection's recommendation about activities and social isolation.
Enough suitable staff
Inspectors found enough skilled staff to meet people's needs. Recruitment checks were also in place before staff started work.
“There were enough skilled staff deployed to support people and meet their needs.” from the report
Kind and respectful care
Staff spent time talking with people and supported their choices, privacy and dignity. Care was described and observed as warm and compassionate.
“Staff cared for people in a relaxed, warm and friendly manner.” from the report
Personalised support
Care plans included people's preferences, histories and changing needs. Families and other professionals were involved where appropriate.
“Care plans were person centred and contained guidance about people's personal preferences for how they liked to be supported.” from the report
Activities improved
Since the previous inspection, the home had introduced more activities and afternoon one-to-one social care. This was intended to reduce social isolation, including for people who stayed in their rooms.
“The provider had also made staff available each afternoon for 'social care'.” from the report
Window safety
seriousOn the first day, some window restrictors on the first and second floors were not robust or fit for purpose. Inspectors said this created a risk of serious injury, but the provider arranged repairs immediately and supplied evidence that suitable restrictors had been fitted.
“This meant that people were at risk of serious injury from falls from heights.” from the report
- 01How have the window restrictors been checked and maintained since the inspection?
- 02How are activities planned for people who do not want to join group activities or who spend time in their rooms?
- 03How often are care plans reviewed, and how will my relative and our family be involved?
- 04How do you check that medicines continue to be given and recorded correctly?
- 05How do you monitor staffing levels when people's care needs change?
This was an unannounced inspection covering all five CQC questions, including observations, discussions with people and staff, and checks of care, staffing and quality records. This explanation was written from the published report of 28 July 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 Nursing Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 14 February 2011.
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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