Archived: Birkin Lodge Care Home

Updated 30 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was carried out to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was carried out on 22 February 2016 and was unannounced. The inspection team consisted of three inspectors.

Before the inspection we looked at records that were sent to us by the registered provider and the local authority to inform us of significant changes and events. We reviewed our previous inspection reports and sought feedback from the local authority commissioning service and safeguarding team.

We looked at five people’s care records. This included assessments of needs, care plans and records of the care delivered. We observed to check that people received the care and treatment agreed in their care plan. We reviewed documentation that related to staff management and two staff recruitment files. We looked at records relating to the monitoring, safety and quality of the service and sampled the services’ policies and procedures.

We spoke with six people who lived in the service and two people’s relatives to gather their feedback. We reviewed comments and feedback sent to the commission and the service to understand people’s experience of the care provided. We spoke with the manager, the regional support manager, the deputy manager, the regional clinical lead and three members of staff. We also obtained feedback from health and social care professionals involved in the care of people using the service.

Updated 30 March 2016

Birkin Lodge Care Home provides care and accommodation to up to 50 older people. The home is set over three floors providing a combination of residential care and nursing care. People that use the service have a range of care needs and complex health needs requiring care from registered nursing staff. The service at Birkin lodge is provided by the Brighterkind group, which is part of Four Seasons Health Care Group.

This inspection was carried out on 22 February 2016 by three inspectors. It was an unannounced inspection. There were 24 people using the service at the time of the inspection. Building work was underway at the service to refurbish the premises. Two of the three floors had been refurbished and work was due for completion on the third floor in March 2016.

There was a new manager in post who had joined the service the previous week. The manager was not yet registered with the Care Quality Commission (CQC), but told us they were in the process of applying. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection, in May 2015, the service was in breach of regulations relating to the provision of personalised care, managing risks to individuals and effective monitoring and improvement of the service. At this inspection we found improvements had been made to these areas and the requirements of the regulations met. However, practices need time to be embedded.

At this inspection we found that staff did not consistently follow safe practice for administering and managing people’s medicines. Systems for administering medicines did not ensure that people received their prescribed medicines on time.

Records were not completed accurately. There were gaps in people’s care plans about their preferences to ensure they consistently received a personalised service.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

There were sufficient staff on duty to meet people’s needs. Staffing levels were calculated and adjusted according to people’s changing needs. There were thorough recruitment procedures in place to ensure staff were suitable to work with people. Regular checks were made to ensure nursing staff remained registered and safe to practice.

Staff were knowledgeable and competent to meet people’s needs. They had the opportunity to receive further training specific to the needs of the people they supported. All members of staff received regular one to one supervision sessions. Staff felt supported in their roles and were clear about their responsibilities. This ensured they were supported to work to the expected standards.

Staff sought and obtained people’s consent before they helped them. They understood the requirements of the Mental Capacity Act (MCA) 2005 when helping people to make decisions. The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options were considered.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People praised the food they received and they enjoyed their meal times. Staff knew about and provided for people’s dietary preferences and restrictions. Nursing staff monitored people’s health needs and made prompt referrals to other health care professionals when needed.

The premises had been recently refurbished and were appropriate for the needs of the people living there. The risk of the spread of infection in the service was managed effectively.

Staff understood people’s preferences and delivered care in a personalised way. Staff knew people well and provided a caring service. People had their privacy and dignity respected and staff recognised their right to independence.

People were involved in their day to day care. People’s care plans were reviewed with their participation and relatives were invited to attend reviews that were scheduled. People were at the heart of the service. Clear information about the home, the facilities, and how to complain was provided to people and visitors.

People were involved in the planning of activities that responded to their individual needs. A broad range of activities was available that ways to keep people occupied and stimulated.

Staff told us they felt supported by the manager and supported to provide a high quality service. The manager was open and transparent in their approach. Emphasis was placed on continuous improvement of the service. Improvements had been made to the culture of the service to ensure people received personalised care. The changes need to be embedded in staff practice to ensure they are sustained.

The registered provider kept up to date with any changes in legislation that might affect the service and carried out comprehensive audits to identify how the service could improve. They acted on the results of these audits and made necessary changes to improve the quality of the service and care.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.