Silver Birches

Updated 5 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Silver Birches is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Silver Birches is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 22 August 2023 and ended on 25 August 2023. We visited the service on 22 and 23 August 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people, 9 relatives, the registered manager and nominated individual, deputy manager, cook, cleaner, and 3 care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 2 healthcare professionals who visited the service during the inspection.

We reviewed a variety of documents including 2 peoples care plans, and 4 peoples medicines records. We also reviewed various documentation relating to the management of the service.

During off site inspection activity we received additional documentation from the registered manager.

Updated 5 October 2023

About the service

Silver Birches is a residential care home providing a regulated activity for up to 19 people. The service provides support to people with dementia, physical disability and mental health. At the time of our inspection there were 12 people using the service. The care home accommodates people in one adapted building.

People’s experience of using this service and what we found

Shortfalls remained with infection control processes and procedures with some equipment and bedding found to be unclean. Systems and processes where not robust enough to ensure these checks were consistent enough.

People and their relatives were not always involved when their care needs were reviewed.

We have made a recommendation about reviews of care.

There was limited activity at the service for people to occupy their time.

We have made a recommendation about activities.

The provider and registered manager had addressed a significant number of the concerns we previously identified. They had implemented systems and processes to improve the oversight at the service. More time was required to provide assurance that recent changes to systems were effective and fully embedded.

Medicines and risks to people’s health and welfare were safely managed. Recordings in care plans and risk assessments were detailed and guided staff how to meet people’s needs. Staffing levels were sufficient to meet people’s needs.

Safely recruited staff provided kind and compassionate care. Staff knew people well and how best to support them in line with their individual preferences.

People were safe and protected from the risk of harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 18 May 2023)

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of one regulation.

This service has been in Special Measures since 18 May 2023. During this inspection the provider demonstrated that a number of improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Silver Birches on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.