Birchmere House

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

People were not consistently kept safe due to delays in responding to call bells. Although staffing levels often met planned numbers, a high reliance on agency staff who did not always know people well affected the quality of care, particularly at night. Some risk assessments also lacked the level of detail needed to guide safe and personalised support.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect. Some interactions were task‑focused, and some people reported limited access to showers, having a choice in gender of the staff that supported them and activities due to the complexity of their needs and ongoing staffing pressures. This led to variable experiences of person-centred care.

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. Staff did not always feel confident speaking up or that their views would be acted upon. Governance processes were in place but had not always identified issues found during the inspection, which meant opportunities for learning and improvement were missed.

The service was in breach of legal regulation in relation to governance at the service.