Birkin Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Care plans were person centred and included individual preferences, likes, dislikes and favoured routines. For example, they included what time a person liked to get ready for bed, what time they liked to get up, how they wanted their personal hygiene needs met and how they liked to spend their day. However, it was not clear that people were having their needs met in relation to bathing and showering. Staff had not been recording when they had offered baths and showers and when people had declined. Records showed 20 out of 34 people had not had a bath or shower in a 2-month period. A relative told us, “Mum is now showering; we attend a family and friends meeting and were told both baths are out of action, I think mum was having bed baths. Mum says to me ‘can you help me get to the sink to brush my teeth’ I question why this isn’t being done.” Staff told us there was a bath and shower rota in place, which could be considered institutionalised. We discussed this with the registered manager who told us, the rota was there as a guide and prompt to ensure people received the minimum bath or shower to be once a week.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. The service worked with other health professionals involved in people’s care. A person had been seen by the falls team as they had been prone to falling. The falls team had recommended a home exercise programme. There was no mention of this exercise programme in the person’s care plans and risk assessments. Care notes did not reflect that exercises were being done. We asked staff and they were not aware of these exercises. The person had continued to fall frequently. We discussed this with the registered manager, after the inspection visit, they told us they had located the exercise programme in the nurse’s office. The exercises should have been completed once a day and there was no record of them being done. The registered manager had a staff meeting to get this resolved and exercise guidance was moved to the person’s bedroom. Information was shared with staff during handover regarding any changes to people’s health or care needs. Relatives told us, they felt staff supported people to ensure they were aware of upcoming appointments and communicated well with GPs and health specialists to ensure people received continuity of care. A relative told us, “Mum isn’t motivated to eat but I feel that is due to her compromised swallow due to stroke. Speech and Language therapists are involved.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. There was a lack of signage and way marking around the service to direct people to communal areas, most people’s bedroom doors did not have their names on. There was no dementia friendly signage on doors such as toilets, bathrooms and shower rooms. Staff were aware of people’s individual communication needs for example, people who may have hearing or visual impairments. Staff shared how they provided information and communicated with people. A staff member said, “We use a white board for a few people, things have improved now they have hearing aids. We had a person who used a picture board, we also use pointing and gestures.” Another staff member said, “We use writing to communicate, and a few people use white boards they make their choices. Hearing aids help. I do care plans as part of my role, we use resident of the day to update these monthly and we do this with the resident.”

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. We observed good practice from staff in relation to listening and involving people with their care and making decisions. The registered manager shared with us meeting records to show that they had met with people living at the service. The last meeting had taken place in November 2024, 11 people had attended. The meeting records showed people were involved in decision making such as event planning, fund raising and how they wanted to spend their money. Minutes of the meeting were available for all people living at the service, regardless of whether they had attended the meeting. People were offered informal opportunities to feedback about the service, the registered manager spent time walking round the service daily and chatting with people. Other updates about the service were also shared at these meetings. People and their relatives were sent surveys about the service every 6 months, the surveys had just been sent out.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People were supported with medical appointments and follow up appointments. We observed people receiving visits from healthcare professionals during the assessment visit. People’s care records showed that they had received medical help. A relative told us their loved one has visits from healthcare professionals. People were supported to maintain contact with their friends and families. We observed people receiving visits from friends and families during the inspection.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. However, some improvement was required to ensure every person experienced equality in relation to their environment. A person’s room had a very strong odour, and it had been identified their flooring needed to be replaced. Flooring specialists had been and advised it was not safe to complete the works with the person in the room (they were cared for in bed), due to their assessed needs they could only be moved to a ground floor large room to complete the works, and their bed needed to be disassembled and rebuilt in an alternative room. This meant they were stuck in their room until another ground floor room became available. The management team explained additional cleaning was being carried out in the room. However, this was not enough to remove the odour.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. The provider had systems and processes in place to understand the diverse health and care needs of people living at the service. Some people had a DNACPR (Do not attempt cardiopulmonary resuscitation) form in place. This is an advanced decision not to attempt CPR. It is not about other treatments or care. Some people had ReSPECT (Recommended Summary Plan for Emergency Care & Treatment) forms in place. A ReSPECT form records a person's wishes about a range of care and treatments. End of life care plans were as comprehensive as the person wanted it to be and plans were clear in cases where people had chosen not to discuss this element of their care. The service provided a lot of care to people at the end of their lives. Staff told us that they worked closely with the local hospice to ensure people had effective support and pain relief to ensure people had dignified, pain free deaths.