Birchmere House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Birchmere House provides residential and nursing care to older people. The home has three floors accommodating up to 76 people in one adapted building. On the day of our visit 53 people lived at the home and two of these people were in hospital. The home is located in Solihull, West Midlands.

Recently, the service provision changed. The provider for the home is now two separate companies with joint responsibility for the home. The name of the service also changed from 'Birchmere', to 'Birchmere House'. The changes in registration delayed the publication of this report.

Our last inspection took place on 29 September and 17 October 2016. This inspection was a focussed responsive inspection where we looked at the key questions of 'safe' and 'well-led'. This was in response to information we had received in relation to people's safety and how risks were managed, particularly in the reminiscence area for people living with dementia. However, since that inspection the providers have closed the reminiscence area of the home and the maximum occupancy at the home has reduced from 131 to 76. Prior to this, our last comprehensive inspection where we looked at all five key questions of safe, effective, caring, responsive and well-led, was March 2016.

At the focussed inspection we found there was one continued breach of regulation 17 (Good governance) associated with the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014. The home was rated as 'Requires Improvement'. This was because further improvements were required to establish systems and processes and to complete accurate and up to date records of each person's care and treatment.

The provider sent us an action plan which stated all the required improvements would be completed by 20 May 2017. During this inspection we checked whether the improvements had been made and we found sufficient action had been taken in response to the breach in regulation.

There was a registered manager at the home. They had started work at the home in June 2017 and registered with us in December 2017. A registered manager is a person who has registered with the Care Quality Commission 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.

People felt safe living at Birchmere House and there were enough staff to support their care needs in a timely way. Procedures were in place to protect people from harm. The staff and the registered manager understood their responsibilities to keep people safe. Staff had received training in 'safeguarding adults' to protect people from harm and described to us the signs which might indicate someone was at risk.

Processes were in place to keep people safe in the event of an emergency. People had personal fire evacuation plans and staff understood the actions they needed to take in the event of an emergency. Accidents and incidents that happened in the home were monitored and action was taken to reduce the risk of reoccurrence. Checks took place to ensure the environment and equipment was safe to use.

The provider's recruitment procedures minimised risks to people's safety. Recruiting new staff had been one of the provider's priorities over the previous six months to ensure people received consistent care from familiar staff. New staff received effective support and training when they started working at the home. Staff had completed the training they needed to be effective in their roles.

Risk assessments identified potential risks to people's health and wellbeing. Staff had a good knowledge o