Birch Hill Care Centre

Updated 31 October 2018

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 planned 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.

The inspection took place on 8 and 22 August 2018. The inspection was carried out by one adult social care inspector. The first day of the inspection was unannounced which meant the provider did not know we would be visiting. The second day of the inspection was announced.

Prior to the inspection we reviewed information we held about the service including statutory notifications. Notifications are changes, events or incidents that the provider is legally obliged to inform us of.

We contacted Northumberland and Scottish Borders safeguarding and commissioning teams. We used the information they provided when planning this inspection.

The provider completed a provider information return (PIR) prior to the inspection. A PIR is a form which asks the provider to give some key information about their service; how it is addressing the five questions and what improvements they plan to make.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk to us.

We spoke with the registered manager, deputy manager, house leader, four care staff, three relatives, and 10 people. Following the inspection we received feedback from a GP, a social worker, reviewing officer and a further three relatives.

We looked at three staff recruitment files, four care plans and a variety of records related to the quality and safety of the service.

Updated 31 October 2018

The inspection took place on 8 and 22 August 2018. The inspection was unannounced and carried out by one adult social care inspector.

We last visited the service in December 2015 where we rated the service as good. At this inspection we found the provider continued to meet all of the regulations we inspected against and had introduced a number of changes and improvements. We have rated the effective and well led key questions as outstanding so the overall rating for the service is outstanding.

Birch Hill is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. Birch Hill accommodates up to 24 people, most of whom are living with dementia. There were 23 people living in the home at the time of the inspection.

There was an experienced registered manager in place. 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.

The service was extremely effective. Bespoke and innovative training was provided to staff to help them to understand the experiences of people living with dementia. Relatives were also supported to gain a greater understanding of how people might be affected by their dementia related condition. They learned about the person centred model staff followed to minimise behavioural disturbance and distress and maximise potential, quality of life and wellbeing.

Changes in practice and the environment showed staff had taken training and advice regarding dementia care best practice on board. Steps had been taken to minimise noise and improve lighting and there was great attention to detail in order to maximise the comfort of people living in the home.

Staff received regular supervision and appraisals and were well supported to carry out their roles effectively.

The nutritional needs of people were extremely well supported through personalised ordering of meals and flexibility in the provision of food and drinks. Snack shacks and hydration stations ensured people had access to food and drinks throughout the day, and food was available at all times of the day and night.

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

In addition to routine audits and quality assurance systems, the registered manager and deputy continuously looked at ways to develop the service and enhance the experience of people living in Birch Hill. The outcome of this was an extremely well-led service. They accessed various forums and networks to help them find new ways of working with the aim of improving care. There were numerous examples of new ideas being put into practice seen during our inspection. Staff felt extremely well supported and morale was good in the home. There was an ever present shared sense of purpose with all staff demonstrating that the needs and wishes of people living in Birch Hill were paramount.

People told us they felt safe at Birch Hill and systems were in place to monitor the safety of the premises and equipment. Medicines continued to be managed safely and there were suitable numbers of staff on duty.

Staff were caring and courteous. We observed numerous examples of compassionate care during the inspection and observed the privacy and dignity of people was maintained.

A range of activities were available and people were involved and included in decisions about the home wherever possible. The individual needs and preferences were taken into account when planning activities including the provision of early bird activities for early risers and evening activities for “night owls.” Staffing was planned around the needs of people using the service to ensure they could be supported at times convenient to them. Person centred care plans were in place which were up to date and regularly reviewed. A complaints procedure was also in place.