The Birches - Care Home

Updated 6 September 2019

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 Care Act 2014.

Inspection team

The first day of the inspection was completed by one inspector and one assistant inspector and completed by one inspector on the second day.

Service and service type

The Birches – Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at information sent to us since the last inspection such as notifications about accidents and safeguarding alerts. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service, two relatives and three health and social care professionals. We also spoke with the cook, three care staff, activities co-ordinator, the registered manager and the Quality Assurance and Compliance Manager. 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 with us.

We completed a tour of the environment to look at the cleanliness of the service and the facilities available for people. We also looked at a range of documentation including four people’s care files and medication records for three people. We looked at a selection of documentation for the management and running of the service such as recruitment, induction, supervision and staff training. We also looked at audits, and compliments and complaints.

Updated 6 September 2019

About the service

The Birches – Care Home is a residential care home. The service accommodates people across four bungalows and two self-contained flats. The bungalows can be accessed via a secure door leading from one to another, but each bungalow was treated as a separate entity. The service is registered to provide support for 31 people who may be living with a learning disability and autism. At the time of our inspection, 27 people lived at the service.

The service is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design and layout. Although the bungalows were all at one location, we found they were separate, and all had their own communal areas. The service was working in line with the principles of Registering the Right Support to ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were happy with the service and complimentary of staff. A relative said, “The service and all the staff from the registered manager, office staff, carers, chef and cleaners are brilliant. We have not met such wonderful people for a long time.”

People felt safe with staff and there was enough staff to meet people’s needs in a timely way. Recruitment, induction and ongoing training processes helped ensure only suitable staff were employed and that they had the required skills and knowledge. Staff were supported by the management team through supervision, appraisals and meetings.

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.

Staff respected people as individuals, helped people to follow their own routines and to pursue a wide range of hobbies and interests. Staff promoted people’s independence, provided appropriate support and maintained people’s privacy and dignity. People enjoyed the meals and their health and wellbeing was monitored. Referrals were made to healthcare services in a timely manner and staff followed professional advice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The registered manager had ensured there was a supportive and positive culture and engaged people in the development of the service, they told us, “People are at the centre of everything we do and every decision we make.” The management team closely monitored the quality of the service and addressed problems promptly.

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 requires improvement (published 11 July 2018) and there were multiple breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.