The Birches

Updated 24 September 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered 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.

Inspection team:

The inspection was carried out by one inspector.

Service and service type:

The Birches is a ‘care home’. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of the inspection the service had a manager registered with CQC. Registered managers and the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced.

What we did:

Before the inspection we reviewed the information we held about the service. This included any statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted local commissioners of the service to gain their views. We used the information the provider sent us in the ‘provider information return’. 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 used all this information to formulate a ‘planning tool’; this helped us to identify key areas we needed to focus on during the inspection.

During the inspection:

We spoke with a director of operations, registered manager, four members of care staff, one person who was living at The Birches, and three relatives over the phone.

We looked at care records of three people receiving support, a sample of staff recruitment files, medication records, and other records and documentation relating to the management and quality monitoring of the service.

Updated 24 September 2019

About the service:

The Birches is a ‘care home’ that provides accommodation and personal care for up to seven people with acquired brain injury; six people were living in the home at the time of our inspection. Accommodation was found across two floors, and parts of the home had been adapted to safely support people who were living there. Well maintained living, dining and gardens areas were also provided.

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

Staffing levels were based on individual support needs of the people who were living at the home. We received mixed feedback about the numbers of staff who were employed at the home.

Safe recruitment procedures were in place. People received safe and effective care from staff who had been appropriately recruited and had undergone the correct recruitment checks.

Staff received regular supervisions and appraisals. Staff were also supported with a variety of different training, learning and development opportunities to support their skills and abilities.

Medication processes and procedures were safely in place. Staff were appropriately trained, and care records contained the relevant information in relation to medicine support people needed. We identified several administrative errors which the registered manager responded to and immediately rectified.

People’s support needs and areas of risk management were assessed and determined from the outset. Support needs and areas of risk were regularly reviewed, and staff were provided with the most relevant and up to date information they needed.

People were protected from avoidable harm; safeguarding and whistleblowing procedures were in place and staff knew how to report any concerns they had as a way of keeping people safe.

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

It was evident during the inspection that the staff team were familiar with the people who lived at The Birches. We discussed with the registered manager how more detailed, person-centred care information would be beneficial.

Service design and adaptations were tailored around the needs of the people living at the home. The home offered assisted equipment, supported independence and accommodated people’s equality and diversity support needs.

Activities and stimulation were primarily offered on a one to one basis. Staff provided activity support that was tailored around individual choice and preference.

There was an up to date complaints policy in place. Complaints were responded to and managed in line with company policy.

Quality assurance systems were effectively in place and helped to ensure the quality and safety of care was routinely monitored, assessed and improved upon accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was ‘good’ (published 30 March 2017).

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.