Birling House

Updated 8 August 2017

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 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.

This inspection took place on 11 July 2017 and was unannounced.

The inspection team consisted of one inspector and an expert by experience. The expert by experience had personal experience of using similar services. They had worked with people who have a dual diagnosis of learning disability and mental health and people with autism.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to decide which areas to focus on during our inspection.

We spoke with seven people who used the service and four relatives about their experience of the service. Not everyone was able to verbally share with us their experiences of life at the service. This was because of their complex needs. We therefore spent time observing people and how care was delivered.

We spoke with eight care workers, one senior care worker, one team leader, catering manager, maintenance man, deputy manager, registered manager and the head of business affairs and corporate affairs. We also requested information by email from healthcare professionals involved in the service. These included professionals from the community learning disabilities team, local authority care managers, continuing healthcare professionals, NHS and the GP.

We looked at the provider’s records. These included four people’s care records, which included care plans, health records, risk assessments and daily care records. We looked at eight staff files, a sample of audits, satisfaction surveys, staff rotas, and policies and procedures.

We asked the registered manager to send additional information after the inspection visit, including training records and business plan. The information we requested was sent to us in a timely manner.

Updated 8 August 2017

The inspection was carried out on 11 July 2017, and was an unannounced inspection.

Birling House provides accommodation and personal care for people with physical disabilities, learning disabilities, neurological diseases, such as Huntington’s Disease, Parkinson’s Disease and Multiple Sclerosis. Huntingdon’s disease is a hereditary disease marked by the degeneration of brain cells causing progressive dementia. The accommodation is arranged over two floors. A passenger lift is available to take people between floors. There were 30 people living in the service when we inspected.

There was a registered manager employed at the service. 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.

At the last Care Quality Commission (CQC) inspection in 03 June 2015, the service was rated Good in all domains.

At this inspection we found the service remained Good.

The service continued to provide a safe service to people. This included systems in place intended to minimise the risks to people, including from abuse and to safely manage their medicines.

There were enough staff to keep people safe. The provider had appropriate arrangements in place to check the suitability of new staff. People were supported by staff who were trained and supported to meet their needs.

Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. Staff received regular training and supervision to help them to meet people's needs effectively.

Systems were in place to assess and meet people’s dietary and health needs. They also received the support they needed to stay healthy and to access healthcare services.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider and staff understood their responsibilities under the Mental Capacity Act 2005.

Staff were caring and treated people with dignity and respect and ensured people's privacy was maintained particularly when being supported with their personal care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The registered manager ensured the complaints procedure was made available to people to enable them to make a complaint if they needed to. Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support.

The registered manager provided good leadership. They checked staff were focussed on people experiencing good quality care and support. People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted.

Further information is in the detailed findings below.