We carried out a review of the data available to us about Birchwood House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Birchwood House, you can give feedback on this service.
Birchwood House is a residential care home providing personal care for up to seven people with autism or a learning disability. At the time of inspection there were four people using the service. The service was provided to people in one building across two floors.
People’s experience of using this service and what we found
We received information from a coroner raising concerns about fire safety at this provider’s services. We inspected the service to check the fire safety arrangements. People were protected from the risks associated with a fire outbreak. There were enough staff on duty to manage in the event of an emergency. Staff had received training in fire safety and were knowledgeable about what to do if there was a fire. Fire detection systems and fire safety equipment were well maintained and regularly checked. People had personal emergency evacuation plans detailing their support needs in the event of an emergency.
People were protected from the risks associated with the spread of infection. Checks were carried out when visitors first entered the service. Staff wore personal protective equipment such as masks as required and encouraged visitors to wash their hands and wear masks.
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 7 August 2020).
Why we inspected
We undertook this targeted inspection to check on fire safety at the service. The inspection was prompted in response to concerns received from a coroner following a death as the result of a fire in one of the provider’s other services. A decision was made for us to inspect and examine those risks.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found no evidence during this inspection that people were at risk of harm from these concerns.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Birchwood House is a residential care home providing personal care to six people with learning disabilities at the time of the inspection. The service can support up to seven people in one building.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures 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
We have made one recommendation about staff training.
People, a relative and staff spoke positively about the leadership in the service. The provider carried out quality checks to identify areas for improvement. People and staff had regular meetings so they could be updated on service development and could give their views about the service. The provider worked jointly with other agencies to achieve good outcomes for people.
Staff were supported in their role with supervision and appraisals. People’s care needs were assessed before they began to use the service. Staff supported people with their nutritional, hydration and healthcare needs.
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.
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.
People using the service had risk assessments carried out to protect them from the risks of avoidable harm. Staff knew about safeguarding and whistleblowing procedures. Medicines were managed safely and people were protected from the risks associated with the spread of infection. The provider had a system in place to learn lessons from accidents and incidents.
People and a relative told us staff were caring. Staff demonstrated they knew people and their care needs well. The provider and staff understood how to provide a fair and equal service. People were involved in their care planning and were encouraged to make choices. Relatives were kept informed of their relative’s wellbeing. Staff understood how to maintain people’s privacy, dignity and independence.
Care plans were detailed and personalised. Staff understood how to deliver a personalised care service. People’s communication needs were met. People participated in a range of activities that interested them. There was a system in place for people to make a complaint. People had an end of life care plan in place so staff would know how to provide care in accordance with their wishes should this be required.
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 24 July 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.
At the previous inspection published on 11 December 2014, the service was rated Good. This inspection took place on 28 April and 2 May 2017 and the service remains Good.
There was a registered manager at this 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.
The provider had a recruitment system in place to ensure the suitability of staff working at the service and there were enough staff on duty to meet people’s needs. Staff were knowledgeable about how to report concerns or abuse. Comprehensive risk assessments were carried out with management plans in place to enable people to receive safe care. There were systems in place to maintain the safety of the premises.
The provider had systems in place to ensure the safe administration of medicines. However we found an issue with medicines and have made a recommendation around this.
Staff received appropriate support through supervisions, appraisals and training opportunities. Appropriate applications for Deprivation of Liberty Safeguards had been applied for and authorised. Staff were aware of the need to obtain consent before delivering care.
People were offered a choice of nutritious food and drink and were involved in meal preparation. People also had access to healthcare professionals as required to meet their day to day health needs.
Staff were knowledgeable about the people they were supporting including their preferences to ensure a personalised service was provided. Staff respected people’s privacy and dignity and were knowledgeable about assisting people to maintain their independence.
A variety of activities were offered which included trips into the community and people had daily meetings to decide which activities they wished to participate in that day. The service had a keyworker system whereby people had a named care worker to oversee their care needs. Relatives knew how to complain and the provider dealt with complaints in accordance with their policy.
The provider had systems to obtain feedback on the quality of the service from people who used the service and from staff. Regular meetings were held for people who used the service to involve them in the development of the service and with staff to keep them updated with policy changes. The provider had various quality assurance systems in place to identify areas for improvement.
We have made one recommendation to the provider and further information is in the detailed findings below.
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, and to provide a rating for the service under the Care Act 2014.
There was a registered manager at the service at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
At the last inspection in May 2013 the service was found to be meeting the regulations we looked at.
Birchwood House is a care home providing personal care and support for people with learning disabilities. At the time of the inspection they were providing personal care and support to six people.
People told us they felt safe and were happy with the care and support provided. We found that systems were in place to help ensure people were safe. For example, staff had a good understanding of what constituted abuse and the abuse reporting procedures. People’s finances were managed and audited regularly by staff.
There were enough staff available to support people if they needed to attend appointments or go to the community. Staff told us that they felt supported by the manager and senior staff. They completed training which helped them to carry out their jobs.
People received support from staff at the home and also from healthcare professionals based in the community. The provider had established good links with these community professionals which included community learning disability teams, speech and therapy teams, psychiatrists and psychologists which helped people in enhancing their physical and mental health.
Staff had established positive relationships with people using the service and people were supported to maintain their relationships with family. People were supported to pursue their own individual activities and interests, with the support of staff if required.
Staff, people, and other health professionals viewed the registered manager positively. Quality assurance systems were in place which included seeking the views of people that used the service.
People we spoke with told us they "liked" the care they received and felt their needs were being met by the service. We found people were initially assessed before they entered the service. We found initial assessments we viewed included cognitive assessments to determine mental capacity and assessed people's individual care needs.
People we spoke with told us they felt safe in the service and they had no concerns. We found people's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.
There were effective recruitment and selection processes in place. Staff we spoke with told us they completed an application form when they applied for their jobs and underwent an interview.
People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There was documentary evidence people could give their feedback about the service.
Staff told us they worked with other services and professionals to ensure that appropriate care planning took place. We found evidence that people were involved with a range of external professionals and services involved in their care and treatment.
We found people had person centred care plans (PCP) which identified and provided care that met their individual needs. Staff told us people were involved in the planning the delivery of their care and treatment. We found documentary evidence to support this.
The provider ensured staff employed to provide personal care to people who used the service were suitably qualified, skilled and experienced. We found staff had appropriate training and support to undertake their roles and responsibilities and meet the needs of people in the home.