The Care Quality Commission
  • Care Home
  • Care home

Birling House

Overall: Good read more about inspection ratings

89 High Street, Snodland, Kent, ME6 5AN (01634) 244689

Provided and run by:
The Mortimer Society

All Inspections

11 July 2017

During a routine inspection

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.

3 June 2015

During a routine inspection

The inspection was carried out on 3 June 2015 and was unannounced.

The service provided 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 was arranged over two floors. A passenger lift was available to take people between floors. There were 27 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.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The registered manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

People felt safe and staff understood their responsibilities to protect people living with disabilities and degenerative illness. Staff had received training about protecting people from abuse. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.

The registered manager and care staff used their experience and knowledge of people’s needs to assess how they planned people’s care to maintain their safety, health and wellbeing. Risks were assessed and management plans implemented by staff to protect people from harm.

There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell.

People and their relatives described a service that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered.

Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected.

The registered manager involved people in planning their care by assessing their needs when they first moved in and then by asking people if they were happy with the care they received. Staff knew people well and people had been asked about who they were and about their life experiences. This helped staff deliver care to people as individuals.

Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. The risk in the service was assessed and the steps to be taken to minimise them were understood by staff.

Managers ensured that they had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. The premises and equipment in the service were well maintained.

Recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the service. The registered manager ensured that they employed enough staff to meet people’s assessed needs. Staffing levels were kept under constant review as people’s needs changed.

Staff understood the challenges people faced and supported people to maintain their health by ensuring people had enough to eat and drink. All of the comments about the food were good.

If people complained they were listened to and the registered manager made changes or suggested solutions that people were happy with. The actions taken were fed back to people.

The registered manager ensured that they followed best practice for people living with degenerative illnesses resulting in physical disabilities or loss of cognitive function.

People felt that the service was well led. They told us that managers were approachable and listened to their views. The registered manager of the service and other senior managers provided good leadership. The provider and registered manager developed business plans to improve the service. This was reflected in the positive feedback given about staff by the people who experienced care from them.

24 February 2014

During an inspection looking at part of the service

This inspection was carried out to follow up compliance actions from our inspection on 24 July 2013. During that visit we found non-compliance with three of the standards we inspected. During this visit we found that improvements had been made.

We spent some time with people who used the service and spoke with a relative who visited the service weekly who praised the quality of the service their family member received. They said, "You can't fault it here." "I can't think of anything that could be improved." We found that the atmosphere in the home was calm and relaxed. We saw that staff were attentive to people and provided care and support with patience, kindness and good humour.

We found that people were treated with respect. New care plans had been formulated for each person and staff described how people were involved as far as possible in this process. Where people were not able to be directly involved due to their illness, family members were consulted to make sure that people's needs and preferences were fully understood.

We looked at quality assurance systems. We found that these had been improved to make sure that people were assured of a good service.

We looked at records kept by the service. We found that records were completed accurately and were accessible to staff when they were needed.

Overall we found that this service was safe, effective, caring, responsive and well-led and had achieved compliance with all the standards we inspected.

24 July 2013

During a routine inspection

During our inspection we spoke to people who used the service, staff and managers. We also used observation tools to observe interactions between people and staff. We saw that there were some positive interactions. However staff did not always engage with people living in the home when they needed staff attention.

We received concerns that people were being assisted to get up, washed and dressed by night staff which was not in line with people's wishes. We found that these concerns were correct for a number of people.

We looked at people's care records and observed staff giving care throughout the day. We saw that staff knew people well and delivered care in line with people's needs.

We observed people over breakfast and lunchtime periods and throughout the day. We saw that people were able to have food and drinks when they wanted them. We saw that staff followed guidance from speech and language therapists to ensure that people were supported appropriately to maintain adequate nutrition and hydration.

We looked at how the service monitored the quality of the service provided. We found that some areas were not effective and the service had not always acted on shortfalls that had been identified.

We looked at records kept by the service. We found that records were not always completed accurately and were not easily accessible when they were needed.

21 January 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service. Many of the people using the service had complex needs including communication difficulties which meant they were not always able to tell us about their experiences. We observed how people interacted with staff. We saw staff working with people, helping them with their day to day needs. We saw that people were content and routines were flexible and relevant to the people who lived at Birling House. The home was clan and well organised and staff were well supervised and supported.

We spoke with some of the people who lived in the home and they told us that they were happy and felt well supported. People said, 'I love it here.' 'Staff are lovely.' 'It's always nice and clean.' 'I choose what I want to do.'

People told us about the different activities that they participated in. They said that they were able to go out and were supported by staff to do so. We saw that people took part in a programme of activities. A large group of people were enjoying music therapy during our visit. People we spoke with told us were supported to make their own decisions.