Birnbeck House - Care Home Learning Disabilities

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The provider was previously in breach of the legal regulation in relation to staffing. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

We found improvements were needed to ensure the provider had effectively assessed and mitigated risks for people. The provider was previously in breach of the legal regulation in relation to safe care and treatment. Improvements were not found at this assessment, and the provider remained in breach of this regulation.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The service had completed risk assessments which provided information on how to support people. However, we observed some information to mitigate risks to people was not current. For example, some people’s moving and handling risk assessments did not contain information about new equipment or moving and handling instructions, as advised by an occupational therapist. We fed this back to the manager and team leader who started to update the risk assessments during our inspection.

The service had not completed risk assessments for people at risk of dehydration. Where the service needed to monitor people’s fluid intake to reduce their risk of dehydration, their care plans and records contained conflicting information about their daily target fluid intake. This meant it was not clear if people were drinking enough fluids, or how this was monitored to reduce their risk of dehydration. We fed this back to the manager, and they had started to update some of this information.

The service supported some people who required support with repositioning to reduce their risk of pressure injuries. One person’s risk assessment recorded they should be repositioned very 3 to 4 hours. However, this was not recorded as being completed. Documentation we reviewed for another person confirmed on occasions they had not received repositioning as regularly as required. This meant people were at risk of pressure damage to their skin. We did not find any evidence people had come to harm.

Staff were recording people’s incidents of distress, but these were not routinely monitored by the management team for themes and trends. Identifying themes and trends is important as it could assist in finding ways to reduce distress for the person.

However, the provider had made some improvements. People who were assessed as being at high risk of choking had specific eating and drinking care plans which detailed any modified diets they had. They were only supported to eat by staff who had been assessed as competent to support them.

People’s pain profiles had been reviewed and recorded person specific information about how they communicated. People’s care plans had some information for staff to support people to manage risks where required, this included for personal care and constipation.

People’s relatives generally thought risks to people were well managed.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider ensured staff had suitable employment checks undertaken before working in the service. This included identification checks, Disclosure and Barring Service Checks (DBS) and previous employment references. Profiles of agency staff recorded their completed training, employment checks and induction checklists.

The provider used a training matrix to monitor training compliance. This demonstrated staff had received appropriate training for their role. All staff had now completed the provider’s learning disabilities and autism tier 2 training. Staff told us they regularly completed training. One staff member said, “All of us are now well trained. I do appreciate we have been given lots of training.”

Staff received regular supervisions. Supervision records were now more detailed and documented any agreed actions for staff to complete. The service completed staff competency checks in various areas such as dysphagia and moving and handling.

Staffing levels were provided in line with the service’s assessed requirements. The service had recruited more permanent staff. The use of agency staff at the service had decreased. Regular agency staff worked at the service where possible to minimise the impact to people. People’s relatives did not raise any concerns about staffing levels.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.