29 December 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 was a comprehensive inspection.
The inspection took place on 9 and 12 October 2017 and was unannounced. The inspection team included one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before our inspection we looked at records that were sent to us by the registered manager and the local authority to inform us of significant changes and events. We also reviewed our previous inspection report. We did not ask the registered provider to complete a provider information return (PIR) on this occasion. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make.
We spoke with ten people using the service and five people’s relatives. We spoke with the registered manager and two members of care staff.
We looked at three people’s care plans and records. We reviewed documentation that related to staff management and three staff recruitment files. We looked at records concerning the monitoring, safety and quality of the service and we sampled the service's policies and procedures.
29 December 2017
Birchwood Care Services is a home care agency situated in an annexe of Birchwood House Residential Home in Speldhurst on the outskirts of Tunbridge Wells. Birchwood Care Services provide care and support to people in their own homes. The service assists people with physical disabilities, people living with dementia and adults over 65 yrs. The service specialising in supporting people in rural areas who have found it difficult to access other care services. There were 57 people using the service at the time of our inspection.
There was a registered manager in post. 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 inspection, the service was rated Good. At this inspection we found the service remained Good and met all relevant fundamental standards.
Why the service is rated Good
Staff knew how to recognise and respond to the signs of abuse. Risks to individuals’ safety and wellbeing were assessed and minimised. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Medicines were managed safely.
There was a sufficient number of staff deployed to meet people’s needs. Staff received the training and support they needed to meet people’s individual needs. Robust recruitment procedures were followed to ensure staff were of suitable character to carry out their role. We made a recommendation to review the way staff are deployed to take account of user feedback about receiving a specified call time.
Staff knew each person well and understood how to meet their needs. People told us that staff communicated effectively with them and treated them with kindness and respect. People were supported to make their own decisions and remain as independent as possible. Staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.
People were promptly referred to health care professionals when needed. Staff knew about and provided for people’s dietary preferences and restrictions. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. These records helped staff deliver personalised care.
The registered manager and the provider were open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was a system of monitoring checks and audits to identify any improvements that needed to be made. Action had been taken as a result of these checks to improve the quality of the service and care. Records were maintained accurately to allow the registered manager to monitor care delivery.
Further information is in the detailed findings below.