Birchwood & Co Case Management Ltd

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.

This is the first assessment for this newly registered service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. An overview record of accidents and incidents had recently been introduced, providing improved oversight. These records were routinely reviewed to identify themes or trends, and any learning proactively shared to reduce future risk. We found the management team were open and transparent and wanted to drive improvement at the service.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People’s needs were assessed before support began, with input from them and, where appropriate, their families. The service drew on a multi-disciplinary team of skilled professionals from a range of backgrounds who were employed by the service. In addition, they worked collaboratively with external professionals from both statutory and private services to ensure that people received well-coordinated, safe and consistent support. This joint working approach helped to facilitate smooth transitions between services.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. While no recent issues had required formal reporting, previous records evidenced appropriate reporting processes in place to ensure safeguarding concerns were reported promptly to the local authority and CQC. Relatives told us they felt safe with the support provided by Birchwood and Co Case Management Limited. One relative commented, “100% yes” when asked if they felt their relative was safe. Staff had completed safeguarding training for both adults and children and the provider’s policy guided staff about how to recognise and report abuse. Staff told us they felt confident to raise concerns if they felt people were at risk and that action would be taken. One staff member told us, “I would report it immediately to my manager and follow safeguarding procedures to ensure the person is safe.” There were processes in place to review people’s capacity in line with the MCA.The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). We found the service was working within the principles of the MCA.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Care records and risk assessments were detailed and person centred, providing clear guidance for staff on how to support people safely. We identified that options for recording some aspects of support delivered on the electronic system were limited and may create a potential risk. We discussed this with the provider who agreed to speak to the developers to address the issue. The service was also in the process of transitioning to a new electronic system which as well as offering improved functionality also offered more options for improved oversight and risk management.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Assessments of the environment were completed prior to support commencing and reviewed at regular intervals. However, the formal recording of these checks required improvement to strengthen oversight and evidence that areas such as service dates were identified and acted upon. The provider confirmed that the new electronic system being introduced would provide the option for improved recording of checks completed and track and flag service dates for equipment.

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. Staff completed an induction on commencement of employment and ongoing training and refreshers to enable them to carry out their role effectively. However, some areas of training needed review or implementation to ensure people were supported safely, effectively and in line with best practice. This included training on learning disability and autism which met the Oliver McGowan code of practice and areas such as positive behavioural support and epilepsy. Improved oversight of training compliance, supervision and competency checks were also needed. The provider advised training was being sourced and agreed to prioritise this for staff alongside improving systems for monitoring training, supervision and competency checks. Recruitment procedures were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people. Where staff had transferred into the service, some staffing information was missing from records which the provider agreed to address in retrospect as well as ensuring health information and employment history was completed in full for all staff including those recruited by an agency. Staff overall told us they felt supported in their roles and received regular support and supervision. A few staff felt more frequent check ins, team building sessions and full staff meetings would further improve teamwork and wellbeing.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff received training in infection prevention and control (IPC), and policies were in place to manage the risk of infection. No concerns were raised by staff or families about the availability of personal protective equipment (PPE) or the management of infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff were trained in medicines administration, and their competency had been assessed. People were supported by staff who followed systems and processes to administer, record and store medicines safely. Records of completed competency assessments required clearer oversight which the provider agreed to action. The provider had a medicines policy, and this included the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).The introduction of a new electronic system was also expected to strengthen the oversight of medicines administration. Families raised no concerns about medicines.