Birches Grove

Birches Grove supports people with a learning disability and/or mental health needs. It accommodates up to four people in a four bedded detached house on a residential estate. There were three people living at Birches Grove at the time of the inspection.

We found the following examples of good practice.

People understood the measures in place to protect them from COVID-19. Visits to the service and to people’s family homes had been adapted in line with recognised safe visiting guidance and lockdown restrictions. People spoke with their friends and relatives regularly, by telephone and via video calls.

People using the service were in a household bubble but maintained social distance from others during our visit. People were supported to access local areas for walks and drives out, as lockdown permitted. People enjoyed being part of an online art activity club and were involved in craft and domestic activities within the service.

People were admitted to the service safely, including when they returned from hospital or a visit to their family home. People were tested for COVID-19 before admission and were supported to self-isolate on arrival. This reduced the risk of introducing infection to others at Birches Grove.

People and staff had been supported to receive their vaccinations and COVID-19 testing. Staff ensured people accessed health care when needed and supported them with regular testing.

The provider ensured the staff team were updated on changes to national guidance and step by step procedures were in place for staff to refer to in the event of an outbreak. The provider shared lessons learned across their services to ensure people were protected from COVID-19.

Birches Grove is a care home which is registered to support up to four adults living with a learning disability. The service was fully occupied at the time of the inspection.

People’s experience of using this service:

People continued to receive safe care and staff knew how to recognise and act upon any concerns of suspected abuse. People’s risks surrounding their well-being or individual conditions, had been assessed and reviewed regularly. Medicines were administered and stored safely, and people received medicines as prescribed. There was a system to record accident and incidents.

There was a sufficient team of regular staff working with people who had training relevant to their roles and were well supported. People were supported to maintain good food intake and meet their 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.

People said they were ‘like a family’ there. We observed positive, caring interaction which demonstrated staff had a good rapport with people. Staff had a good understanding of people’s communication needs and they respected people's dignity, privacy and independence. People’s confidentiality was respected.

Staff respected people's lifestyle choices and people were involved in decisions about their care and support. People were supported to access activities of their choice, such as art classes or continuing with their employment. People were supported to live independent lives and spend their days as they wished.

The registered manager ensured their quality assurance systems remained effective. There was an open, transparent and positive culture promoted by the team. There was a system to manage complaints and people and staff were involved in running of the service and listened to.

Rating at last inspection:

At the last inspection the service was rated Good (report published 2 December 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Birches Grove is set in a quiet residential area. It had a lounge/dining room area, kitchen and four bedrooms upstairs. People could freely move around the home and had access to a secure and private back garden.

A new manager had been appointed. They were in process of applying to be the registered manager which is required by the homes conditions of registration. 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.

People told us they enjoyed living at Birches Grove. Staff approached people in a kind and caring manner. They ensured people received care and support in accordance to their preferences and needs. Their privacy and dignity were respected. People enjoyed arrange of activities. Some people were independent in the community and had a part time job or volunteered. Others enjoyed activities with the support of staff.

People were supported by staff who had been trained and supported to carry out their role. Systems were in place to check the criminal and employment backgrounds of new staff to ensure they were of good character. The staffing levels of the home were adjusted according to people’s health and social support needs.

Staff had been suitably trained in subjects such as safeguarding, fire safety and managing challenging behaviour. They were confident in their abilities. Staff told us they felt trained to carry out their role and were aware of their responsibilities to ensure people were kept safe and to report any concerns.

People’s care and support needs and associated risks were assessed and documented. People received the care and support they needed. Measures were in place to support people and allow them to undertake new opportunities. There were sufficient numbers of staff to ensure people’s needs were being met.

People’s medicines were managed safely. Some people were supported to manage their own medicines. Their care records provided staff with information about their background, levels of independence and their support requirements. People were supported to make decisions about their care. The managers recognised that people care plans needed to be thoroughly reviewed and updated. Plans were in place to review people’s care plans to ensure they reflected everyone’s needs and consent to their care.

A new manager was in post. They had gained a good understanding of the home and the actions they needed to take to ensure people received high quality care and staff were trained and supported. Quality monitoring systems were in place to check and address any shortfalls in the service. Most identified shortfalls had been acted on. People’s views and opinions were listened to. There were opportunities for people to raise concerns. Complaints were investigated and acted on by the manager.

We sampled records for three of the four people living at the home and found that risk assessments and care plans had been reviewed regularly. Our observations and discussions with staff and people who used the service demonstrated that care plans were being followed. Appropriate support had been sought from health professionals to make sure that people's needs were being met.

People were protected against the risk of abuse as people using the service were confident in raising their concerns and staff responded appropriately to them. One person told us, 'Staff listen to us'.

Appropriate checks had been carried out before staff started work at the home. One person said they were '...happy with all the staff'they are kind and caring'. Supervision had been carried out with new staff members during their induction to ensure they knew what was expected of them and they had the information they needed to perform their role.

Quality monitoring was carried out at regular intervals in the home and an action plan was being completed to address identified shortfalls. Although there was no registered manager at the home at the time of the inspection the provider had made suitable arrangements to manage the service.

We found that the needs of three people living at the home were being met but there were significant shortfalls in meeting the needs of one person living at Birches Grove. We found that this person's care plans had not always been followed and some needs had not been addressed effectively. During our visit we found that some staff had not recognised or responded appropriately to safeguarding concerns raised by one person at the home.

Appropriate checks and risk assessments had not always been carried out before staff were employed to care for people at the home. This meant vulnerable people were placed at risk. Insufficient analysis and investigation of incidents meant that appropriate changes to care were not put in place to protect people. Although 'your voice' meetings were held reguarly with people at the home, their concerns were not always given due regard.