We carried out a review of the data available to us about The Birches on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Birches, you can give feedback on this service.
The Birches is a residential care home providing personal care to up to seven people. The service provides support to adults with mental health needs. At the time of our inspection there were seven people using the service.
The Birches accommodates people in one adapted building across three floors. There are communal living and dining areas and an accessible garden with outdoor seating.
People’s experience of using this service and what we found
People were protected from harm and abuse, staff had received training in this area and understood how to report any concerns. People’s medicines were safely managed, and staff were recruited safely. There were sufficient numbers of staff available to meet the needs of the people using the service. Risks which affected people’s daily lives were assessed and monitored. We were assured that the provider had sufficient infection, prevention and control measures in place.
Staff training was relevant and up to date, there was effective systems in place to support and supervise staff. People were encouraged and supported to cook their own meals and people planned what they would like to eat. Staff sought guidance from external professionals when required.
Staff were respectful and maintained people’s dignity, privacy and independence. People were given the opportunity to be involved in their care planning and how they wished to be supported, care plans contained information on people’s lifestyle choices, preferences and decisions.
People’s needs were regularly reviewed, and support was adjusted as required. People were supported to access their chosen hobbies and interests and relatives told us staff kept them up to date with relevant information about their family members’ care.
There was a positive, person-centred approach to the delivery of people's care. The provider and registered manager had a good oversight through the regular audits they carried out. We found the systems in place to be robust and identified areas for improvement which were then actioned.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 16 May 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The Birches is registered to provide accommodation and personal care for up to seven adults with mental health needs. It is situated in Chesterfield. Six people were living there at the time of our inspection.
People's experience of using this service:
Systems were in place to monitor the quality of the service provision; however, these were not always effective in ensuring issues were identified or improvements were made and sustained.
Improvements were required to the service's governance arrangements to assess and monitor the quality of the service and ensure that action was taken as required.
Whilst people received their medicines safely and as prescribed by their GP, the completion of the medicine administration records needed attention.
People and staff were positive about the care provided at The Birches.
Staff knew people well and had developed meaningful relationships with them. People were given choice and supported to develop daily living skills.
Staff were kind and caring and people were treated with dignity and respect.
People received effective care from staff who understood how to recognise and report issues of concern and potential abuse. Staff were recruited safely, were visible in the service and responded to people quickly.
There was a complaints system in place and people felt able to raise concerns which were addressed.
People could access the community and take part in a range of activities which promoted their wellbeing.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
People's health was well managed and there were positive links with other professionals to ensure that individual needs were met.
People and staff were positive about the manager and felt they were approachable.
Rating at last inspection: Good (report published 7 October 2016)
Why we inspected: This was a planned inspection based on the previous rating.
Enforcement: Please see the 'action we have told the provider to take' section towards the end of the report.
Follow up: We will continue to monitor all intelligence received about the service 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
The Birches is registered to provide accommodation and personal care for up to seven adults with mental health needs. Seven people were living there at the time of our inspection.
The service did not have a registered manager at the time of our inspection visit. 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 provider had appointed a member of staff who was in the process of applying to become the registered manager. The service also had a manager in place who was responsible for the day-to-day running of the service.
People were protected from the risk of abuse and avoidable harm. Risks associated with care were identified and assessed. Staff had clear guidance about how to meet people’s individual needs. Care plans were regularly reviewed with people and updated to meet their changing needs and preferences. People were supported and cared for by sufficient staff who were suitably skilled, experienced and knowledgeable about people’s needs.
The provider took steps to ensure checks were undertaken to ensure that potential staff were suitable to work with people needing care. Staff received one-to-one supervision and had regular checks on their knowledge and skills. They also received training the provider felt necessary to meet the needs of people at the service.
The systems for managing medicines were safe, and staff worked in cooperation with health and social care professionals to ensure that people received appropriate healthcare and treatment in a timely manner.
Arrangements were in place to assess whether people were able to consent to their care. The provider was meeting the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS). This meant people’s rights were being upheld, and any restrictions in their care were lawful and proportionate.
People were supported to be involved in their care planning and delivery by staff who respected and supported their individual choices. The support people received was tailored to meet their individual needs, wishes and aspirations.
Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care. Regular checks were undertaken on all aspects of care provision and actions were taken to improve people’s experience of care.
The provider demonstrated that people, relatives and staff felt confident in the way the service was managed, and that everyone felt confident to raise concerns or suggest improvements.
The purpose of this inspection was to respond to concerns which had been raised about the service and ensure people using the service were safe from the risk of unsafe care or treatment. There were 7 people living at the home at the time of our visit. We spoke with three people. We were not able to speak with everyone. One person was in hospital. We also looked at care plans and other records. We spoke with the manager and deputy manager working at the service. We used the evidence we collected during our inspection to answer five questions. A summary of what we found is set out below.
Is the service safe?
We spoke with three people who told us they felt safe. One person told us, 'It's much better than anywhere I have been previously.' They said, 'I feel safe and can raise concerns with the deputy manager who listens.' Another person told us if they had any concerns they would contact their social worker. Another person said they would contact the police if they had major concerns. One person told us they had raised concerns about how a member of staff spoke with people. They said their concern had been taken seriously and the service had acted to protect people.
Is the service effective?
The service had developed care plans to support people. We saw people had been involved in the development of their care plans and had discussed the content with their link worker. Link workers reviewed people's care plans regularly to ensure they continued to meet people's needs.
Is the service responsive?
People we spoke with told us they were sometimes cold. One person told us they had two duvets on their bed. Another person told us they were sometimes so cold they felt physical pain. Care staff said they were not aware feeling cold was related to the person's medical condition. However, the service had not obtained advice from healthcare professionals about the likelihood or how to support the person.
Is the service caring?
Everyone we spoke with told us care staff were kind and supportive. One person told us they enjoyed spending time with care staff and said they wished staff had more time to support them rather than cleaning or carrying out other roles.
Is the service well led?
The provider had systems in place for identifying, assessing and managing risks relating to the health, welfare and safety of people using the service.
We saw that people were consulted and gave consent in writing before they received care or treatment. They were involved and in control of these decisions. All people using the service had capacity to consent.
We saw that people's care records contained detailed information about their needs and they had access to a range of health and social care professionals to support them. Care and treatment was planned in a way to ensure each person's personal safety and wellbeing.
We saw from observation, records and speaking to staff that the premises were suitable and safe and were maintained to a high standard. A person using the service said, "Yes, security is good and I do feel safe here".
We found that there were adequate numbers of suitably trained and experienced staff to meet people's needs. Two people using the service said that they felt there had been sufficient staff on duty at all times.
An effective complaints system was available, people using the service were able to tell us how they would make a complaint.
We found that people were involved in making decisions about their care and support. We saw that people were supported in their chosen lifestyles and relationships.
People were protected from abuse and from the risk of excessive physical restraint by staff awareness and the policies in place.
We found that staff recruitment procedures included making all necessary checks before staff started working with people using the service. We saw that staff had appropriate training to ensure they could meet people’s needs.
We found that people using the service and staff had the opportunity to give their views about the service provided. We saw that changes were made to the service in response to people’s views and in response to incidents and the findings of audits.