Birchwood

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People were assessed for the provider to assure themselves they could meet their needs. People visited the service prior to coming to live at the service and the service worked closely with the person and relatives in getting to know the person.

A relative told us that the transition to the service was well managed. Staff from the service visited them in their previous setting to consider if they were suitable. They and the family member visited the service, and they were given the opportunity to choose a bedroom. On the day they moved in the service held a welcome party. The relative commented, “The staff are great. They have got to know and understand [family members name]. [Family members name] is happy here. If I had known how well it worked out, I need not have worried. It was a big decision moving [family members name] into a care home but it was the right time.”

People’s needs were kept under review and updated as needs changed. People were involved in setting goals to improve their quality of life and support them to achieve their aspirations.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The service delivered care and treatment in line with evidence-based practice and recognised good practice for people with learning and physical disabilities. These included person-centred care planning, positive behaviour support approaches, and the use of inclusive communication methods such as Makaton, speech generating devices and easy read information to promote safe care.

People’s nutrition and hydration needs were identified and managed in line with current guidance. Malnutrition screening tools (MUST) and waterlow assessments (used to assess pressure ulcer risk) were in use and kept under review. Staff were informed of people’s dietary requirements, which were incorporated into meal preparation.

People were actively involved in choosing what they ate, with no fixed menus in place. Individuals planned shopping trips with staff or chose to have food delivered. People were offered a range of meal and dessert options on a daily basis and were encouraged to take part in cooking and baking activities where this was of interest to them.

The service work collaboratively with external specialists and professionals to ensure people had access to evidence-based interventions and the most appropriate assistance technology. This included close partnership working with Speech and Language Therapists (SaLT) to maintain and optimise the use of Eye Gaze technology. This collaborative approach supported people to communicate more effectively and to participate actively in decisions about their lives and care. This enabled an individual to express views on changes on social care at Parliament with the service supporting them to attend and contribute which gave them a voice outside of the service.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider had clear systems in place to ensure information was shared effectively among team members, enabling them to consistently meet people’s needs. Staff were kept updated on changes in people at handovers and the electronic care plan system was updated following health professional’s reviews to inform staff of any changes to people’s care and treatment.

The registered manager emailed all staff to inform them of important changes relating to the running of the service. All staff were encouraged to attend staff meetings with staff on night duty or days off able to access those meetings via a team’s call. These practices promoted teamwork and effective communication across the team to support people.

A relative commented, “You get the impression staff are working as a team and I often see and hear them offer to support each other with tasks”.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service worked closely with a range of health professionals to support people to live healthier lives. People received regular health and medicines reviews, and a GP visited the service weekly to review people’s health needs. Where required, timely referrals were made to other health professionals, including district nurses and mental health teams.

The service used a virtual consultation platform to enable prompt access to GPs and other healthcare professionals and to support escalation to specialist services when needed. The service also had access to a clinician who provided clinical oversight, including guidance and training for staff in relation to enteral nutrition.

The provider demonstrated a proactive approach to health promotion while respecting people’s rights to make their own decisions. Regular health clinics were in place to raise awareness of health conditions relevant to the people they supported. Records showed recent clinics had covered men’s health, hydration and nutrition, bowel care and medicines optimisation. This helped ensure staff were informed and able to promote people’s health and wellbeing effectively.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Care plans were kept under review and updated in response to changes in people. The regular access to the GP and SaLT meant people were regularly monitored to improve outcomes for them in relation to their medical, health and well-being needs.

People had a named key worker. (A key worker isa named staff member responsible for coordinating personalised care, acting as the main point of contact for the person and their family.) Staff completed monthly key workers reports which identified any changes in individual’s needs. It highlighted outcomes of health appointments and noted forthcoming health appointments as well as reporting and including photographs on activities people had been involved in over the month. These enabled the service to monitor and have oversight of the persons care to improve outcomes for them.

People were aware who their key workers were and had a positive relationship with them. A person commented, “I have a great relationship with [key workers name]. They have only been my keyworker for a month. We are compatible and we laugh a lot together”. Another relative told us their family member’s key worker was not right for them. The registered manager was informed and this was addressed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The leadership team maintained a strong focus on Human Rights‑based practice, including robust knowledge of the Mental Capacity Act 2005 (MCA). This ensured staff were confident in supporting people to make their own decisions wherever possible, and to act lawfully and respectfully when individuals require decision‑making support. Leaders participated in regular Quality Clinics to ensure their knowledge remained current regarding best practice, regulatory standards, and legislative changes. Staff responsible for completing assessments were trained in the Mental Capacity Act 2005 and applied its principles in practice.

People’s consent to care was sought and respected. From our observations and records viewed we saw people were supported to make decisions about their care and treatment where they had capacity. Where people lacked capacity, assessments and best interest decisions were comprehensively completed in line with legislation and involved those relevant to the person.

Staff recognised the importance of promoting choice and recognised when to seek further advice if a person’s capacity changed. This supported people to receive care and treatment that reflected their wishes and was delivered lawfully.