Birchwood House

Cateswell Court is a residential care home which can support up to eight people in one adapted building. The service specialised in supporting people with mental health needs. There were five people using the service at the time of this inspection.

People’s experience of using this service and what we found

There had been changes within the management team and the home had experienced an unsettled time. The provider had identified that improvements were needed. Progress had been made on their own improvement plan and some further embedding was needed. Some risks to people were not mitigated.

Staff understood their safeguarding responsibilities. There had been a number of staff changes in recent months. However, progress was being made on ensuring there was a stable staff team in place. There was enough staff on duty to support people. Staff were recruited safely.

People received their medicines as prescribed. Infection control policies and procedures were in place to keep people safe.

People were satisfied with the quality of care and support they received. People knew how to make a complaint if needed. The provider had a system in place to make sure incidents and complaints were investigated and people were informed of the outcome.

People and staff were supported to have their say about how the service could be improved. Regular checks and audits took place to monitor, review and improve the quality of the service.

Rating at last inspection

The last rating for this service was good (published 22 January 2019).

At this inspection we found improvements were needed to safe care and welfare.

Why we inspected

The inspection was prompted in part due to concerns received about a high turnover of staff, management changes and safeguarding concerns. A decision was made for us to inspect and examine those risks.

We undertook this focused inspection on 15 September 2021.This report covers our findings in relation to the key Questions, Safe and Well- led only. The ratings from the previous inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We found that some risks to people were not always well managed.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The inspection visit took place on 12 November 2018 and was unannounced.

There was a registered manager in post and they were present during the inspection. 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 continued to receive care that made them feel safe and staff understood how to protect people from abuse and harm. Risks to people were assessed and guidance about how to manage these was available for staff to refer to/follow. Safe recruitment of staff was carried out and adequate numbers of staff were available to people. People received medicines as required.

People continued to receive effective support from staff with a sufficient level of skills and knowledge to meet their specific needs. 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 support this practice. People were assisted to access appropriate healthcare support and received an adequate diet and hydration.

The care people received was provided with kindness, compassion and dignity. People were supported to express their views and be involved as much as possible in making decisions. Staff supported people to have choices and independence, wherever possible. People’s diverse needs were recognised and staff enabled people to access activities should they so wish.

The provider had effective systems in place to regularly review people’s care provision, with their involvement. People’s care was personalised and care plans contained information about the person, their needs, choices and cultural needs. Care staff knew people’s needs and respected them. People were able to speak openly with staff and understood how to make a complaint.

The service continued to be well-led, including making detailed checks and monitoring of the quality of the service. People and staff were positive about the leadership skills of the registered manager. We were provided with information we expected to receive.

At the time of our last inspection in January 2015, Cateswell Court was found to be meeting the requirements of their registration in accordance with the regulations.

Cateswell Court provides accommodation and personal care for up to eight people who require support to live in the community. At the time of our inspection, there were seven people living at the location.

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.

The service was safe because people were supported by enough members of staff who had been safely recruited. Staff had the knowledge and skills they required to protect people from the risk of abuse and avoidable harm and they knew what the reporting procedures were. People were supported to have their medication when they required it from staff that had the relevant knowledge and skills they required to promote safe medication management.

The service was effective because people received care and support with their consent where possible, and people’s rights were protected because key processes had been fully followed to ensure people were not unlawfully restricted.

People’s nutritional needs were assessed and monitored to identify any risks associated with nutrition and hydration and they were encouraged to be as independent as possible with preparing food they enjoyed.

People were supported to maintain good health because staff worked closely with other health and social care professionals when necessary.

The service was very caring because people were supported by staff that were kind, caring and who took the time to get to know them, including their personal histories, likes and dislikes. People were also cared for by staff that protected their privacy and dignity and respected them as individuals.

People were encouraged to be as independent as possible and were supported to express their views in all aspects of their lives including the care and support that was provided to them, as far as reasonably possible. People felt involved in the planning and review of their care because the provider promoted person-centred, recovery focused values and staff communicated with them in ways they could understand.

People had an enhanced sense of well-being and quality of life because staff actively encouraged and supported them to engage in activities that were meaningful to them. People were also supported to maintain positive relationships with their friends and relatives and with people from the local community.

Staff felt supported and appreciated in their work and reported Cateswell Court to have an open and honest leadership culture. The management team endeavoured to improve and develop the service and had systems in place to assess and constantly monitor the quality of the service. People were encouraged to offer feedback on the quality of the service and knew how to complain if they needed to. They felt that the registered manager was responsive to feedback and staff reported the registered manager to be a positive role model who was dedicated to providing a high quality service.

At the time of our inspection eight people lived at 27-29 Cateswell Court. During our inspection we spoke with or spent some time with six of the people who lived there, staff on duty and the registered manager. We later spoke with two people's relatives and two healthcare professionals.

We found that people who lived there were treated with respect and dignity. One person told us, 'Staff always knock on my bed room door.'

We saw that people's independence was promoted by staff. One staff member told us, 'Our aim is to help people develop their skills to be as independent as possible. We do this alongside other healthcare professionals, such as peoples' community psychiatric nurses.'

We found that care was planned and that people's needs had been assessed by a range of healthcare professionals including specialist nurses. This meant that staff had enabled people to have their health care and safety needs monitored and met.

We found that processes were in place to protect people from the risk of harm or abuse. One relative told us, 'I have no concerns. My relative is well looked after there.'

We found that the premises were suitable for the people that lived there. Overall we found that rooms were homely and adequately maintained.

We saw that systems were in place to monitor the quality of the services provided so that actions, when needed, could be made to make improvements.