Archived: Silver Birch

Updated 16 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Silver Birch is a ‘care home’ providing short term care for respite. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was in the process of registering with the Care Quality Commission. Once registered it means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the commissioners and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and two relatives contacted us about their experience of the care provided. We spoke with three members of staff including the manager.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the manager to validate evidence found. We looked at training data and quality assurance records.

Updated 16 October 2019

About the service

Silver Birch is a residential care home providing personal care for up to five people with learning and physical disabilities who require a short break (respite) with specialised facilities. At the time of the inspection there were two people staying there.

The home is on one level with accessibility to secure gardens. The home has been specially equipped to ensure people can access all areas of the home with ease. The bedrooms all have assistive technology, televisions, several have ceiling tracking hoist systems, and all have adaptive mobility ensuite washrooms.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that while people use the service they can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties in the area. However. the size of the service having a negative impact on people was lessened by the building design fitting into the residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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

There were sufficient numbers of suitably qualified staff to meet people’s needs. Staff training was ongoing and people had received sufficient training to safely support and care for people. Staff were supported by the manager through regular staff meetings, supervision and appraisals.The provider had policies and procedures to support the safe recruitment of staff. .

We saw the service worked with a variety of external agencies and health professionals to provide appropriate care and support to meet people’s physical and emotional health needs.People received support to maintain good nutrition and hydration in line with their personal choice. People’s healthcare needs were well understood and met promptly.

Where safeguarding concerns or incidents had occurred, these had been reported by the manager to the appropriate authorities and we could see records of the actions that had been taken by the service to protect people.

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's communication needs were thoroughly assessed and understood by staff. This helped to support people's communication needs and the Accessible Information Standard (AIS).

The manager displayed knowledge and understanding around the importance of openness and working closely with other agencies and healthcare professionals to make sure people had good care. Hazards to people’s safety had been identified and managed. People were supported to access activities that were made available to them and pastimes of their choice. A relative told us, “The service focusses on meeting all of our relative’s needs in a safe and homely environment.”

People were treated with respect and their dignity and privacy were actively promoted by the staff supporting them. A relative told us, “This is a fantastic service which results in our relative being settled and happy during their visits.”

Governance and quality assurance systems allowed the service to demonstrate effectively the safety and quality of the provision. The manager and staff used recognised monitoring tools to analyse trends and highlight areas they could work on to improve support for people. Staff felt valued and respected by their manager and were included in decisions about service development.

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

Rating at last inspection

The last rating for this service was good published (23 January 2017)

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Silver Birch on our website at www.cqc.org.uk.

Follow up

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