We visited Birmingham Community Assessment and Treatment Service on the 4 and 5 July 2011 as part of a scheduled review of compliance. We identified concerns with the quality and safety of care and the care environment. We discussed the concerns with the provider and some immediate actions were agreed. The provider had already commissioned an external review of the service following concerns that they had identified and actions were being taken to improve the quality and care people were receiving at the service. We accepted that we needed to give the provider time to deliver the improvements required across the service. We made an additional visit to the service on the 14 July 2011 to review the progress that was being made against the action plan. We found that a range of audits and reviews were taking place and immediate improvements were noted. This included the review of care plan documentation, daily handover of information by staff about people's support needs, staff training and environmental safety risk assessments.
We followed up our concerns by visiting the service again on the 4 November 2011 to review the experiences and quality of care, and ensure that the improvements we had previously seen were being sustained and put into practice. During this visit, we talked to people living at the home, and asked staff about people's needs. We also looked at people's care plans. An expert by experience joined us on this visit. Experts by experience are people who have experience of using services; either first hand or as a family carer and so have a better understanding of how the needs of people could be met. This helped us to get a clearer picture of what it was like to use the service.
A mental health act commissioner was also present at the visit to the service on the 4 November 2011. The mental health act commissioner focuses upon the care, treatment and support for people who are detained under the Mental Health Act 1983. The mental health act commissioner produces their own findings of the visit to the service within a separate report which has been sent to the provider.
People using the service told the expert by experience that they felt safe. They said they would talk with the deputy manager if they had any concerns and felt they would be listened to and action taken. People told the expert by experience that staff try and help them to become independent. One person commented, 'the cook helps me to prepare food but I would like more interaction with the cook when they are ordering food and planning menus for the week'.
All of the people using the service who spoke with the expert by experience said they were able to choose how they spent their days. Comments from people included, 'I can go out when I like' and 'I attend a college course'.
People talked about the weekly meetings that were held every Friday for people to share their experiences of the services they were receiving. The expert by experience was told by some people that there were occasions when they felt that staff did not listen to them. One of the comments shared with the expert by experience was staff 'talk to me like I'm a child'. People felt that sometimes staff were not available when they needed to talk about things.