All inspections: Birchwood Bungalow - Care Quality Commission

Birchwood Bungalow provides accommodation and personal care for up to seven people with learning disabilities. It does not provide nursing care. The home) accommodates seven people in one adapted building.

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 people who use the service 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.

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

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Only one person living in the home had limited verbal communication skills. The other people who used the service were unable to communicate verbally due to their complex needs. People`s relatives told us, people received care and support from staff in a safe way and caring way.

People`s care plans reflected their needs but also their likes, dislikes and preferences. Positive behaviour support plans were used by staff to promote people`s wellbeing by understanding their behaviours and pre-empt any incidents.

Risk assessments were in place to give staff guidance on how to help people stay safe when out in the community or in the home receiving care and support.

People`s dietary needs were met and if they required support from health care professionals staff involved them. People had planned annual health checks.

Relatives told us they always found staff caring and respectful towards people. They felt confident that if they raised any concerns the management in the home would take those seriously and resolve them.

Staff used a range of communication tools to help people express their views, likes and dislikes. Staff felt supported by the registered manager and the provider`s operations manager. They received training relevant to their roles and regular supervisions.

The provider began work to refresh and improve the environment people lived in. the work was effectively planned, and risk assessed to ensure minimal disruption to people`s normal routines.

A number of methods were used to assess the quality and safety of the service people received and continuous improvements were made in response to the findings.

Rating at last inspection: The last rating for this service was Good (report published in February 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 Birchwood Bungalow 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.

The inspection took place on 24 January 2017 and was unannounced.

Birchwood Bungalow provides accommodation and personal care for up to seven people with learning disabilities. It does not provide nursing care.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We last inspected the service on 29 July 2014 and found the service was meeting the required standards at that time.

People who used the service were unable to communicate verbally due to their complex needs. However, people’s relatives told us that they felt that people were safe living at Birchwood Bungalow. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines were managed safely.

Staff received regular one to one supervision from a member of the management team which made them feel supported and valued. People received support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.

People’s relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care as much as they were able. Visitors to the home were encouraged at any time of the day. There were areas of the home that did not always promote people’s dignity and these were scheduled for refurbishment to help make the home a more pleasant place for people to live.

The provider had arrangements to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.

There was an open and respectful culture in the home and relatives and staff were comfortable to speak with the registered manager if they had a concern. The provider regularly monitored the health and safety of the environment and the quality of the care and support provided for people who used the service. The layout of the home was appropriate to meet people’s needs however, some areas would benefit from a programme of refurbishment.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was unannounced. When we inspected the service on 31 May 2013 we found that the service satisfied the legal requirements in the areas that we looked at.

Birchwood Bungalow provides accommodation and personal care for seven people who have learning difficulties. The registered manager has been in place since January 2013. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care or treatment. This includes decisions about depriving people of their liberty so that they get the care and treatment they need where there is no less restrictive way of achieving this. DoLS require providers to submit applications to a ‘Supervisory Body’, the appropriate local authority, for authority to do so. We found that the service had complied with the requirements of MCA and DoLS.

Because of people’s complex needs they were unable to communicate verbally. However, staff members communicated with people effectively and used different ways of enhancing that communication. Staff treated people in a caring, responsive and respectful way and with dignity and respect. They knew the people they cared for and supported well and always used people’s preferred names.

People were involved in deciding what food and drink they had. They were supported to access healthcare services to maintain and promote their health and well-being. They were encouraged to make their rooms at the home their own personal space. People, their relatives or advocates had been involved in the development of their care plans which were reviewed on an annual basis, or more frequently if required. They were supported in a wide range of interests and hobbies, both as group activities or on an individual basis, which suited to their needs. They were encouraged to pursue their interests outside of the home to enable them to develop links with the local community.

There were enough qualified, skilled and experienced staff to meet people’s needs. All necessary checks had been completed before new staff members had started work at the home and they had completed an induction programme when they started work. Staff members received additional training in areas that improved their capability in providing care and support to people who lived at the home and had regular supervision and appraisal meetings with the manager at which their performance and development were discussed

Staff members were able to demonstrate a good understanding of procedures in connection with the prevention of abuse. Risks in respect of the home and the provision of care and support to people had been identified, regularly reviewed and steps taken to reduce the on-going risk.

The provider had an effective system to regularly assess and monitor the quality of service that people received and an effective complaints system.

We used a number of different methods to help us assess the experiences of people using the service, because they had complex needs which meant they were not able to tell us their experiences. However, they were able to express that they were happy with the care and support they received from the staff by their facial gestures and by pointing at objects they liked, such as toys and magazines.

We found that the home was meeting the standards we inspected. People received care and support that met their needs. The environment was comfortable, safe and well maintained. There were sufficient numbers of staff on duty to meet the needs of people. Confidential records had been kept safely and securely.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

We observed that people were smiling when spoken to and when informed that they were going out for lunch, they went to the front door and waited for staff to take them to the minibus. We also observed that people were happily looking at magazines of their choosing, some were participating in an art and craft session and others were watching the television.

You can see our judgements on the front page of this report.

During our site visit, we met all seven people using the service. They were not able to give verbal feedback. However, they all communicated with us with sounds and gestures and with expressions of contentment. They interacted well with members of staff, who understood the way in which they communicated.

A relative we spoke with said that the person using the service 'is very happy living in the home.' The same relative commented, 'We see different staff all the time; there is no continuity of care. However all the staff we've met are very good; they are very helpful and polite.'

This was echoed by another relative we spoke with who commented, 'The service has a high turnover of staff and managers. My relative is being cared for by different staff each time I visit. There is no stability or continuity of care. However, all the staff are superb. I can't fault them.'

When asked about informed choices and decision-making, a relative said, 'The staff keep us informed of any changes or incidents. We attended the annual review. The social worker and the staff from the service were present. We were given the care plan to sign afterwards.'

Birchwood Bungalow

All Inspections

14 August 2019

During a routine inspection

24 January 2017

During a routine inspection

29 July 2014

During a routine inspection

31 May 2013

During a routine inspection

29 August 2012

During a routine inspection

16 March 2012

During an inspection in response to concerns