Birch House

We assessed all the quality statements within the key question of safe. Staff and leaders were able to identify situations that amounted to safeguarding. There were some shortfalls in the assessment of risks to people, which were immediately addressed during the assessment process. Staff had ongoing training but some staff were more skilled than others in supporting people. Medicines were administered, stored and recorded safely. Staff were recruited safely and there were enough staff to support people. Accidents and incidents were reviewed and actioned. The environment was clean and regular checks were made to ensure it remained a safe environment for people.

We assessed all the quality statements within the key question of safe. People’s holistic needs were assessed including the best ways to communicate with people. Staff supported people to access health professionals when needed to make sure people received the most appropriate care and support. There was effective monitoring of people’s health care needs. An area for improvement was identified in relation to ensuring people received the best outcomes through setting goals based on their dreams and aspirations. Decision making had not consistently followed best practice. Some decisions had been recorded without evidencing that people had been assessed to check if they could understand, retain and weigh up the information and communicate their decision about the matter concerned.

We assessed all the quality statements in the key question of caring. People were treated as individuals as staff knew people’s individual needs and preferences. Staff communicated with people in their own communication styles and treated people with kindness and dignity. People were supported to take part in daily living skills which promoted their independence. People were able to make choices about their care and treatment but this was not always supported by their care records.

We assessed all the quality statements in the key question of responsive. Skills variations in the staff team impacted on how people received personalised care. This had been recognised and was being addressed by the registered manager. People had access to appropriate health professionals. Work was being undertaken to ensure people were supported to plan for their future and decide what they wanted if their health deteriorated. People and relatives felt listened to. People were communicated with in a way they could understand.

We assessed all the quality statements in the key question of well led. The provider had identified areas for improvement but had yet to work through the specifics of how and when each area would be addressed. Staff said although there had been some changes in the staff team they were committed to the aims and values of the service. Staff told us there was a positive culture within the service and they felt supported. Staff thought they worked well as a team.