Birch House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

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.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives said people were treated with kindness. One person told us, “The manager is lovely”. A relative said, “The care is good and it is a good team. Staff genuinely care. People are always nicely dressed”.

Staff were clearly able to describe how they treated people with kindness and dignity. They said they were confident to challenge any staff member who did not act according to these principles. Some staff told us they had mentored new staff and this was an important part of their role to ensure people were treated well at all times in their own home.

We observed staff supporting people with kindness and compassion whilst maintaining their dignity. There was a relaxed atmosphere at lunchtime and people sat together with staff to enjoy the social occasion in one another’s company.

Relatives told us that people’s individual needs and preferences were understood. One person told us, “The manager understands your needs”. Comments from relatives included, “My relative laughs together with staff”; and “Staff are very patient and understand his needs. They know how to communicate with him”.

Staff described the service as a ‘family home’ where each person had different needs and unique personalities. Staff knew people’s strengths, abilities and preferences. Staff explained that one person had their own unique words and language which they understood. Staff were knowledgeable that some people liked to have a structured routine and they endeavoured to make this happen for them as this made them feel safe and comfortable.

We observed staff respecting people’s choices and treating people as individuals. This included staff communicating with people using their own unique styles.

Care plans contained information to inform staff about peoples’ needs and preferences including any cultural or religious needs. There was also information about people’s life history to help staff understand people’s past experiences and circumstances. People’s bedrooms were personal, where people had photographs, pictures and items that were important to them. This created a homely atmosphere and a place where people could enjoy time on their own.

People told us they made their own lunch and breakfast and chose what they wanted to eat for their evening meal. People said a staff member showed everyone picture cards of meals and then each person chose what they would like to eat. These meal choices made up the weekly menu. People also told us they were responsible for doing their laundry and had specific household tasks such as putting out the placemats for the evening meal. A relative told us, “Independence is promoted. They engage him to help tidy up and make a sandwich”.

Staff described how they encouraged people to make informed choices such as what they wanted to eat and what clothes they wanted to wear. They explained how people were supported to take part in daily living skills and how these were broken down into smaller parts if people could not manage to complete the whole task. Staff told us this could involve verbal prompts or hand over hand guidance.

We saw people’s independence was promoted. One person said they “Cup of tea”. This person was then asked if they wanted a cup of tea and when the responded they did, they were supported to go to the kitchen to make themselves a drink. Another person handed a staff member some rubbish. This person was prompted to put the rubbish in the bin for themselves.

Some people’s care notes contained a blanket statement that people were not able to make choices and decisions about their care. This was contrary to other information which set out if people needed physical support, verbal prompts or simple explanations to promote their independence and make choices. This is an area identified as needing further improvement.

Relatives said staff knew people well and were therefore easily able to respond if people were not their usual selves, in pain or discomfort.

Staff were able to describe how people presented when they were happy and content and when they were not their usual selves. They said if this was the case they tried several options and suggestions with people in order to find out what was troubling them.

We observed staff responding to people's needs in a timely manner. Staff were understanding of people's varying communication needs including non-verbal cluses and gave assistance when needed.

Staff told us they received good support from the registered manager. Staff gave examples of how the registered manager had taken their personal circumstances into consideration in the performance of their role. Staff said although the registered manager was only at the service for half of the week, they were always contactable by phone if they needed help or support. Staff appreciated the registered manager knew people who lived at the service well and took on the role of support staff if this was needed.

Processes to support staff well-being included formal one to one support through supervision and staff meetings. The registered manager regularly communicated with staff and checked in with their well-being, although this was not always formally recorded.