Birch House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

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.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives gave mixed views about if people were at the centre of their care. Some relatives commented that the service was designed around people’s needs. Comments included, “There is supervision and also freedom for people to do what they want and to make decisions with support from staff”; and “Birch House is chilled and calm and very predictable which suits my relative”. However, other comments included, “Some staff are better at communicating with people than others. On occasion staff have upset people with the way they have delivered a message”; and “Sometimes people who like to go out have not gone out at all in a whole week. This means they get bored and it can lead to behaviours”.

Staff told us there was a mix of skills in the staff team. They said most staff had a good knowledge of what was meant by person-centred care. However, staff told us that some staff lacked this knowledge and experience and they being supervised and retrained to help ensure this was consistently put into practice.

We observed differences in how staff interacted with people to promote their well-being and ensure they were at the centre of their care. Staff ensured they interacted with people for short periods of time on a frequent basis. This included engaging people in daily living tasks, conversations, activities and acknowledging and praising people for their participation. People benefited from these regular interactions and sought out these staff’s company. However, some staff had little engagement with people.

Relatives gave positive feedback about how people were supported to access the health care services they needed.

Staff understood their responsibilities in making sure people were able to access advice and treatment from healthcare professionals. The manager said there were no barriers to accessing the health care services people needed.

The provider ensured that care was joined up, flexible and supported continuity. There were processes to ensure people had access to health care services. Staff ensured people were accompanied to appointments, made a record of the outcome and shared this with the staff team and family members as appropriate.

Relatives told us that staff were able to communicate with people in a way they could understand. One relative told us, “Staff talk to her and understand her. Staff know what she wants”.

Staff told us posters and signage were available to enable those who cannot read to be able to follow pictorial prompts. Staff showed us pictures of food and meals that were used to help people decide what they wanted to eat. Staff told us they had also used photographs or where people were being supported to go for those people who may not understand a verbal description.

The service had an Accessible Information policy. Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. The Accessible Information Standard tells organisations what they have to do to help people with a disability or sensory loss, get information in a way they understand. It also says that people should get the support they need in relation to communication. The provider informed us they were able to provide all information in easy read format for those residents who were able to read.

People and their relatives said they were listened to and involved in the service. One person told us, “There is one staff I don’t like. There are some staff I can talk to. Yes, they listen to me”. One relative told us, “Staff do involve me. When I bring things up with the manager, she says she brings them up at a staff meeting”. Another relative said, “The manager is very approachable so I trust her that she will act on my concerns”. Relatives told us particularly enjoyed receiving photographs of what their family members had been doing with their time shared over a secure media site. However, some relatives said they did not always receive a weekly plan of activities as agreed.

Staff told us there was a keyworker system in place whereby each person was allocated a staff member to take a specific interest in their care. Staff explained this involved making sure people had everything they needed, their family members were communicated with, and the person attended any appointments.

There were some missed opportunities for involving people in their care. Weekly resident meetings only involved discussions about what people wanted to eat. They did not include any discussions around how people wanted to spend their time. Daily notes did not always reflect what was recorded in people’s planner of activities. Records did not evidence if people had declined a proposed activity and if any alternatives had been offered. This has been identified as an area for improvement.

People’s families told us their relatives could access care, treatment and support when they needed to and in a way that worked for them. However, we found there was inequity in how people were supported to achieve their goals and how responsive staff were in interacting with people.

Staff told us there were no barriers to people accessing the service.

There were no barriers to people with a learning disability or autism being referred or admitted to Birch House. People’s needs were assessed before moving into the service. People would only not be admitted if the registered manager thought staff did not have the appropriate skills to provide safe care to an individual.

Relatives felt respected and indicated they and their family members were treated equally by the staff.

Staff told us that the regularly discussed people’s experiences and outcomes such as when they had taken part in activities, if the person enjoyed the experience or not. Formal reviews of peoples’ care took place yearly and included their health care, social care and well-being.

The provider had processes to gain feedback of the experiences and outcomes of staff and people who used the service. The results of the relatives’ survey in May 2024 were that the service was safe, effective, caring, responsive and well-led. One relative commented, “Birch House is a warm, lovely and friendly home. I have nothing but praise for Birch House”. The result of the last staff survey was overall positive. The only negative comments were around a staff member who had since left the service.

There were mixed views from relatives about whether people were involved in discussion about important life changes such as moving towards greater independence or if someone’s health deteriorated. Some relatives were confident this was taken into consideration and others less so. One relative told us, “There is no ambition to make their lives bigger”.

Staff told us that some people had plans, initiated by the funding authority, to move towards more independent living. However, consideration had not been given to plans for people if their health deteriorated or they were at the end of their lives.

There was a lack of processes to help people plan for their future. During the inspection the registered manager started to develop plans, based on people’s wishes and preferences.