Archived: Care Management Group - 7 Birdhurst Rise

Care Management Group 7 Birdhurst Rise is a residential care home for up to nine people who have a learning disability, some have mental health related issues and behaviour that challenges. At the time of our inspection seven people were using the service.

The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff did not wear anything that suggested they were care staff when coming and going with people.

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

Staff knew how to keep people safe. They used different ways to communicate with people to find out how they were feeling and what choices they wanted to make. Care records helped staff know what was important to people and how they wanted to be supported. Information was available for people in a way they could understand.

People knew staff and the registered manager. They were comfortable approaching them, asking questions or speaking about their day. Staff took time to listen and responded appropriately. Staff treated people with kindness and respect and relatives told us staff were kind and caring. Staff had received training and had the support they needed to understand and meet people’s needs.

People were encouraged to make choices about their lives and to be as independent as they could be. Staff helped people work towards their goals and encouraged people to engage in the activities they wanted to do. Staff supported people to follow their interests and to learn new skills. Staff helped people keep in contact with their family and friends.

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.

Staff supported people to attend health care appointments and made sure heath care professionals knew how to support people during treatment.

Managers and staff put people at the centre of the service. People were asked their views about how the service was run and what staff could do to make things better.

Managers and staff knew how to record and report concerns, this included any safeguarding concerns. When an incident or accident happened, the reason was investigated and changes were made to make things better for people.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 20 April 2017) .

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection in May 2015, the service was rated Good. At this inspection we found the service remained good.

The service demonstrated they continued to meet the regulations and fundamental standards.

People were fully involved in how the service was run. The home had a homely feel and reflected the interests and lives of the people who lived there. The home was well decorated and safely maintained.

People received care and support from a regular group of staff who knew them well and understood their needs and preferences. Staff morale was good. There were sufficient numbers of suitably vetted and skilled staff deployed to meet people’s needs.

Staff identified risks to people’s health and safety and put necessary guidance and plans in place to manage the risks. People had access to the health care services they needed and received their medicines safely. There were checks in place to ensure staff managed people’s medicines appropriately. Staff treated people with compassion and kindness; and respected their dignity and privacy.

People's care records recognised their rights and were person centred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service was well managed by an experienced person who gave consistent leadership and direction. Quality assurance systems were robust and contributed to continued improvements. Record management was excellent and records were well organised and easy to access.

Throughout our visit, people were comfortable and relaxed in the company of the staff supporting them. One person using the service said the staff were 'nice people'. Another person told us 'I like it all here.'

The three relatives we spoke with were complimentary about the home and the progress made by people using the service. One told us their family member was 'very well looked after' and had 'come on leaps and bounds' since moving there. Another described the care provider as a 'professional outfit.' A third relative said their family member was 'extremely relaxed' and 'very, very settled.'

People using the service had personalised support plans, which were current and outlined how they wanted their care and support to be provided. This meant staff had the information they needed to meet people's individual needs. Where people did not have mental capacity to consent, care was provided in their best interests. Relatives of people using the service told us they felt involved and were in regular contact with their family members.

People received effective care and support because the service had sufficient numbers of staff to support people. The staff team had a variety of skills and experience and had undertaken relevant qualifications to care for people. Staff told us they had ongoing training and supervision and were supported by management to do their job.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was a complaints process which showed that people who used the service and their families were supported to raise any concerns. All relatives we spoke with were aware of the complaints procedure but said they had 'no complaints.' One relative told us, 'I have all the numbers and would get straight on the phone if something was wrong.'

Plans of care were person centred, well created and closely reflected the specific needs of the person. People's needs were regularly reviewed to make sure they got the right care and support. Records showed us that families and professionals involved in people's care were consulted.

People benefitted from a stable staff team who had worked at the home for several years. Staff told us that they were happy working at the home and felt well supported by the manager.

The provider regularly monitored the care, facilities and support for people using the service and staff received appropriate training and support to meet people's needs.