Birchwood House is a residential care home providing accommodation with personal care and support for up to seven people with learning disabilities and behaviours that challenge services. At the time of this inspection there were six people using the service.

At the previous inspection published on 11 December 2014, the service was rated Good. This inspection took place on 28 April and 2 May 2017 and the service remains Good.

There was a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission 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.

The provider had a recruitment system in place to ensure the suitability of staff working at the service and there were enough staff on duty to meet people’s needs. Staff were knowledgeable about how to report concerns or abuse. Comprehensive risk assessments were carried out with management plans in place to enable people to receive safe care. There were systems in place to maintain the safety of the premises.

The provider had systems in place to ensure the safe administration of medicines. However we found an issue with medicines and have made a recommendation around this.

Staff received appropriate support through supervisions, appraisals and training opportunities. Appropriate applications for Deprivation of Liberty Safeguards had been applied for and authorised. Staff were aware of the need to obtain consent before delivering care.

People were offered a choice of nutritious food and drink and were involved in meal preparation. People also had access to healthcare professionals as required to meet their day to day health needs.

Staff were knowledgeable about the people they were supporting including their preferences to ensure a personalised service was provided. Staff respected people’s privacy and dignity and were knowledgeable about assisting people to maintain their independence.

A variety of activities were offered which included trips into the community and people had daily meetings to decide which activities they wished to participate in that day. The service had a keyworker system whereby people had a named care worker to oversee their care needs. Relatives knew how to complain and the provider dealt with complaints in accordance with their policy.

The provider had systems to obtain feedback on the quality of the service from people who used the service and from staff. Regular meetings were held for people who used the service to involve them in the development of the service and with staff to keep them updated with policy changes. The provider had various quality assurance systems in place to identify areas for improvement.

We have made one recommendation to the provider and further information is in the detailed findings below.

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 provide a rating for the service under the Care Act 2014.

There was a registered manager at the service at the time of our inspection. 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.

At the last inspection in May 2013 the service was found to be meeting the regulations we looked at.

Birchwood House is a care home providing personal care and support for people with learning disabilities. At the time of the inspection they were providing personal care and support to six people.

People told us they felt safe and were happy with the care and support provided. We found that systems were in place to help ensure people were safe. For example, staff had a good understanding of what constituted abuse and the abuse reporting procedures. People’s finances were managed and audited regularly by staff.

There were enough staff available to support people if they needed to attend appointments or go to the community. Staff told us that they felt supported by the manager and senior staff. They completed training which helped them to carry out their jobs.

People received support from staff at the home and also from healthcare professionals based in the community. The provider had established good links with these community professionals which included community learning disability teams, speech and therapy teams, psychiatrists and psychologists which helped people in enhancing their physical and mental health.

Staff had established positive relationships with people using the service and people were supported to maintain their relationships with family. People were supported to pursue their own individual activities and interests, with the support of staff if required.

Staff, people, and other health professionals viewed the registered manager positively. Quality assurance systems were in place which included seeking the views of people that used the service.

People who used the service told us they had their own privacy and their own rooms. We found people who used the service understood the care and treatment choices available to them. Staff told us they explained people's care and treatment choices to them.

People we spoke with told us they "liked" the care they received and felt their needs were being met by the service. We found people were initially assessed before they entered the service. We found initial assessments we viewed included cognitive assessments to determine mental capacity and assessed people's individual care needs.

People we spoke with told us they felt safe in the service and they had no concerns. We found people’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

There were effective recruitment and selection processes in place. Staff we spoke with told us they completed an application form when they applied for their jobs and underwent an interview.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There was documentary evidence people could give their feedback about the service.

People who used the service told us they “felt safe” living at the home. We found the provider had a safeguarding adult's policy in place and that staff had safeguarding adult's training and they could describe the different forms of abuse and how to recognise the signs.

Staff told us they worked with other services and professionals to ensure that appropriate care planning took place. We found evidence that people were involved with a range of external professionals and services involved in their care and treatment.

We found people had person centred care plans (PCP) which identified and provided care that met their individual needs. Staff told us people were involved in the planning the delivery of their care and treatment. We found documentary evidence to support this.

The provider ensured staff employed to provide personal care to people who used the service were suitably qualified, skilled and experienced. We found staff had appropriate training and support to undertake their roles and responsibilities and meet the needs of people in the home.

During our visit, people told us that they liked to go out with staff, they liked their bedrooms in the care home and they enjoyed the food and activities provided for them.