Bircham House is registered to provide personal care to people living in their own flats within an extra care scheme in Sawston near Cambridge. At the time of our inspection a service was being provided to older people, people living with dementia, people living with mental health conditions, younger adults and people living with physical disabilities or sensory impairment. There were 26 people receiving personal care from the service and there were seven care staff employed at the time of this inspection.

This comprehensive inspection took place on 16 August 2017 and was unannounced.

There was a registered manager in place. 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 registered manager was not in the service during the inspection.

The provider's policy on administration and recording of medication had been followed by staff. People had their medication administered as prescribed. Audits in relation to medication administration had been completed and were robust, as they identified where areas of improvement were required.

People’s needs were assessed and reviewed so that staff knew how to support them and maintain their wellbeing. People's care plans contained information, which detailed their individual care and support needs. Staff treated people with care and respect and made sure that their privacy and dignity was respected all of the time.

There was a system in place to record complaints. These records included the investigation and outcomes of complaints. Reviews of these records showed that people were satisfied with the outcomes.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and could describe how people were supported to make decisions. Training had been provided by the service and staff were aware of current information and regulations regarding people’s consent to care. This meant that there was a reduced risk that any decisions, made on people's behalf by staff, would not be in their best interest and as least restrictive as possible.

The provider had a recruitment process in place and staff were only employed in the service after all essential safety checks had been satisfactorily completed. Training was available for all staff which provided them with the skills they needed to meet people’s health and wellbeing requirements.

People were involved in how their care and support was provided. People’s health and welfare needs were identified and acted on where necessary. People were provided with a choice of food and drink.

There were systems in place to monitor and audit the quality of the service provided. People and staff were able to provide feedback and information and feel listened to. Audits carried out were effective and this meant that the provider was able to drive forward any necessary improvements.

Staff meetings, supervision and individual staff appraisals were completed regularly. Staff were supported by the registered manager and care manager during the day. An out of hours on call system was in place to support staff, when required.