Archived: Barnfield House Liskeard

Updated 4 February 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 10 December 2016. This was an unannounced inspection which meant the staff and provider did not know we would be visiting. The inspection team consisted of an inspector.

Before visiting the service we reviewed previous inspection reports, the information we held about the service and notifications of incidents. A notification is information about important events which the service is required to send to us by law.

During the inspection we spoke with seven people who were able to express their views of living in the service. We looked around the premises and observed care practices. We observed interactions between people and staff throughout the day.

We also spoke with two care staff, the administrator and the manager. The registered person was not available. We looked at three records relating to the care of individuals, staff recruitment files, staff duty rosters, staff training records and records relating to the running of the home.

Updated 4 February 2017

Barnfield House provides care for up to 13 people who have mental health needs. On the day of the inspection 11 people were living at the service. We carried out this unannounced inspection of Barnfield House on the 10 December 2016

The service is required to have a registered manager and at the time of our inspection there was no registered manager in post. A registered manager is a person who has registered with the CQC 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 and associated regulations about how the service is run. The provider had appointed a new manager in the last two months and they had contacted the commission to commence the registered manager application.

There had been four changes in manager over the last two years at the service and this has caused some instability in the service. This has meant that people and staff have felt insecure and some systems and processes were not robust.

The manager was aware that some records and procedures needed to be amended to ensure compliance with the regulations. The manager had identified that the service needed to review care documentation to ensure that people's care needs were accurately identified.

The manager also identified that there were gaps in recruitment and training records for staff. For example in the areas of staff induction process, supervision, training and recruitment. The manager had also identified that the service’s policies and procedures needed to be updated and had started to review some of these, for example the recruitment process. As the manager recognised the shortfalls of the service she appointed an administrator to assist her to put more robust systems in place, for example in the area of recruitment and training. This then allowed the manager time to get to know people, staff and to review care documentation. It is acknowledged that the manager has been in post for a short time and it is to her credit that she has identified these issues quickly and is actively trying to address the issues raised.

People told us they were pleased with the appointment of the new manager and were complimentary about her approach and the changes that had already occurred at the service. People were complimentary about the manager saying she was “brilliant", “fantastic “she really cares and listens” and “we want her to stay.” We received positive comments about the staff team from people, saying they are “Caring” and “Kind.” One person said "I am happy here, the staff are kind and have time to listen to me.” People were invited to attend residents’ meetings so that their views on the service could be heard.

Staff echoed this view and said they were pleased with the changes that the new manager had already made to the service, for example reviewing care plans, training and supervision. One member of staff said “I enjoy coming to work now”. Staff were pleased that induction, supervision and training were being looked at and that their views were being sought on the running of the service.

People told us they felt safe living in the service. The majority of people we spoke with said they got on with each other well. Some people had lived at Barnfield House for many years and had developed firm friendships with others in the service. People told us they were completely satisfied with the care provided and the manner in which it was given.

We saw staff providing care to people in a calm and sensitive manner and at the person’s pace. When staff talked with us about individuals in the service they spoke about them in a caring and compassionate manner. Staff demonstrated a good knowledge of the people they supported. People’s privacy, dignity and independence were respected by staff. We saw many examples of kindness, patience and empathy from staff to people who lived at the service.

The majority of people who used the service who we spoke with told us they did not want to participate in any activities. People said they were happy to organise their own time and gave examples of going out for a walk or getting a taxi into the town centre.

The manager had a good understanding of the Mental Capacity Act 2005 (MCA) and how to make sure people who did not have the mental capacity to make decisions for themselves, had their legal rights protected. Where people did not have the capacity to make certain decisions the service involved family and relevant professionals to ensure decisions were made in the person’s best interests.

Staff felt there was enough staff on duty. The manager reviewed people’s dependency levels regularly and told us of an occasion when staffing levels were increased so that people received the support they needed. The manager had undertaken some shifts at the service which helped her get to know people, staff and how the service was run.

We saw the service’s complaints procedure which provided people with information on how to make a complaint. People told us they had no concerns at the time of the inspection and if they had any issues they felt able to address them with the manager or staff team.

We found three Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the end of the full version of the report.