Archived: Barnfield

There was a registered manager in post. 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 and associated Regulations about how the service is run. The registered manager helped us during our inspection.

We last inspected Barnfield in June 2016 when we identified a breach of regulation relating to acting within the principals of the Mental Capacity Act. We found at this inspection this had improved.

Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). We identified some areas in relation to people’s medicines that staff needed to improve in. The registered manager took immediate action to address this immediately following our inspection.

The registered manager told us that care records were being worked through as he was aware that these needed to accurately reflect people’s needs. Although we found some improvement was required in this area we were satisfied that people received the care they required despite some records not always reflecting this.

Accidents and incidents were recorded and action taken to help prevent reoccurrence. Where people had risks related to them, these had been identified and guidance was in place for staff.

People lived in an environment that the staff checked regularly to help ensure it was safe for them. Staff were knowledgeable in relation to their responsibilities with regard to safeguarding and the registered provider carried out checks to help ensure they only employed suitable staff to work in the home.

Staff supported people to eat a good range of foods and those with a specific dietary requirement were provided with appropriate food. People had access to external health services and professional involvement was sought by staff when appropriate to help maintain good health.

People were encouraged to take part in activities both in the communal lounge and also in individual living areas. People lived in a homely environment. People’s rooms were cosy and personalised and there was programme of redecoration taking place in the home.

We found the registered manager had good management oversight of the home and there was a good culture within the team. Staff told us they felt supported and valued and we found staff had the opportunity to meet with their line manager regularly to discuss their role. Staff received an induction when commencing within the home and their training was updated routinely to ensure staff continued to work to best practice.

There were a sufficient number of staff on duty and we did not see people needing to wait for attention. It was evident staff knew people well and respected people when they wished to have time alone. Staff were caring to people and there was easy going conversation between people and staff.

People, relatives and staff were involved in the running of the home. Regular meetings were held and a questionnaire circulated so people could give their views on the care provided. Where suggestions and ideas were raised these were listened to by the registered manager.

Staff and the registered provider undertook quality assurance audits to ensure the care provided was of a standard people should expect. Any areas identified as needing improvement were actioned. Regular fire checks and fire drills were carried out to help ensure staff would know what to do in the event of an emergency and there was a contingency plan in place should the home have to close.

A complaints procedure was available for any concerns. People and relatives could also leave positive comments and feedback.

During our inspection made two recommendations to the provider.

This was an unannounced inspection that took place on 13 June 2016.

The home was without a registered manager as they had left the home two weeks prior to our inspection. 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 and associated Regulations about how the service is run. The new manager was present on the day and she and the deputy manager assisted us with our inspection. The new manager told us they would be starting the process of applying to become the registered manager.

Care records for people were not always accurate and some information around the risks identified for people was missing which meant staff may not know how to respond.

Staff had not always followed the legal requirements in relation to the Mental Capacity Act 2005. Where people had restrictions in place to keep them safe, staff had submitted the appropriate DoLS applications. Staff were heard to obtain people’s consent before they supported them.

Staff followed correct and appropriate procedures in administering medicines and medicines were stored safely and appropriately. People were cared for by a sufficient number of staff which meant they did not have to wait to be attended to. People knew who to speak to if they needed to make a complaint.

Staff knew how to look out for any signs of abuse and who they would report abuse to should they need to. The provider carried out appropriate recruitment checks on staff before they started working at Barnfield.

Were people had falls or accidents, staff took appropriate steps to help ensure the risk of reoccurrence was reduced. Staff worked with external health professionals in this respect. If the home had to be evacuated in the event of an emergency staff knew what action they needed to take.

People had care responsive to their needs. People were provided with a choice of meals each day and those who had dietary requirements received appropriate food. However, we found those people on a soft diet were not offered the same choice of meals. Staff maintained people’s health and ensured good access to healthcare professionals when needed.

There was a good atmosphere in the home where people and staff interacted in an easy-going manner. Staff were kind, caring and respectful to people and there was good relationships between staff and people. People could make their own decisions and have privacy when they wished it. Visitors were welcomed into the home and staff knew relatives well. People told us they did not get bored and they had access to a range of activities which they enjoyed.

Care was provided to people by staff who were trained and received relevant support from their manager. This included regular supervisions and an annual appraisal with their line manager.

Care plans were individualised and contained information to guide staff on how someone wished to be cared for. Information included detail around people’s mobility, food and personal care needs. Some agency staff did not always know relevant information about people, however there was always a permanent member of staff on each unit to assist. People moving into the home may not always have been made to feel welcome. The manager was aware that pre-assessment information needed to be completed in a more comprehensive way.

Quality assurance checks were carried out to help drive improvement within the home. The manager had their own action plan which they had been developing since starting at Barnfield. They recognised the areas that needed to improve and were actively working on them.

There was an open positive culture within the home and it was evident the new manager was respected by staff and staff morale had improved since they had taken over the role.

During the inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made some recommendations to the provider. You can see what action we told the provider to take at the back of the full version of the report.

There were fifty four people in the home on the day of our inspection, two people were in hospital and there were seven empty beds. We met and spoke with several people throughout the home during our visit. People told us they liked living in the home and were well cared for. They also said the staff were kind and caring.

We were told that people had the opportunity to visit the home if possible before they moved there to ensure they were happy with the choice. Relatives did this when people were unable to visit for themselves.

We saw the home was clean and hygienic and people were satisfied with the standard of cleanliness.

People told us they liked their rooms and had everything the needed to help them feel comfortable.

We saw a wide range of activities in place which were outlined in the "Barnfield Newsletter". The home also had a day care service located on the ground floor where people from the community came and people who used the service also used for planned activities.

Staff told us they liked working in the home. They said they received the training and supervision necessary to undertake their roles. We saw staff were caring and professional in their manner and had a good understanding of people's care needs.

We saw systems in place that monitored quality assurance.

The people we spoke with told us they were happy with the care they received. One person told us there were plenty of activities for people to be involved in. Another person told us she sometimes did not like the food offered but the staff always prepared an alternative meal.

The people we spoke with told us they had no concerns with their medication and felt they were well supported by the staff. They told us they were happy with the staff and told us they were treated well. They also told us that they had no concerns about the care they received.