Hill Barn Care Home

Updated 28 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hill Barn Care Home name is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hill Barn Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people using the service and 6 relatives about their experience of using the service. We spoke with 8 staff, this included the registered manager, the operations director, 2 senior care assistants, 3 care assistants and a member of the domestic staff. During the inspection we carried out observations of the support provided and reviewed the care records relating to 4 people's care and 3 people’s medicines. We reviewed a range of records related to the running of the service. This included audits, training records, meeting minutes, environmental risks, medicines management, and records relating to incidents.

Updated 28 October 2023

About the service

Hill Barn Care Home is a residential care home providing personal care to up to 26 people. The service provides support to older people some of whom may be living with dementia. At the time of our inspection there were 25 people using the service.

Hill Barn Care Home provides accommodation over the ground floor in a single building. There are two communal lounges and large grounds.

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

Improvements were needed to recruitment processes. The provider had recently implemented a staff file audit to address this going forward. Whilst there appeared to be sufficient staff, we noted some improvements needed around the deployment of staff. This was to ensure people in communal areas were not left for extended periods of time on their own. We found some areas of the environment could pose a potential risk. The provider had identified these and actions were planned to address these following the inspection.

People and relatives spoke highly of the quality of the meal provision. We identified some further improvements needed to ensure people were better supported with their meal options and choices. The physical environment required some refurbishment. This included in relation to improving the environment to meet the needs of people living with dementia. The provider had a list of planned works such as refurbishing bedrooms and carpets.

Some governance systems required further work to ensure they were robust. The provider had identified this and was in the process of reviewing and putting in to place new audits. The registered manager was passionate and committed to the service but had had limited management support, this had restricted their ability to improve and develop the service. At the time of the inspection the provider was in the process of putting in place additional assistance to support the registered manager.

Staff had a good understanding of how to support people to stay safe. Risks to people such as in relation to pressure care and malnutrition were well managed. Systmes were in place to support oversight and management of identified risks, this included in relation to incidents. Staff had a good understanding of adult safeguarding and how to report concerns. People received their medicines safely.

People's bedrooms were pleasant and personalised. The registered manager emphasised the importance of staff knowing people as individuals and ensuring their rooms reflected this. Nationally recognised tools to assess risks to people's skin integrity and malnutrition were used. Staff felt well supported to carry out their roles, they received a range of training. People and relatives told us they had confidence in the staff team. Staff monitored people's health and were proactive in ensuring they access health care when needed. People's consent to care had been sought and their ability to do so assessed. 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.

People were supported by a kind and caring staff team. People and staff spoke positively about the kind care they received. Staff demonstrated they cared about the people they supported and each other. People's spiritual needs were supported as well as relationships with important people in their life. People were listened to about their care.

People received person- centred care. This was supported by a stable and consistent staff team who knew the people they supported well. People told us they did not feel restricted and their individual preferences around their routines were supported. People and relatives told us they were happy with the activities on offer. Where people preferred to stay in their rooms staff had ensured they were kept stimulated in line with their preferences.

There was a positive person-centred culture in the home. Staff spoke positively their role and the support they received from the registered manager. Relatives told us the communication was good and they felt involved in the service. The service had a homely feel, with a family ethos and atmosphere. A family member said, “The home is a ‘homely home’. It’s not a hotel. There may be posher places around, but this is a true care home. There’s a low turnover of staff and management and the chef has been there years. Continuity of care is so important I believe.”

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 the service under the previous provider was good published on 01 November 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.