Barnfield

Updated 13 October 2018

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.

The first inspection day took place on 26 June 2018 and was unannounced. The first day of inspection was carried out by one Adult Social Care 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. Their area of expertise included mental health and autism.

The lead inspector returned to the service on the 5 July 2018 to complete the inspection and feed back to the management team. We gave the provider notice we were returning for the second day of inspection.

Before the inspection we reviewed information held on our systems, this included notifications we had received from the service. A notification is information about important events, which the service is required by law to send us.

Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection, we met and spoke with the registered manager, the deputy manager, five care workers as well as a senior operational manager who was visiting the service on the second day of inspection. We also spoke on the telephone with a director of the provider organisation. We met and spoke with all the people living in the home. As some people were unable to communicate fully with us, we also spent time in their company during activities they were doing both in the home and elsewhere.

We reviewed three people’s care records, five medicine administration records, two staff records, staffing rotas and staff training records. We also reviewed records of audits and checks carried out in the home.

After the inspection we contacted 12 relatives of people living at the home to ask them about the care and support their family member received. We received five responses. We also contacted eight health and social care professionals as well as the staff at the local GP surgery for feedback. We received three responses.

Updated 13 October 2018

We carried out a comprehensive inspection of Barnfield on the 26 June and 5 July 2018. The first day of inspection was unannounced; we arranged the second day of inspection before we visited.

Barnfield is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 11 people in a main farmhouse and two adjoining buildings. The home provided accommodation for more than the six people recommended in Registering the Right Support and other best practice guidance. However, in many other respects the service demonstrated the values that underpin the Registering the Right Support ethos. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. At Barnfield, people were encouraged to do activities of their choice in the home, the village and in the wider community. The registered manager supported them to do this by ensuring they could use both private and public transport and staff were available if they needed to be accompanied.

This was the first inspection of this service since the provider, United Response, had registered it with the CQC in June 2017. The home had previously been registered under another provider, Robert Owen Communities, who had merged with United Response. United Response is a UK wide registered charity that supports adults and young people with learning disabilities, including autism, sensory impairment, and people living with dementia, mental health needs and physical disabilities.

Staff demonstrated the provider's values, to deliver person-centred care that recognised, promoted and respected people as individuals. This approach helped people to fulfil their potential to lead a full and active life in society. The home offered each person a weekly programme of activities which they had helped to choose. Activities were offered both within the home and in the local community which helped support people to maintain and expand their interests. Activities included swimming, participating in art and craft sessions, playing a musical instrument, going to college, working, attending day services in a local town, socialising and attending church. People were supported to have life skills such as cooking, laundry and housework.

There was a positive, open and empowering culture shared by staff and people. Staff were dedicated to helping people realise their goals and ambitions.

People were placed at the centre of their care by staff who were knowledgeable, enthusiastic and positive about providing care which fulfilled people’s ambitions and needs. Staff were very caring, compassionate and passionate about supporting each person to achieve their dreams and ambitions. They recognised each person as an individual and worked with them to develop skills and interests. People were encouraged to do a wide range of activities. These activities helped people have fun and improve skills as well as meet physical, mental and social inclusion needs.

Throughout the inspection we observed numerous interactions where staff showed gentleness, compassion, kindness and respect to people.

The home was a key part of the local village community. It was located a short walk from the centre of the village and some people were able to walk to the village independently. People in the home enjoyed the benefits of village life, as they used the village hall for a weekly lunch and dance club, rang the local church bells and had friends in the village. The home also joined in events run by the village such as an annual scarecrow contest. In turn the local community were very supportive of the home, and villagers regularly attended events such as quiz nights, concerts and carol services which the home ran. This helped people feel part of community life.

People took a real pride in Barnfield Farm and enjoyed working both indoors and in the extensive gardens. Fund raising events were run regularly by people and staff, including an annual open day, a concert, quiz nights and a carol service. These events were opportunities for the people at Barnfield to invite family, friends and neighbours in the local village. People were really enthused by these events and described how the events gave them an opportunity to display their skills and things they had made.

Funds raised had led to improvements to the home, which as a consequence had a computer room and a sensory room which people used. Further fund raising was planned to develop a sensory garden within the grounds.

People were encouraged remain in touch with family by visits, phone calls and the use of social media. People were also supported to have friends both in the home and in the community, who they met at social functions and by visiting each other’s homes.

Care and support was based on thorough and detailed care plans which were reviewed regularly and kept up to date with their changing needs and preferences.

People said staff were very kind and helped them achieve a full and happy life. There was also very positive feedback from relatives who all described the home as “very caring”, “Excellent” and “Fantastic.” Relatives and visiting professionals all said the staff were very responsive to people needs and preferences.

Care records described the care people needed to support them. There was detailed information about people’s individual risks and needs well as information about their preferences. Staff knew people very well and were able to describe the care and support they needed. Where people were newly arrived in the home, there had been detailed planning and preparation to ensure that their risks, needs and preferences were known and understood by staff prior to them coming.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. This included supporting people to travel independently, hold down jobs and study for qualifications.

Staff worked in partnership with people when planning care and support. Information was provided to people in an accessible format to enable them to make decisions about their care and support. Before new people were invited to come and live at Barnfield, people living there already had an opportunity to meet them. People were then able to feedback whether they felt they would like the person come to live at the home.

Health and social care professionals said staff contacted them appropriately. Where the professionals gave advice about a person’s care, there was evidence that staff followed this. For example, some people were supported to do hydrotherapy exercises which had been developed by a specialist. Staff ensured the person was supported to do the exercises correctly as the home had made training videos which staff could watch to refresh their memory.

There were exceptionally thorough arrangements to assess and manage people needs before they joined the home, during their stay and to prepare them to move on to another home.

People's consent to care and treatment was sought. Staff used the Mental Capacity Act (MCA) 2005 and understood how this applied to their practice. Staff had undertaken training about the MCA. They were able to describe what it meant and understood their responsibilities in relation to the Act.

Staff also understood how to keep people safe from the risks of abuse by others. The registered manager understood what they needed to do if they identified possible abuse, which included reporting to the local authority safeguarding team as well as informing the CQC.

Staff took time to ensure people had a meal of their choice, which they had helped to prepare. There were details about food that people liked and disliked which meant people always had alternatives meals if they wanted something else. Drinks were available throughout the day to ensure people remained hydrated.

Medicines were received, stored, administered and disposed of safely. Medicine administration records and other records relating to medicines were completed accurately.

There was a manager in post who had registered with the CQC in June 2018. 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 2008 and associated Regulations about how the service is run.

At this inspection, we found the home was well run, although some aspects of environmental safety needed improvement. The work to improve these additional safety features was carried out during and immediately after the inspection.

There were systems in place to monitor the quality and safety of the home. Evidence of what works best was used to continually review and improve systems and practice.

The home was clean and well maintained. There were systems in place, which staff followed, to ensure a safe and infection-free environment. People’s bedrooms were individually decorated and furnished according to their preferences.

Staff were recruited safely. Staff undertook an induction to introduce them to the service and ensure they had the knowledge and skills to support people safely. Staff were supported to refresh their knowledge and skills and take nationally recognised vocational qualifications.

There was a policy and procedures to deal with complaints. People said they had not needed to complain. No complaints had been received since the last inspection.

Please note that the summary