Archived: Barnby Gate

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Prior to our inspection we reviewed all the information we had received from the provider. We utilised a variety of different methods to help us understand the experiences of people residing at the home because they had complex needs this meant they were not able to tell us their experiences.

We spoke with the area manager and the person in charge, a person's relative via a telephone conversation and three support staff. We also looked at some of the records held in the service, including the support files for two people. We observed the support people received from the staff and carried out a tour of the building and outdoor areas.

Is the service safe?

We found the service to be safe, as people were supported in an environment that was maintained to a safe, clean and hygienic standard. We also found equipment at the home had been maintained and serviced on a regular basis.

Staff told us there were sufficient staff to support people. One member of staff told us, 'The staffing levels are good at the moment. We do one to one activities with people and we have plenty of time.' Another said, 'It's a good staff ratio, there are three staff on at the moment and three service users are in the home.'

We found that an on call system was in operation to ensure a member of the management team was available at all times should an emergency situation arise.

We found that staff personnel records contained information required by the Health and Social Care Act to ensure that staff employed to work at the home were suitable and had the skills and experience needed to support the people.

Staff benefited from an induction period and training packages to ensure their knowledge and skills remained up to date. One member told us, 'The training covers everything that we need. I had an induction folder and a training folder to go through. They included infection control, data protection, medication management, health and safety, first aid and fire awareness. We also looked at the home's policies and procedures which included the safeguarding and the whistle blowing procedures. It's a brilliant induction, in fact it's the best I have been on. We have refresher training as well.'

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted recently proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

Systems were in place to ensure that care and support could be delivered in such a way as to meet the individual needs and preference of people. Furthermore, our observations throughout the day of the inspection demonstrated that support staff had a very good insight into the needs of people and how they were to be met.

Is the service caring?

Through our observations we established that support staff were respectful and caring. We noted that they utilised effective listening skills, especially if people had communication difficulties. We also observed staff asking people to make choices in relation to their day to day activities and all interactions were undertaken in a warm and friendly manner which promoted the dignity and respect of people.

Is the service responsive?

We found that systems were in place to ensure that effective needs assessments could be performed when people expressed a desire to move into the home. We found that the assessments could utilise information from people's relatives if necessary, together with information from professionals such as social workers so as to build a comprehensive picture of people's holistic needs.

We found that people's support plans highlighted people's individual needs and preferences. We also found that they would have benefited from additional risk assessments in relation to pressure ulcer prevention.

We found that people had access to a varied activities programme both within the home and the broader community. People were also supported to maintain relationships with their friends and relatives.

Is the service well-led?

We found that staff had a good understanding of the aims and objectives of the home and told us they received appropriate support and direction from the management team. One member of staff told us, 'I had a supervision session about four weeks after I started. I have had informal supervisions since then. I feel very well supported, if I have a problem I can go to the manager at any time.'

We also found that staff meetings were performed to provide a forum to discuss any developments within the home. Staff also told us the meetings were useful in clarifying their roles and responsibilities.

We found that the person in charge was planning to undertake a quality assurance process in April 2014 to establish the views of people residing at the home, or those acting on their behalf to determine where improvement to the quality of service provision could be made.

We spoke with two relatives about their views. We also spoke with a team leader and three support workers. The registered manager was not present on the day of our inspection. We looked at service information, support plan files for three people and did a tour of both buildings.

Relatives we spoke with told us they felt communication with the home was good and that they felt included in discussions and decisions relating to their relative's needs. Comments included, 'I'm happy with Mencap, there are a lot of review meetings and input for (name of relative) is good.'

People were safeguarded against the risk of abuse; we saw the provider had a safeguarding policy and procedure. A relative told us, 'The staff team are very committed; I have every faith in that they keep people safe.'

We found that staff were not always appropriately supported. The supervision system in place was not working well.

We saw records did not always include the information required to protect people against the risks of unsafe or inappropriate care and support. Systems in place were informal or not working as well as they could.