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Inspection carried out on 16 September 2016

During a routine inspection

This inspection took place on 16 & 22 September and was unannounced. Bernhard Baron Cottage Homes provides accommodation and personal care for up to 60 older people, some of who may have a diagnosis of early dementia. At the time of inspection there were 59 people using the service. The home comprises a main building with 34 bedrooms and 24 self-contained cottages in the grounds. The service is a registered charity and managed by a board of appointed Trustees.

The home had a registered manager. 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 2008 and associated Regulations about how the service is run.

People who used the service said they were safe. Staff knew how to recognise the signs of abuse and what to do if they thought someone was at risk. However, not all of the appropriate recruitment checks had been completed before volunteers began work. A legionella risk assessment had not been completed and there was a potential of risk to the safety of people’s medicines management.

People gave us very positive feedback about the care they received. People were able to express their views and preferences about their care and these were acted on. People were treated with respect and their privacy was protected.

The provider, registered manager and staff made sure they supported people to live fulfilled and meaningful lives in the way they wanted to. An extensive range of meaningful and enjoyable activities was offered, and people gave us enthusiastic and positive feedback about the quality of their lives living at the home.

People’s care needs were regularly assessed and people were involved in making decisions about their care. People’s support needs were assessed and care plans were developed to detail how these needs should be met. Care plans were detailed which helped staff provide the individual care people needed. People knew how to make a complaint or raise concerns with the registered manager and told us these were acted on when they did so. There was an appropriate complaints system in place and any concerns raised had been thoroughly investigated.

People were asked for their consent appropriately and staff and the registered manager had a good understanding of the Mental Capacity Act 2005 (MCA). This legislation provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make decisions for themselves. Care workers knew that any decisions made on someone else’s behalf must be in their best interests.

There were enough staff to meet people’s care needs and staff had regular training, supervision and appraisal to support them. Staff gave positive feedback about the quality of the training and people who use the service said staff were well trained.

Incidents and accidents were thoroughly investigated and action taken to reduce the risk of them being repeated. The registered manager and staff understood the importance of learning from incidents so they could make improvements to the service.

People who needed it were supported to eat and drink enough and food was nutritious and well made. Staff knew what to do if they thought someone was at risk of malnutrition or dehydration. People gave us positive feedback about the food. People’s day to day health care needs were met.

The service was well led by a dedicated registered manager and management team. There was a commitment to provide high quality care which was tailored to people’s individual choices and preferences. Feedback from people who use the service, relatives and staff was positive, and staff felt well motivated and supported in their role.

The provider carried out audits to ensure people experienced safe and good quality care. People were asked for their feedback about the quality of the service, and where areas for improvement were identified appropriate action was taken.

Inspection carried out on 16 September 2013

During a routine inspection

During our inspection we spoke with six people who used the service. We also spoke with seven staff members; these were the registered manager, the care manager, the Trustees representative, a senior care worker, two care workers and the first chef. We also took information from other sources to help us understand the views of people who used the service, which included resident and visitor surveys.

The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us, "The care is excellent. I can’t express the tender loving care that they give each one of us.” Another person who used the service told us, "The staff are lovely people and I have not had a moment of regret coming here.”

Staff we spoke with had a good understanding of the support needs of the people who used the service. One member of staff we spoke with told us, "I think the residents are happy with the care we provide.”

The people who use the service were supported to have adequate nutrition and hydration. People were given choices of food and drink to meet their diverse needs.

We saw evidence that the provider had an effective recruitment and selection procedure in place to ensure that staff were qualified to do their job.

The service had a system in place to effectively deal with comments and complaints.

We also saw that care plans, staff records and other records relevant to the management of the home were accurate, fit for purpose and held securely.

Inspection carried out on 21 February 2013

During a routine inspection

During our inspection we found that the premises were clean and well maintained and the atmosphere was relaxed and homely.

We found that comprehensive and well maintained person centred support plans enabled care workers to meet people's assessed needs in a structured and consistent manner.

Risk assessments and safeguarding policies and procedures ensured that people using the service were safe.

In accordance with their individual care plans, people were supported to make choices about their daily lives. They had input into how the home was run and were able to influence decision making processes.

Positive comments from people using the service and their relatives indicated a high level of satisfaction with the home and the services provided:

“It’s just lovely here, everyone is so kind, they can’t do enough for you. I have everything I need, including my family nearby”.

“My mother loves living here and she is so happy with her room. We are delighted with the care that she receives There’s nowhere else like it”.

Appropriate arrangements were in place in relation to storing, administering handling and recording medicines.

We found that there were enough qualified, skilled and experienced staff in place to meet people's needs.

Care workers had developed awareness and a sound understanding of each individual's care needs. This was evident from direct observation of individuals being supported in a professional, sensitive and respectful manner.

Inspection carried out on 8 February 2012

During a routine inspection

During our visit we spoke with the registered manager, a care manager, a deputy manager, two carers, the maintenance person, the activities coordintor, seven people who used the service and one representative.

People who used the service told us that they receive care in a way that was respectful

of their privacy and dignity. When we asked people about their care plans and reviews, we were told that they are involved as much or as little as they like.

People who used the service told us that they were treated by care staff in a kind and

caring manner. We were told that care staff were respectful and open to changes in

care needs.

People told us that there are lots of activities to go to and that they are free to attend

the ones that they like.

People who used the service told us that they felt safe living at the service.

People told us that they thought there were enough staff on duty and that staff were

approachable and willing to help. People who used the service told us that they can speak with staff and the managers at any time and they feel included in decisions made about the care they received and the way in which the service was run.

Reports under our old system of regulation (including those from before CQC was created)