Archived: Barnfield Residential Home

Barnfield Residential Home is registered to provide personal care and accommodation for up to 24 older people. At the time of this inspection there were 20 people living there.

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 2008 and associated Regulations about how the service is run.

People told us they were happy with the service they received. Comments included, “I cannot fault the carers. You could not get better carers anywhere,” and “They are Lovely.” People were protected from abuse because the provider had systems in place to ensure checks of new staff character and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse.

During our inspection we saw there were sufficient staff on duty, although some people and staff told us there were certain times of the day when staff were sometimes rushed. The registered manager told us staffing levels had recently been increased in the mornings and this had made a positive improvement. Staffing levels in the evenings had also been adjusted and they were keeping this under review.

Medicines were stored and administered safely. There were some gaps in the administration records for creams, although the daily records contained evidence that creams had been applied. During our inspection the manager put new systems in place to ensure medicine administration records would be checked at the end of each shift and any errors or omissions investigated and addressed immediately.

There were safe storage and recording systems in place for money held by the home on behalf of those people who requested assistance with cash for their day-to-day spending needs, such as hairdressing and toiletries.

Each person had been consulted and involved in drawing up a comprehensive plan covering all aspects of their health and personal care needs. The plans were divided into sections to enable information to be located quickly. Information in the plans had been regularly reviewed and provided good information for staff on all tasks the person wanted support and assistance with. This included all areas of potential risk.

People were supported to obtain medical advice and treatment promptly when necessary. Staff offered to escort people to medical appointments if necessary.

Staff were caring. Comments included “They are lovely. It’s nice when you have people like that”, and “The staff are marvellous.” Throughout our inspection we saw staff treating people with kindness and respect. They responded positively and promptly to requests for assistance.

People knew how to raise a complaint and said they would not hesitate to speak with the registered manager if they had any concerns. Information on how to make a complaint was displayed in each bedroom.

People were offered a range of activities throughout the week on an individual and group basis. An activities co-ordinator was employed in the home two days per week. A notice board in the main entrance showed the activities on offer each day. This included visits from entertainers and external organisations.

People told us the home was well managed. There were monitoring systems in place covering all aspects of the service and action plans had been put in place to address any issues arising from these. The kitchen had recently been upgraded and a major programme of updating and improvement was about to begin to all areas, including upgrading the fire precautions and redecoration of most areas.

Before our inspection we reviewed all the information we held about the home. We examined previous inspection reports and notifications received by the Care Quality Commission.

On the day of our visit we were told that there were 24 people living at Barnfield Residential Home. We looked at the care files of four people living there, and we met with each person, their relatives, and with three staff to find out if the care and services they received met people's needs.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

The service was safe because people's health and care needs were understood by a trained and supported staff. Risks to people's health and welfare were understood and managed in line with their agreement. Equipment was provided where necessary, for example, pressure relieving mattresses and adjustable beds.

There was monitoring of events and incidents and measures were put in place to minimise a repeat of any issues. This included, changes to health care needs and some medication incidents. People's medicines were being managed on their behalf in a competent way.

People told us they were confident there were sufficient staff to meet their needs. We saw call bells were answered promptly and routines were carried out efficiently.

Care plans included considerations of the Mental Capacity Act (2005) and staff demonstrated an understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and how they applied to their practice. We found the location to be meeting the requirements of the Mental Capacity Act (2005). People's human rights were therefore properly recognised, respected and promoted.

Is the service effective?

The service was effective because people's health and well-being was promoted. Their quality of life was optimised. People did not appear rushed and the home was relaxed and welcoming. People told us the level of activities had improved in recent months.

Care plans provided instructions to staff about the care each person wanted and needed. We saw evidence of multi-professional visits and appointments, for example GP, speech and language therapist, and community nurses.

Is the service caring?

The service was caring because we saw how staff were observant to people's needs and responded appropriately. Throughout the inspection, we saw staff communicating in a warm and caring manner. The relationships between staff and people in the home were friendly, cheerful and positive. For example, we saw staff gave people time to communicate, offered choices, and offered support in a gentle, friendly and caring manner.

People told us 'The staff are lovely. Nothing is too much trouble. I can ask anything at any time,' 'They are more than kind ' I am spoilt rotten!' and 'They are very caring. I am happy about everything now. It's a lot happier place now.'

Is the service responsive?

The service was responsive because people's likes and dislikes were taken into account. For example, people were able to choose what time they got up and went to bed. The staff we spoke with were able to explain in detail the care each person required, including communication needs, and individual likes and dislikes. People told us they were confident if they had any concerns these would be sorted out quickly. Comments included 'I can speak out ' and I do ' if anything is wrong. They sort it out. It doesn't happen often.'

Care files were regularly updated and provided staff with sufficient information about each person's needs to ensure their health and welfare needs were met safely.

Is the service well-led?

A new manager had been appointed in recent months. People we spoke with, relatives and staff told us the service had improved significantly since the new manager started. Comments included 'It's getting a lot better,' and 'It's much better now.'

Staff felt the service was well-led and their views were listened to. They had opportunity to speak out through regular supervision sessions, staff meetings, and daily handover sessions. They told us they felt valued and their views were listened to and acted upon.

There was one vacant room in the home on the day of our visit.

We spent time with all of the people living in the home and had meaningful conversations with five of the people. We spoke with two relatives and one visiting GP. We spoke with five members of staff, a senior member of staff and the temporary manager.

We saw that the atmosphere in the home was friendly and homely.

People's care and treatment was planned and delivered in a way that was intended to ensure people's welfare and safety. All of the people we spoke with told us that they got the care they needed. Comments included "staff will always help", "they (the staff) are very good" and "nothing is too much trouble". We saw good interactions between staff and people throughout our visit. One relative told us that "it's (the home) always nice" and that they were always welcomed at the home. One visiting GP told us that they considered the care "to be very good" and that the staff were "very caring". The home uses regular staff from a care agency when needed.

Varied healthy home cooked meals were provided for people living at the home. People were complimentary of the food and comments included "there's always a choice", "it (the food) is very good" and "very happy with the food".

People received their medicines but we saw that these were not always being stored, administered, recorded or disposed of accurately or safely.

People we spoke with were positive about the skills and abilities of the staff who supported them. Comments included "there are enough staff", "staff will always help" and "the carers are absolutely wonderful". One visiting GP told us that he considered the care to be good and that the staff were "very caring". They said that people always looked "well cared for" and "very happy". The home used regular agency staff.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted upon. People and staff told us that they felt listened to and could bring up any concerns to the manager in the home. We saw that regular audits on care, treatment and services are undertaken by a manager from another home.

People spoken with during our visit, told us that they knew how to make a complaint and that they would feel comfortable informing the manager about any concerns they had.

People were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent it. This included recruitment processes that ensured the suitability of new staff. People told us they felt safe, well cared for, and able to raise any concerns with staff. They confirmed their property was treated with respect by staff. They also confirmed staff answered call bells quickly enough. One added 'Especially at night'someone comes straight away.'

People's views and experiences were taken into account. One person told us 'They always ask you what you want.' Some people explained that they liked to get up late and did so. Others said they liked to get up earlier, and that staff always helped them to do this. They told us they had a choice of meals.

There were effective systems in place to manage risks to the health, safety and welfare of people who used the service and others. When we asked if staff noticed if they were under the weather or unwell, people confirmed this was so. One person replied 'If you're a bit quiet, they say 'Are you okay?' ' All those we spoke with confirmed they got the care they needed.