Barrington Lodge

Updated 21 May 2022

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 Care Act 2014.

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

Our inspection was completed by one inspector and a specialist nurse advisor.

Service and service type

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

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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

Notice of inspection

This inspection was unannounced. The inspection activity all took place on 15 March 2022.

What we did before the inspection

We reviewed the information we had received about the service since they registered with us, including any statutory notifications received. We reviewed the provider information return. This is information providers are required to send us with key information about their service, what they do well and improvements they plan to make. We used all of this information to plan our inspection

During the inspection

We spoke with two people using the service and one relative. Most people were unable to share their feedback due to their level of dementia. Because of this we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager, deputy manager, two support workers, the activities officer, the clinical lead and a nurse and we reviewed a range of records. These included care and staff records and records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We also received feedback from the local authority who recently inspected the service.

Updated 21 May 2022

About the service

Barrington Lodge is a nursing home for up to 44 older people, many of whom were living with dementia. At the time of the inspection 42 people were receiving personal and nursing care.

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

Staff recruitment could be improved as the provider did not always obtain references and check gaps in employment history in line with their recruitment policy. The audits in place to check people received a good standard of care required improvement. These audits had not identified the issues we found including staff recruitment, pressure mattress settings being inappropriate to prevent pressure ulcers, medicine temperature checks, lack of a Legionella risk assessment, inaccurate fluid charts, a staff member not wearing PPE, issues in responding appropriately in the case of a heart attack and the way one staff member supported a person to eat.

The registered manager was also a registered nurse and a director. They were experienced and understood their role and responsibilities well overall and took action to improve any gaps in their knowledge, as did staff. The registered manager engaged well with people using the service, relatives and staff and staff felt well supported by the registered manager. The registered manager notified CQC of significant events, such as allegations of abuse, as required by law.

People received the right support in relation to risks such as those relating to living with dementia and other risks in their daily lives. There were enough staff to support people safely and recruitment was ongoing. Staff received training in infection control, including the safe use of personal protective equipment (PPE) to reduce the risk of COVID-19 transmission. People received the right support in relation to their medicines and the registered manager had good oversight of this. The premises were maintained safely with regular checks carried out by staff and external contractors.

Staff received the training and support they needed to meet people’s needs with regular supervision from their line manager. People were supported to maintain their mental and physical health and to maintain contact with professionals involved in their care. People received food and drink of their choice in sufficient quantities with snacks available outside of mealtimes. 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 positive about staff and had developed good relationships with them. People received consistency of care from a small number of staff who knew them well. People were encouraged to be involved in their care as much as possible, including taking part in their own personal care. Staff treated people with dignity and were trained in how to keep personal information confidential. People’s care plans were based on their individual needs and preferences and were kept up to date. The registered manager investigated and responded to any concerns or complaints in line with their policy.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This service was inspected on 9 August 2021 and the report was published on 8 September 2021. The service was rated good.

Why we inspected

This inspection was prompted because we received concerns regarding risks relating to bed rails, staffing levels, infection control practices, the care provided to people isolating in their rooms and the management of the service. We did not find evidence in relation to these specific concerns at this inspection.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to recruitment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.