We carried out a review of the data available to us about Baytrees on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Baytrees, you can give feedback on this service.
We found the following examples of good practice.
The service had a flexible staff group with bank staff and regular agency staff used to ensure people had the support they needed. There was good oversight of infection control in the home with regular spot checks of hand hygiene and cleaning.
The manager had considered people’s individual risks related to COVID-19 and had supported them to understand how to keep themselves safe in the home and in their community. The manager had a good understanding of capacity and helping people make decisions related to COVID-19, such as testing and vaccination.
There was good space available for staff to take breaks, to remove PPE and eat and drink. A garden room had been adapted for one person to give them some additional space to help when restrictions meant more activities and time was spent at the home.
Baytrees 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.
Baytrees accommodates up to four people with learning disabilities in one adapted building. There were four people at the service at the time of inspection.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. 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 our last inspection, we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager in place at the time of our inspection. 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.
The registered manager had a sound understanding of people’s needs and regularly worked alongside staff to offer support and guidance. People’s relatives told us that the registered manager was friendly, approachable and kept them updated about their family members’ health and wellbeing. There were systems in place to gain feedback about the service and deal with complaints. People’s families expressed confidence in the registered manager’s ability to handle concerns appropriately.
The registered manager carried out a series of audits and quality assurance checks to monitor the quality and safety of the service. They had demonstrated that they were able to implement recommendations from external health and safety professionals, which helped maintain a safe environment.
Some people had complex health needs which required ongoing input from health professionals. The provider took on board recommendations and ensured that people were supported to have their health regularly monitored.
People were provided with a diet appropriate to their needs. Where people had specific requirements, staff made the arrangements to ensure this was accommodated.
Risks to people in relation to their anxiety and behaviour were assessed, monitored and mitigated. Staff were skilled in adopting a wide range of strategies to de-escalate potentially challenging situations without the need for physical intervention.
When incidents took place, the registered manager looked for trends and lesson that could be learnt to reduce the risk of reoccurrence.
Staff had received training and support to help ensure they were effective in their role. Staff knew people’s needs well and were caring and patient in their approach.
People’s needs in relation to communication were fully assessed and staff were skilled in implementing personalised strategies. This meant people had choice and a level of control around their daily routines and activities. Where people had needs in relation to their environment, the provider made adaptations accordingly to help the home remain a safe and comfortable place to live.
People were treated with dignity and respect. Where people liked their privacy, this was clearly understood by staff. People’s preferred personal care routines were documented in their care plans, which people and their relatives contributed towards developing.
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.
The provider had signed up to a NHS England led initiative to help ensure people were not overmedicated. There were examples where the provider had worked in partnership with people, health professionals and families to reduce the need for people to take medicines prescribed in relation to anxiety and behaviour.
There were sufficient numbers of suitably skilled and qualified staff in place. The provider had recruitment processes in place to identify suitable candidates for the role.
The home was a clean and hygienic environment and there were systems in place to prevent the risk of infections spreading.
This unannounced inspection of Baytrees took place on 17 and 18 June 2015. The service offers accommodation and support to four people who may have learning disabilities or autism. The primary aim at Baytrees is to support people to lead a full and active life within their local communities and continue with life-long learning and personal development. The home is a detached house, with a substantial rear garden, within a residential area, which has been furnished to meet individual needs.
The service 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 and relatives told us they trusted the staff who made them feel safe. Staff had completed safeguarding training and had access to current guidance. They were able to recognise if people were at risk and knew what action they should take to protect them. People were safeguarded from the risk of abuse. Staff had responded appropriately to safeguarding incidents to protect people. The provider had made changes to people’s care as a result of incidents to safeguard them.
People’s safety was promoted through individualised risk assessments. Risks had been identified, and plans were in place to manage these effectively. Staff understood the risks to people’s health and welfare, and followed guidance to safely manage them.
The registered manager completed a daily staffing needs analysis to ensure there were always sufficient staff with the necessary experience and skills to support people safely. Whenever possible the registered manager and staff worked together with people to identify in advance when their needs and dependency were likely to increase.
People were cared for by staff who had undergone the required pre-employment checks to ensure their suitability and had received an induction based on the social care industry requirements. The induction also took into account the specific needs of the people cared for by the service, including autism and epilepsy. Staff had the required training updated in accordance with the provider’s policy. The provider supported staff to meet people’s needs with an effective programme of induction, supervision and appraisal. Staff were encouraged to undertake additional relevant qualifications to enable them to provide people’s care effectively and were supported with their career development.
Medicines were administered safely in a way people preferred, by trained staff who had their competency assessed by the registered manager.
People were actively involved in making decisions about their care and were asked for their consent before being supported. Relationships between staff and people were relaxed and positive. Staff engaged with people to identify their individual needs and what they wanted to achieve in the future. Staff showed flexibility and creativity in supporting people to become more independent. People were encouraged to be as independent as they were able to be, as safely as possible.
Staff had completed training on the Mental Capacity Act (MCA) 2005 and understood their responsibilities. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to support people who do not have capacity to make a specific decision. Where people lacked the capacity to consent to their care, legal requirements had been followed by staff when decisions were made on their behalf. People were supported by staff who supported them to make day to day decisions.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide a lawful way to deprive someone of their liberty, where it is in their best interests or is necessary to protect them from harm. The registered manager had completed the required training and was aware of relevant case law. The registered manager had taken the necessary action to ensure people’s rights were recognised and maintained.
People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice.
There was a friendly and relaxed atmosphere within the service, where people were encouraged by staff to express their feelings, whilst respecting others. People told us that when they had a problem or were worried they felt happy to talk with any of the staff. Whenever people had raised concerns or issues prompt action had been taken by the registered manager to address them.
People’s dignity and privacy were respected and supported by staff, who were skilled in using individual’s specific communication methods. Staff were aware of changes in people’s needs, which were reported to relevant healthcare services promptly where required.
The provider had deployed sufficient staff to provide stimulating activities for people. The activities programme had been revised, and there were a range of events arranged. This ensured people were supported to pursue social activities which protected them from social isolation.
People told us they knew how to complain and that the registered manager encouraged them to raise concerns. When complaints were made they were investigated and action was taken by the provider to make improvements where required.
Staff had received training in the values of the provider as part of their induction, which were discussed during all team meetings. People, their relatives and staff told us the service was well managed, with an open and positive culture. People and staff told us the registered manager was very approachable, willing to listen and make any necessary changes to improve things for people.
The registered manager provided clear and direct leadership and effectively operated systems to assure the quality of the service and drive improvements.
People’s needs were accurately reflected in detailed plans of care and risk assessments, which were up to date. These plans contained appropriate levels of information. For example, if a member of staff from another service arrived to provide support in response to staff absence after reading these plans they would be able to support people safely. Throughout the inspection the registered manager and staff were able to find any information we asked to look at promptly.
People’s and staff records were stored securely, protecting their confidential information from unauthorised persons, whilst remaining accessible to authorised staff. Processes were in place to protect staff and people’s confidential information.
People living at Baytrees had complex needs and were not able to fully tell us what they thought about the support and care provided. On our arrival one person said 'I'm happy here'. A parent of an individual said, 'They provide a really good service and always contact us straight away to keep us updated of any change'.
We were able to observe staff being responsive to the needs of the individuals in a respectful and supportive way that was in keeping with their care and support plans.
People's care plans detailed how they wanted their needs to be met and supported the choices they had made. People's health and social care needs were reviewed and met to promote their wellbeing.
Staff had received the training and support they needed to support the people who used the services. These included professional qualifications.
People and their relatives or advocates had opportunities to contribute their views about the quality of the service. They also knew who to contact should they have a concern or complaint about the services provided. The home had processes in place to promote the safety of the home and to monitor and improve outcomes for people who used the services.
We saw that the staff understood people's needs and gave them opportunities to make choices relating to their care, activities and nutritional needs.
MInimum staffing levels were maintained and any shortfalls in staffing were covered. Staff had received an appropriate induction and were also supported through a system of regular supervision and appraisals.
The people living in Baytrees lived in a clean and hygienic environment.