Archived: St Barnabas Residential Home

We looked at two people's care records. Other records viewed included information on staffing levels, medication and quality assurance records. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

We saw that medication was stored safely and had restricted access. However, we found people were not always protected against the risks associated with unsafe use and management of medicines. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

There were not always enough staff on duty to meet people's individual needs. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that relevant staff had been trained to understand when an application should be made. However, discussions with the management identified that they were not aware of the latest changes. This meant that they had not reassessed people to identify when a DoLS referral was required to protect a person using the service. The provider confirmed that action would be taken to ensure the referrals were made.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs. One person said, 'Staff are very good, can't fault them.' Another person described the quality of the food cooked by the permanent chef was, 'Really good.' One person told us about the music sessions they enjoyed where they were given, 'Different things to rattle.' We found improvements were needed to ensure people were being supported to access the community.

People confirmed that they were able to see their visitors in private and when they wanted to.

Is the service caring?

Feedback we received and our own observations showed that people were supported by kind and respectful staff. One person who lived in the service described staff as, 'Absolutely marvellous'you can't say enough about any of them dear, they are all so wonderful and friendly.'

When we spoke with staff they demonstrated their commitment to provide a good service.

We saw lunch time was used as a social occasion, with people living in the service and staff eating their meals together. It enabled, where required staff to provide assistance in a kind and respectful manner, as well as instigate conversations. One person remarked, 'When we are having our lunch we discuss who [entertainers] is coming in and look forward to it.'

Is the service responsive?

People's care records showed that where concerns about their health and wellbeing had been identified that staff had taken appropriate action to ensure that people were provided with the support they needed. This had included the purchase of a specialist chair, to ensure a person's safety and comfort.

One person told us they had access to their doctor when they needed to see them. They also commented that the service had originally been recommended to them by a health care professional.

Is the service well-led?

The service had quality assurance systems in place and records showed that shortfalls were not always being identified and / or acted on in a timely manner. As a result, the quality of the service was not continually improving. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

All were positive about the staff, the quality of care they received and praised the friendly and homely atmosphere. This reflected our own observation and feedback we received from a health care professional who felt the staff provided a high standard of personalised care. One person said, 'I think it is very well run, they (staff) look after us very well.'

We saw that meals times were used as a time to encourage social interaction. Staff joined people for their meals and promoted a homely atmosphere. People told us they received tasty home cooked meals, which they enjoyed. One person remarked, 'We have a very good chef, I hope (staff member) doesn't leave.'

People told us staff knew their likes and dislikes and would adapt menus to meet their individual preferences and dietary needs. One person said, 'There is always a choice,' and that if they did not like what was on the set menu, the staff would, 'Cook me something special.'

People told us the location of the service, close to the shops and seafront meant that they could visit and maintain links with the local community. One person told us, 'I like to go down to the pier.' Another person told us how they had enjoyed a trip out with staff shopping.

People told us that they were provided with a clean and comfortable environment to live in.

People told us they would recommend the service to others. One person said, 'I have, but there is a long waiting list.'

People told us they enjoyed the activities and outings which staff arranged. One person told us that staff organised, 'Nice outings to the river.'

People told us that there was enough staff to support their care needs. That staff had never run out of their medication and that they received them at the appropriate time. Health professionals told us people using the service always looked, 'Well cared for.'

People told us that they were given choice and asked for their views especially meal times and arranging outings. One person told us that the catering staff visited each person and showed them the menu list. They told us that, 'You can make any alterations' or discuss alternatives.

We observed that staff answered call bells in a timely manner. This meant that people were not left waiting for assistance. We found that the staffing levels and skill mix were reviewed to ensure they had sufficient staff on duty.