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Archived: Barn Park Residential Home Good

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Reports


Inspection carried out on 5 June 2018

During a routine inspection

This unannounced comprehensive inspection took place on 5 and 12 June 2018.

Barn Park is a rurally located care home providing accommodation and personal care to a maximum of 24 people who may have a physical condition or are living with dementia. At the time of our inspection there were 24 people living at the service.

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.

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 on-going 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.

At this inspection we found the service remained good.

Why the service is rated good:

The service continued to provide safe care to people. One person commented: “I feel very safe living here.” Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

There were effective staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.

The service was caring and people had built strong relationships with staff. People engaged in a wide variety of activities and on occasions spent time in the local community going to specific places of interest.

Staff spoke positively about communication and how the registered and home manager worked well with them and encouraged their professional development.

A number of methods were used to assess the quality and safety of the service people received and made continuous improvements in response to their findings.

Further information is in the detailed findings below.

Inspection carried out on 25 January 2017

During an inspection to make sure that the improvements required had been made

We received information of concern in December 2016 about poor practices within the service. These related to poor moving and handling, poor continence care, not meeting people’s nutritional needs, inappropriate management of one persons’ behaviour and staffing levels. We spoke and wrote to the care manager, who the registered manager delegated responsibility for the running of the home, asking them to investigate the concerns. We received their investigation report in response to each concern we had made them aware of. We also shared the concerns we had received with the local authority safeguarding team. The service was last inspected in February 2016, was rated as good and was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and associated Regulation.

To further seek assurances, we decided to carry out a focused inspection. This unannounced focused inspection took place on 25 and 31 January 2017.

This report only covers our findings in relation to these topics. You can read the report from the last comprehensive inspection by selecting the 'all reports' link for Barn Park Residential Home on our website at www.cqc.org.uk

Barn Park Residential Home is a rurally located care home providing accommodation and personal care to a maximum of 24 people who may have a mental health condition or are living with dementia. At the time of our inspection there were 21 people living at Barn Park.

When we visited 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.

Staff relationships with people were caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

People confirmed their needs were met and received support in a timely manner. The provider had assessed the needs of the people at the service and had decided to increase the staff level each morning.

On one occasion, medicines were not safely managed. Where paracetamol had been brought into the home which were not prescribed for people they had not been safely stored. Action had been taken by the second day of our visit to ensure medicines were stored in their correct packaging. All other aspects of medicines management were appropriately managed on people’s behalf.

Staff were competent when supporting people to mobilise. Moving and handling training was provided for staff and refreshed on a regular basis.

People were supported to eat a balanced and nutritious diet which met their dietary needs.

Staff had been using techniques which were distressing to a person to manage their behaviour. This involved taking a personal possession away from the person when they had taken someone else’s possessions. We established that this was tried on a few occasions and had since stopped as staff recognised that this was not the best way to manage the situation.

We recommend that when decisions are being made regards to managing people’s behaviours that professionals should be involved in line with a best interest process.

Inspection carried out on 4 February 2016

During a routine inspection

The inspection took place on 4 and 5 February 2016. Our previous inspection in October 2013, found the standards we looked at were being met.

Barn Park is registered to provide accommodation and personal care to a maximum of 24 people, most of whom are older people living with dementia. It is not a nursing home and health care needs are met through community health care professionals. There were 24 older people resident when the inspection began.

The 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. 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 provider of Barn Park is also the registered manager. They delegate the day to day running of the home to a senior care worker with the title of care manager.

People were treated with kindness, compassion, dignity and respect. They were supported to remain active, interested in life and empowered to bring ideas into fruition. People were enthused with what they had achieved, such as performing for the local community. There was also daily involvement in daily living tasks and the care of pets and animals.

Safety was promoted because risks were assessed and managed. Staff recruitment included checks that the potential staff member was safe to work in a care home environment and took into account the opinion of people using the service.

Community professionals had confidence in the staff’s knowledge and skills, one saying, “I trust the care workers”. Staff received a broad depth of training and there were enough staff to meet people’s needs in a timely manner. Staffing was kept under review and additional staff could be contacted quickly if necessary to meet any staffing shortfalls.

People were protected from abuse and harm. Staff understood how to recognise abuse and respond to any concerns, including reporting concerns to outside agencies.

People received their medicines as prescribed and in a safe way.

People’s legal rights were upheld because staff understood people’s right to choice, and how to protect people under the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards.

People’s nutritional needs were met by staff who were trained to promote a healthy, balanced diet.

People’s personal care needs were well met. Community nurses praised the home for the standards of care provided, one saying, “People receive good quality care”.

The provider and care manager were innovative and open to ways to improve the service. They engaged with other providers through quality improvement groups.

There were effective arrangements to respond to people’s views and risk was understood, monitored and well managed.

The culture at Barn Park was one of respect; open, friendly and forward looking.

Inspection carried out on 15 October 2013

During a routine inspection

One person using the service was able to tell us what it was like living at Barn Park but we met many others. We also observed staff providing people's care and support. We looked at three care files, the home's feedback surveys and spoke with two care workers and a domestic worker. We spoke with a community psychiatric nurse with knowledge of the home.

We were told "I love it. I feel relaxed. No demands are made of me and I have only praise for the place." A health care worker told us "I am really impressed with them. They go the extra mile." We saw that people lived in a relaxed and friendly environment where physical, emotional and social needs were understood and met.

Staff understood how to ensure people consented to the care they received and their legal rights were upheld.

The home was clean throughout. One person said about the cleanliness "immaculate" and "clothes are cleaned every day." People were protected from infection through cleaning arrangements, staff training and monitoring of standards at the home.

Staff provided a safe and effective service and the standards of their work were monitored. Training at the home was well organised. Staff told us that they felt supported in their work.

We found that records were fully completed and stored confidentially. People, or their family representatives, were involved in their care plans, which provided the detail needed to ensure people's needs were understood and their wellbeing was promoted.

Inspection carried out on 28 November 2012

During a routine inspection

People were consulted about their care and how that care was to be delivered. Where they did not have capacity to make decisions about their own welfare people who knew them best had been consulted and decisions made in their best interest.

We saw that care workers at Barn Park were attentive to people's needs and that people's personal and healthcare needs were being met. For example, personal hygiene needs, monitoring of risk and getting health care expert advice as necessary. Care workers knew people as individuals and there was a relaxed and friendly atmosphere at the home.

Care workers were provided in sufficient numbers and they were skilled in the tasks which we observed, such as moving a person safely. There were detailed records of people’s care needs and how those needs were to be met. Medicines were handled safely by care workers where people could not do this for themselves.

The home had a system for managing any complaints and had responded to comments in that changes had been made for people as requested.

Inspection carried out on 23 February 2012

During an inspection to make sure that the improvements required had been made

When we conducted an unannounced visit to Barn Park on Thursday 23 February 2012 we met people who used the service and there was no indication that they were unhappy with the service. It was therefore unecessary for us to visit the home to meet people toward this inspection, which was to check that the provider was protecting people against the hazard of fire.

We had received information from the provider about the improvements that had been made to the home premises and staff practice. However, we were unable to judge whether fire safety at the home met the relevant regulations, so we also contacted Devon and Somerset fire service.

The information we received indicates that people who use the service are now safer because fire safety arrangements have been improved at the home.

Inspection carried out on 23 February 2012

During an inspection to make sure that the improvements required had been made

We conducted an unannounced visit to Barn Park on Thursday 23 February to review the improvements made by the home toward safeguarding vulnerable people from abuse. When we had conducted our planned visit in May 2011 we had found that the arrangements in place at the home had not been adequate to ensure that people were safe from abuse. The provider had responded by providing an improvement plan, which outlined how they would make improvement.

Whilst we were visiting the home we had concerns about the fire safety arrangements. For example, staff walked past a fire door which had been propped open, ignoring it. We contacted Devon and Somerset Fire and Rescue Service with our concerns. We also asked the provider to assure us that there were adequate arrangements at the home for the monitoring and management of staff where their conduct could adversely affect the safety of people using the service.

Few people who used the service were able to tell us their experience of being at Barn Park due to their health conditions, such as dementia. One person told us that they would take any concerns to the person in charge at the time. They said that they felt safe at Barn Park. Another said she would talk to Xxxx (the acting manager).

We found that the home had made several changes toward safeguarding people who use the service from abuse. These included updated policies, now with information which staff could use to alert the authorities if they have concerns.

We spoke to two care workers and found that they knew how to alert concerns. We saw records which showed that there was a rolling programme of safeguarding training. We also saw that checks were made to ensure that potential staff were suitable to be employed to work with vulnerable adults.

The Devon and Somerset Fire and Rescue Service contacted us when they had been to the home. We were told that, although there were "some deficiencies" in the home's fire safety arrangements the provider was taking their advice and appeared to be working hard to improve safety.

However, the home had not identified the concerns themselves and had not been following their own policy on fire safety.

The provider informed us, in a letter dated 5 March 2012, about the arrangements that had been instigated to improve staff accountability so as to better promote the safety of people who use the service.

Inspection carried out on 14 April 2011

During a routine inspection

People told us:

• “It’s like a family”

• “The food is very good”

• “Carer’s are friendly”

Barn Park is considered by people who use the service and staff to be a friendly home with very much a family atmosphere.

Staff are competent, skilled, caring and have time to care for and engage with people as individuals.

Health and social care professionals with good knowledge of the home have no concerns about the care provided and say: “They are doing a good job” and “There are always knowledgeable staff there when you visit”.

Effort is made to ensure that people are involved in decisions about their care and appropriate decisions are taken in their best interest where they are unable to do this for themselves.

The accommodation is generally domestic in nature, comfortable and homely. However some carpets are becoming worn. Health and safety are taken into account through risk assessment, servicing and maintenance.

There are procedures in place to protect people from abuse but some staff were unsure of how to alert concerns to the appropriate agency should this be necessary.

The management have a professional approach to their work and much effort has gone into continually improving the service.

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