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Inspection Summary


Overall summary & rating

Good

Updated 17 December 2016

This inspection took place on 16 & 22 September and was unannounced. Bernhard Baron Cottage Homes provides accommodation and personal care for up to 60 older people, some of who may have a diagnosis of early dementia. At the time of inspection there were 59 people using the service. The home comprises a main building with 34 bedrooms and 24 self-contained cottages in the grounds. The service is a registered charity and managed by a board of appointed Trustees.

The home 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 who used the service said they were safe. Staff knew how to recognise the signs of abuse and what to do if they thought someone was at risk. However, not all of the appropriate recruitment checks had been completed before volunteers began work. A legionella risk assessment had not been completed and there was a potential of risk to the safety of people’s medicines management.

People gave us very positive feedback about the care they received. People were able to express their views and preferences about their care and these were acted on. People were treated with respect and their privacy was protected.

The provider, registered manager and staff made sure they supported people to live fulfilled and meaningful lives in the way they wanted to. An extensive range of meaningful and enjoyable activities was offered, and people gave us enthusiastic and positive feedback about the quality of their lives living at the home.

People’s care needs were regularly assessed and people were involved in making decisions about their care. People’s support needs were assessed and care plans were developed to detail how these needs should be met. Care plans were detailed which helped staff provide the individual care people needed. People knew how to make a complaint or raise concerns with the registered manager and told us these were acted on when they did so. There was an appropriate complaints system in place and any concerns raised had been thoroughly investigated.

People were asked for their consent appropriately and staff and the registered manager had a good understanding of the Mental Capacity Act 2005 (MCA). This legislation provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make decisions for themselves. Care workers knew that any decisions made on someone else’s behalf must be in their best interests.

There were enough staff to meet people’s care needs and staff had regular training, supervision and appraisal to support them. Staff gave positive feedback about the quality of the training and people who use the service said staff were well trained.

Incidents and accidents were thoroughly investigated and action taken to reduce the risk of them being repeated. The registered manager and staff understood the importance of learning from incidents so they could make improvements to the service.

People who needed it were supported to eat and drink enough and food was nutritious and well made. Staff knew what to do if they thought someone was at risk of malnutrition or dehydration. People gave us positive feedback about the food. People’s day to day health care needs were met.

The service was well led by a dedicated registered manager and management team. There was a commitment to provide high quality care which was tailored to people’s individual choices and preferences. Feedback from people who use the service, relatives and staff was positive, and staff felt well motivated and supported in their role.

The provider carried out audits to ensure people experienced safe and good quality care. People were asked for their feedback about the qual

Inspection areas

Safe

Requires improvement

Updated 17 December 2016

The service was not always safe. Recruitment practices were not robust and medicines administration practice was not as safe as it should be. People were not always protected from the risks of an unsafe environment.

Staff knew what they needed to do to keep people safe from abuse were clear about what they should do to safeguard people.

People had their independence promoted both in and out of the home and individual risk assessments and risk management plans were in place. There were always enough staff to meet people’s needs in a flexible way

Effective

Good

Updated 17 December 2016

The service was good at ensuring people were provided with effective care.

People experienced very effective care. Staff were well supported with training, supervision and appraisal. They were given further training to make sure they could meet the specific care needs of people with such as dementia

People were asked for their consent to care in a way they could understand. The registered manager made sure they and the staff had a good understanding of the Mental Capacity Act (2005) and they always acted in people’s best interests.

People were well supported to have enough food and drink, People were well supported to make their own choices about what they wanted to eat and the food was home made and nutritious.

Caring

Good

Updated 17 December 2016

The service was caring. People were well cared for by staff who treated them with kindness and compassion. Providing people with the best care possible was important for all members of staff and there was a strong person centred culture which put people first.

People were helped to be involved as much as possible in making decisions about their care. All of the feedback people gave about the care they experienced was positive. People were treated with dignity and respect.

Responsive

Good

Updated 17 December 2016

The service was good at responding to people’s needs and preferences.

People experienced care that was responsive to their needs and preferences. Staff were supportive in helping people live as full a life as possible, and were flexible with the hours they worked to enable this to happen.

People’s care plans focused on them as an individual. When people’s needs changed plans were regularly updated and staff informed. Staff made sure they actively involved people in making decisions about their care.

Feedback was actively sought from people and concerns or areas for improvement identified were quickly acted on.

Well-led

Good

Updated 17 December 2016

The leadership and management of the service was good.

The registered manager promoted strong values and a person centred culture which was supported by a committed staff group.

Leadership was visible at all levels and the registered manager and trustees representative were well regarded by people and staff. People experienced a high quality service because the registered manager positively encouraged staff to do so.