Pamela Barnett

Pamela Barnett is a residential care home registered to provide personal care for up to 16 people. The service provides care and support for people who live with learning disabilities and associated needs. The home is a large detached building situated on a village style development together with other similar care homes run by the provider. There are four self-contained flats and at the time of the inspection fifteen people were living in the home.

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

People experienced safe care and were protected from avoidable harm by trusted staff, who had completed safeguarding training and knew how to recognise and report abuse. Staff identified and assessed risks to people effectively and managed them safely. The registered manager ensured enough staff were deployed, with the right mix of skills to deliver care and support to meet people’s needs. Staff had completed a robust recruitment process, including their conduct in previous care roles to assure their suitability to support people living with a learning disability. People received their medicines safely from staff, in accordance with recognised guidance. Staff maintained high standards of cleanliness and hygiene in the home, which reduced the risk of infection, in accordance with the provider's policies and procedures, and government guidance.

Staff assessed all aspects of people’s physical, emotional and social needs and ensured these were met. Staff were effectively supported to develop and maintain the required skills and knowledge to support people with complex needs associated with their learning disability. Staff emphasised the importance of eating and drinking well and reflected best practice in how they supported people to maintain a healthy balanced diet. Staff worked effectively with healthcare professionals to make sure care and treatment met people’s changing needs and consistently achieved good outcomes. People's rooms were personalised to reflect their individuality and safe outside spaces with quiet areas accommodated family visits, including a sensory garden accessible to people who required support with their mobility.

People experienced caring relationships where staff treated them with kindness and compassion in their day-to-day care. People were supported to make decisions about their care and these choices were respected by staff. Staff consistently treated people in a respectful manner and intervened discretely to maintain their personal dignity. Staff knew how to comfort and reassure different people when they were worried or confused.

People experienced person-centred care, which consistently achieved good outcomes and had significantly improved the quality and longevity of their lives. People received information in a way they could understand and process, allowing for any impairment, such as poor eyesight or hearing. People were enabled to live as full a life as possible and were supported to take part in imaginative activities, which enriched the quality of their lives. People were supported to keep in touch with family and friends, which had a positive impact on their well-being. People knew how to make complaints and were confident the management team would listen and address their concerns. The service worked closely with healthcare professionals and sensitively explored people’s end of life care wishes.

The management team led by example and promoted a strong caring, person-centred culture where people and staff felt valued. Staff were passionate about their role and consistently placed people at the heart of the service, clearly demonstrating the caring values of the provider. The registered manager understood their responsibilities to inform people when things went wrong and the importance of conducting thorough investigations to identify lessons learnt to prevent reoccurrences. The governance structure ensured there were robust measures to monitor quality, safety and the experience of people within the service. Quality assurance was embedded within the culture and running of the service, to drive continuous improvement. During the pandemic, staff had used technical solutions to keep families up to date with events and activities going on in the home, which they found reassuring.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

New services should not be developed as part of a campus style development. Pamela Barnett was opened in 2008 prior to this guidance and has been the home of people for 13 years. At the time of inspection, the provider was completing a consultative process with all stakeholders, including people, their families, advocates and commissioners of care, demonstrating they were involved in the future development of the service. • Whilst the home was registered to support 16 people, the building comprised four fully self- contained flats with communal accommodation exclusive to the people living in the flat. Each person had dedicated keyworkers to ensure people experienced good continuity of care from staff with whom they shared a special bond. Relatives, health and social care professionals and commissioners praised the service for maximising the quality of people’s lives, through the consistent provision of choice and control and supporting their independence. People, relatives and commissioners consistently told us they thought Pamela Barnett was the best place for people to be, who considered it to be their home and where they wished to stay. People consistently experienced person-centred, individualised care, which respected their privacy, promoted their dignity and protected their human rights. The provider and management team demonstrated a comprehensive understanding of the Mental Capacity Act. The values and inclusive culture of the service leaders and staff ensured people were empowered to lead enriched and fulfilled lives.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 July 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Pamela Barnett is a residential care service. The service provides care and support for up to sixteen people who have learning disabilities and physical disability. The home is a large detached building situated on a village style development together with other similar care homes run by the provider. There are four self-contained flats and at the time of the inspection fifteen people were living in the home.

People’s experience of using this service:

One relative told us, “All staff are very loving and knows the residents very well and do their best to keep them comfortable and happy.”

Risk assessments were not always reviewed and amended on a regularly basis. This was raised with the registered manager during the inspection process.

We recommend that the service consider current legislation related to the employment of people and act to update their practice accordingly.

The quality assurance processes in place were not always effective in identifying areas for improvement.

The provider used a person-centred approach to care.

Medicines management had effective governance systems in place to ensure that there were minimal medicines errors. Where people were prescribed 'as required' (PRN) medication, the service had protocols and guidance in place to ensure staff knew when to administer PRN medicine.

People were kept safe from risk of harm in the event of an emergency as individual personal emergency plans were in place and correct.

We found that there were numerous activities on offer to people living in the home. People were supported to take part in social and recreational pursuits.

We observed some caring interactions between staff and people that they supported. All staff knew the people they supported well.

Staff were trained in protecting people from abuse. Staff knew how to report abuse and were knowledgeable about safeguarding and identifying the signs of abuse.

Staff were provided with personal protective equipment and understood the importance of infection control

Relatives confirmed that they were involved in the development of people's care needs.

Most people who live at Pamela Barnett were nonverbal. Due to this we did not gain feedback from people.

Rating at last inspection:

The service was inspected in October 2016 (report published November 2016) and was rated good.

Why we inspected:

This was a planned announced inspection based on the rating at the last inspection. This was announced due to the complex people that live at the service.

Follow up: We will continue to monitor all information we receive about this service. This informs our ongoing assessment of their risk profile and ensures we are able to schedule the next inspection accordingly.

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

Pamela Barnett is a care home which is registered to provide care (without nursing) for up to sixteen people with a learning disability and physical disabilities. The home is a large detached building situated on a village style development together with other similar care homes run by the provider. It is situated some distance from local amenities and public transport. There are four self-contained flats and at the time of the inspection sixteen people were living in the home.

The registration certificate was on display and was up to date. There was a registered manager for the service who worked full time hours. 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 recruitment and selection process ensured people were supported by staff of good character. There was a sufficient amount of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse.

People were provided with highly effective care from a core of dedicated staff who had received support through supervision, staff meetings and training. People’s care plans detailed how they wanted their needs to be met. Risk assessments identified risks associated with personal and specific behavioural and/or health related issues. They helped to promote people’s independence whilst minimising the risks. Staff treated people with kindness and respect and had regular contact with their families to make sure they were fully informed about the care and support their relative received.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care.

Staff were supported to receive the training and development they needed to care for and meet people’s individual needs. People received very good quality care. The provider had taken steps to periodically assess and monitor the quality of service that people received. This was undertaken by the home manager and the deputy manager through internal audits, through care reviews and requesting feedback from people and their representatives.

We saw people being treated with dignity and respect. Care workers interpreted people's non-verbal language and gestures effectively to enable appropriate support to be offered.

People were given a varied choice of suitable and nutritious meals and supported to eat where needed. Care workers monitored people’s weight and appropriate action was taken if change was noted. Food was prepared in accordance to people’s religious beliefs.

The home worked in cooperation with other providers of healthcare and supported people to obtain appropriate health and social care support.

The home was secure and care workers used an electronic number key pad to enter the building. Visitors were asked for identification before being allowed entry. Video entry had also been installed. We toured the building and found corridors and fire exits free of clutter and easily accessible. The home was clean and tidy and well maintained.

We viewed a range of records and found these contained appropriate information to protect people from unsafe or inappropriate care. These were securely kept and could be located promptly when requested.

The home was adequately maintained and was clean and tidy. However we found there were no restrictions on people entering the building. This meant the security of the premises was not suitable. Also some of the furniture in one of the lounge areas was worn and the waterproof covers had perished and bin liners were being used to cover seat cushions.

We looked at the system in place for dealing with complaints. We found people were aware of the complaints procedure. When complaints were made they were dealt with in accordance with the home's complaints procedure.