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Inspection carried out on 30 August 2018

During a routine inspection

This inspection took place on 30 August and 4 September 2018 and was unannounced.

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.

Baroda Care is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service provides accommodation and personal care and support to a maximum of 14 people who may have a mental illness. There were 12 people living in the home at the time of our inspection.

There was a friendly atmosphere in the home and staff supported people in a kind and caring way that took account of their individual needs and preferences. People were supported to express their views and be involved in making decisions about their care and support.

There were systems and processes in place to protect people from harm, including how medicines were managed. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.

Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Staff were supported to provide appropriate care to people because they were trained, supervised and appraised. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.

People were supported to have 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.

People received regular and on-going health checks and support to attend appointments. They were supported to eat and drink enough to meet their nutritional needs and to make informed choices about what they ate.

The service was responsive to people’s needs and staff listened to what they said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People could be confident that any concerns or complaints they raised would be dealt with.

The registered manager was promoting an open, empowering and inclusive culture within the service. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

Inspection carried out on 5 January 2016

During a routine inspection

The inspection took place on 5 January 2016 and was unannounced

Baroda Care provides care, support and treatment to a maximum of 14 people who may have a mental illness. The provider works in partnership with other agencies to enable people to live safely in the community.

A registered manager was in place. 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 and associated Regulations about how the service is run.

People told us that they felt safe at Baroda care. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.

People were supported by staff that had the expert skills and knowledge to meet their assessed needs. Best practice training opportunities were provided by various healthcare professionals which gave staff strong understanding and knowledge about people’s diagnosed conditions.

Recruitment practices were safe and relevant checks had been completed before staff commenced work. Staff worked within good practice guidelines to ensure people’s care, treatment and support promoted good quality of life.

Mental capacity assessments were conducted when required and any restrictions or controlled measures in place were frequently reviewed and assessed using the support of various healthcare professionals.

The provider had appropriate arrangements in place to assess people’s capacity to make decisions about their care and treatment. Staff were knowledgeable about the requirements of the Mental Capacity Act 2005.

People who required supervision in the community were supported effectively. Multi-disciplinary teams including community psychiatric nurses, psychiatrists and psychologists were involved in reviewing and updating people’s risk management plans.

Medicines were managed safely. Any changes to people’s medicines were prescribed by the service’s GP and psychiatrist. People were involved before any intervention or changes to their care and treatment were carried out.

People had access to activities that were important and relevant to them. Records showed people’s hobbies and interests were documented and staff accurately described people’s preferred routines. People were protected from social isolation through systems the service had in place. There was a range of activities available within the home and community which aided people’s recovery process.

The service was well led because the provider actively sought, encouraged and supported people’s involvement in the improvement of the service. People’s care and welfare was monitored regularly to make sure their needs were met within a safe environment. The provider had systems in place to regularly assess and monitor the quality of the service provided. Senior management liaised with and obtained guidance and best practice techniques from external agencies, professional bodies and experts in their fields. Records showed care plans had been reviewed regularly and people’s support was personalised and tailored to their individual needs.

People told us the staff were friendly and management were always visible and approachable. Staff were encouraged to contribute to the improvement of the service. Staff told us they would report any concerns to their manager and said the management and leadership of the service very good and very supportive.

Staff were appropriately trained and skilled to deliver safe care. They all received a thorough induction before they started work and fully understood their responsibilities to report any concerns of possible abuse. Records showed staff received training in mental health and how to help people who display behaviours that may challenge others.

The provider had employed skilled staff and took steps to make sure care was based on local and national best practice. Information regarding diagnosed conditions was documented in people’s care plans and risks to health and wellbeing were discussed daily during staff meetings. Staff consistently told us they communicated risks associated with people health and behaviours frequently.

Inspection carried out on 9 December 2013

During a routine inspection

We found that before people received any care or support they were asked for their consent and the provider acted in accordance with their wishes. We saw that staff asked permission from people before providing any help or support.

People�s needs were assessed and care and support was planned and delivered in line with their individual care plan. We looked at a sample of care and support records for seven people. Each person had a personalised support plan in place and a set of risk assessments.

The provider responded appropriately to any allegation of abuse. All staff we spoke with told us that they were confident that the manager would respond correctly to any alligation of abuse.

There were enough qualified, skilled and experienced staff to meet people�s needs. One person said "There are always enough staff to help me".

People's personal records including medical records were accurate and fit for purpose. All records we looked at provided up to date information and guidance on how best to meet people's care needs.

Inspection carried out on 12 February 2013

During a routine inspection

During our inspection we chatted with people about how they felt. Eight people confirmed that they were well and that staff supported them well. We saw that people were able to choose the activity they were engaged in. Two people told us they had been to the local shop, four people were watching the communal television together, one person was having a cigarette in the garden and one person had chosen to sit in a quiet lounge in order to listen to the radio. People using the service approached staff throughout the day to request their medications. We spoke in depth to four people who used the service. One person told us, "Staff have been good to me. I trust them. I know I sometimes need stronger medicine if I am feeling anxious." Another person told us that the food was very good. One person confirmed that they were able to visit the shops when they liked, as long as they informed staff. A fourth person said, "I live here with my spouse and we enjoy our life. Staff are kind and caring. I have no complaints."

We found that the service treated people with dignity and respect. Staff spoke to us about the importance of promoting people's independence and their right to make choices. People's care plans were comprehensive and contained specfic guidance for staff to follow. People were supported to make healthy lifestyle choices, including health eating and regular exercise. Staff had received appropriate training and knew how to support people's recovery.

Inspection carried out on 11 November 2011

During a routine inspection

We spoke with three people who use the service and they told us that they found members of staff �helped them to get better.� One relative told us that her son �had improved tremendously because of the way he is being treated. His confidence has increased.� Another relative told us that members of staff �know how to help people get better. They treat each person as an individual.� People told us that they felt safe living in the home. People we spoke with told us that the manager would listen to their concerns and �do something about it.�