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Inspection carried out on 5 September 2019

During a routine inspection

About the service

Barclay Gardens is a residential care home providing personal care to 37 people at the time of the inspection, some of whom have dementia. The service can support up to 40 older people and younger people.

The care home’s premises are purpose built and consist of four individual units, which are all connected. People have access to a lounge, dining room and kitchenette on each unit. All rooms have ensuite facilities and there are additional specialist bathing facilities on each unit.

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

People and relatives described the service as exceptional. Health professionals praised the outstanding working relationship they had with staff and managers at the home. The registered manager worked collaboratively and efficiently with healthcare professionals to implement new healthcare initiatives. These had considerably improved outcomes for people in terms of their health. People’s holistic needs were met effectively through community services.

Staff received training to enable them to provide safe and effective care to people. This training had a focus on the values of the service, equality and diversity and respecting human rights. Staff undertook dignity pledges as a commitment to provide care which was respectful.

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.

Systems and processes were in place to help keep people safe and risks associated with their care needs had been assessed. People were supported by staff who had been recruited safely. Medicines were managed safely. The service was clean and staff practice helped to reduce the risk of cross infection.

People were cared for by staff who were kind and considerate. People were involved in decisions about their care and support needs. Staff respected people's privacy and dignity and encouraged their independence.

People had positive relationships with staff and had personalised care delivered. Staff understood people’s personalities and their preferences. There were opportunities for people to participate in various activities of their choice. There were arrangements in place for people to raise concerns about the service. People were involved in discussions to identify their wishes for their end-of-life care.

People lived in a care home which had a positive culture. Staff and managers were committed to providing care which centred around the person. Staff were supported in their roles and people and relatives had confidence in the service. The quality of the service and staff practice was monitored and improvements made as required.

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

Rating at last inspection

The last rating for this service was good (published 7 October 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Inspection carried out on 1 September 2016

During a routine inspection

This inspection took place on 1 September 2016 and was unannounced.

Barclay Gardens is a residential home that provides personal care and accommodation for up to 40 older people some of whom are living with dementia. The service accommodates up to 10 people on each unit. At the time of the inspection, there were 34 people living at the service and a registered manager was 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 carried out 19 May 2015 we asked the provider to take action to make improvements to how incidents where people had been potentially harmed were assessed and reported to the local authority and how people’s ability to make decisions was assessed to ensure their rights were fully protected. During this inspection, we found the provider has taken appropriate action.

People told us that they felt safe living at the service and we found staff that could recognise any potential signs of abuse and protected people from harm. Staff managed risks to people and the registered manager had effective reporting and monitoring of accidents in place. The provider had recruitment practices, which kept people safe, and there were sufficient staff to meet people’s needs. People received their medicines as prescribed. Medicines were stored appropriately and there were systems in place to monitor people’s medicine administration.

People received support from a staff team who received the training and support they needed to carry out their roles. People were asked for consent to the care they received, where people lacked capacity the principles of the Mental Capacity Act 2005 were followed. People enjoyed the food and drink they received which met their nutritional needs and preferences. People had access to health care and received support to maintain their health.

People received support from a staff team who were kind and caring and helped them understand and make choices about their care and support. People had their privacy and dignity respected and were encouraged to maintain their independence. People were supported to maintain relationships and people from the local community were encouraged to use the facilities in the home and build relationships with people.

People and their relatives were involved in the development and review of their care plans. People received the care and support they needed and staff understood people’s preferences. People had access to leisure opportunities and plans were in place to offer different activities such as gardening. People‘s complaints were responded to appropriately and the registered manager took steps to make sure they learned from complaints.

People, relatives and staff were involved in the development of the service. The registered manager welcomed ideas for improvement and had systems in place to allow people to share their experiences of the service. The registered manager had developed an open and honest culture. People, relatives and staff told us they felt the service was well led by management and managers made themselves visible and available to people. The registered manager had quality assurance systems in place in order to identify and action areas for improvement within the service.

Inspection carried out on 19/05/2015

During a routine inspection

This inspection took place 19 May 2015 and was unannounced. At the last inspection on 18 September 2013 the home was compliant in all regulations we are required to inspect by law.

Barclay Gardens is registered to provide accommodation with nursing and personal care for a maximum of 40 people. On the day of our inspection 39 people were living at the home.

The home had a registered manager in post but they were not present for the inspection. 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 registered manager and staff had received training in relation to their role in protecting people’s human rights. However, people’s ability to make decisions had not always been formally assessed to ensure their rights were fully protected.

Not all allegations of potential abuse in relation to one person’s behaviours that challenged other people had been reported to the management team by staff. This prevented the management team from being able to assess whether they should make a referral to the local authority for investigation. However, strategies to deal with this had been put into place but had not been discussed with the local authority to determine if the incidents constituted potential abuse. Managers and staff had received training on protecting people from harm and protecting people’s human rights.

Recruitment procedures ensured that only people who were suitable worked at the home. There was an induction programme for new staff, which prepared them carry out their role. Staff were provided with a range of training to help them carry out their duties. Staff received regular support and an annual review of their work to support them to meet people’s needs. There were enough staff employed at the home to meet people’s needs although some staff told us they felt under pressure on the upstairs units when the ‘floating’ staff member was re deployed to work in other areas of the home.

People told us that they liked the food and there was a good choice. However, kitchen staff did not always understand people’s special dietary requirements. People were supported effectively with their health needs and had access to a range of healthcare professionals. People were involved in making decisions about what kind of support they wanted.

People told us staff were caring and we saw positive interactions between staff and people. People told us they were able to have choice and control over the things that were important to them. Staff, people who lived at the home and relatives felt able to speak with the registered manager and provided feedback on the home. They knew how to make complaints. There was a complaints policy and procedure in place. We found complaints were dealt with appropriately and in accordance with the policy.

The provider carried out regular audits to monitor the quality of the service and to plan improvements. However, some issues that had been identified by the operations manager in April 2015 had not yet been rectified.

Inspection carried out on 18 September 2013

During an inspection in response to concerns

People we spoke with told us they continued to receive the support they required. They stated that the staff were helpful and very caring. Comments included, "The staff are excellent. They look after me well".

People considered there were enough staff on duty to meet their current needs. They said, "I have no complaints and I get the help I need". People considered that improvements to the service had been made.

Staff considered that management systems were robust. Staff were aware of their roles and responsibilities. The way that management allocated work meant staff had time to carry out their duties well.

People told us they were consulted about their care and the service provision daily. They said that recently they had been asked to attend a meeting.

The provider took appropriate steps to ensure that the service was effectively managed and could be responsive to people�s changing needs.

Inspection carried out on 30 May 2012

During a routine inspection

We visited the home unannounced to check on the care and welfare of people using this service.

We spoke with seven of the people who were currently using the service. The majority of people we spoke with shared positive experiences of the care they received. They told us they liked living at the home and considered staff respected their privacy and dignity. One person said, �The staff respect my wishes. Everybody is nice and kind, I�m very well looked after.�

People told us they were happy with their care and this was also reflected in discussions held with visiting relatives. One visitor said, �I have no concerns regarding the care and welfare of my relative.�

We found the home in need of redecoration. The interior decoration was poor. One resident�s lounge had a malodour. The call bell system did not extend fully into and around the lounges. This put people at risk of not being able to call for assistance when they needed it.

People told us they got their medication and they received it on time. We found that the health and welfare of people living at Barclay Gardens was being protected in relation to the management of their medication.

People told us staff looked after them well. They considered the staff had the right skills to do their jobs. Staff told us they had received training to keep people safe and meet their needs.

The majority of people told us they were asked on a daily basis if they were alright. Formal meetings or surveys were in place to gain their views about their care or how the service was run. The service did not provide a formal opportunity for relatives to meet and share their views. The provider might like to consider this. One visiting relative told us they were happy to report concerns. They said, �I do complain and they do put things right.�

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