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Inspection Summary


Overall summary & rating

Good

Updated 1 December 2018

We inspected this service on 11 October 2018 and it was unannounced. This meant that the service did not know we were coming. We last inspected the service on 14 February 2017 where it was rated as requires improvement in safe, effective and well-led and good in caring and responsive. This meant it was requires improvement overall. There were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in regulations 12 Safe care and treatment and regulation 11 Need for consent. This was because the provider had failed to ensure infection control practices were not always promoted. They also failed to ensure Mental Capacity Assessments were always conducted and evidence was not always available to demonstrate that decisions had been made in the best interests of those who lived at the home.

Following our last inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve the key questions of safe, effective, responsive and well led to at least good. During this inspection, we found improvements had been made and were meeting the requirements of the current regulation.

The Barn is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The Barn accommodates up to 12 people who require support with personal care in one adapted building. At the time of our inspection 11 people lived at the service. All of the bedrooms were of single occupancy over two floors, there were two communal lounges, kitchen facilities and outside accessible space. The home was located in a residential area of Leyland close to local shops, amenities and public transport links.

The service had a registered manager in post at the time of our 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 was run.

People we spoke with to us they felt safe living in the home. Staff understood how to deal with any allegations of abuse and records we looked at confirmed investigations had been completed.

Systems were in place that ensured medicines were handled safely in the home. Medicines were stored safely in locked cupboards and records had been completed to confirm their administration safely.

Environmental checks and servicing had been completed as well as completed environmental risk assessments that confirmed that the home was safe for people to live in.

Training records confirmed that the staff had undertaken the relevant training to support their role. Appropriate numbers of staff were in place to deliver good care to people and we saw the staff had been recruited appropriately.

People were asked permission from staff before undertaking any care or activity. Details about consent was recorded in people’s care files. Deprivation of Liberty Safeguards applications had been submitted to the assessing authority. People were supported to have maximum 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.

The home was operating under the principle of registering the right support. People were involved in choice in respect of their care and were encouraged to be independent. Car

Inspection areas

Safe

Good

Updated 1 December 2018

The service was safe.

People told us they were happy and felt safe in the home. Systems to act on and deal with allegations of abuse were in place.

Medicines were handled safely in the home. Individual and environmental risk assessments were seen that ensured measures were in place to protect people, visitors and staff.

Recruitment procedures demonstrated that the staff were recruited safely to the home. Appropriate staffing levels were in place to deliver good care to people.

Effective

Good

Updated 1 December 2018

The service was effective.

A variety of training was provided to staff that ensured they had the knowledge and skills to deliver effective care to people.

It was clear people were included in menu choices in the home and we saw a positive mealtime experience.

We saw staff asking people permission before they undertook any care activity. Deprivation of Liberty Safeguards applications had been submitted to the assessing authority.

Care files reflected people’s individual health needs. We saw evidence of reviews by professionals taking place.

Caring

Good

Updated 1 December 2018

The service was caring.

It was clear people received good quality care in the home. People were treated with kindness, dignity and respect.

Choices, likes, needs and wishes were recorded in people’s care files which demonstrated how to ensure people’s individual wishes were met.

Information confirmed people were provided with access to advocacy services to make important decisions.

Responsive

Good

Updated 1 December 2018

The service was responsive.

A good selection of activities was available for people to access. We saw people taking part in activities during our inspection.

Care files were detailed and comprehensive and provided good information about how to support people’s individual person-centred needs.

Systems were in place to record investigate and act on complaints. Positive feedback was received about the home.

Well-led

Good

Updated 1 December 2018

The service was well led.

We received positive feedback about the leadership and management of the home.

Team meetings were undertaken and feedback was obtained about the quality of the service provided to people.

A variety of audits and monitoring was taking place that confirmed the home was safe for people to live in.