7 January 2023
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Barrowhill Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Barrowhill Hall is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager had been in post for 3 months and was in the process of registering. We are currently assessing this application
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 3 people who used the service and 9 relatives about their experience of the care provided. We spoke with 13 members of staff including the manager, clinical lead, nurses, senior care workers, care workers, cook and maintenance staff. We received feedback from 4 visiting professional.
We reviewed a range of records. This included 7 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits and policies and procedures were reviewed.
7 January 2023
About the service
Barrowhill Hall is a residential care home providing personal and nursing care to up to 74 people. The service provides support to people living with dementia, mental health concerns, sensory impairments and younger adults. At the time of our inspection there were 69 people using the service.
People’s experience of using this service and what we found
Governance systems had improved since the last inspection. However, many of the systems in place were newly implemented and needed time to ensure they would monitor risks effectively. These will be reviewed in the next inspection.
Lessons had been learnt since the last inspection. The provider improved risk monitoring and reporting systems. Visiting professionals told us the provider was working in partnership with them to address skin integrity concerns, review medicines and support people at risk of falls. Accident and incident forms were investigated by the management team to analyse patterns and seek support from health and social care professionals. Lessons learnt were shared with the staff team.
Medicines were managed safely by suitably trained staff and people were offered and received pain relief medication. Staff used personal protective equipment (PPE) effectively and attended infection prevention control training.
Staff were recruited safely and received regular supervision and training, including safeguarding training. Staff used personal protective equipment (PPE) effectively and attended infection prevention control training.
Relatives, staff and visiting professionals told us the service had improved. They told us they felt the culture was person centred and the care was provided by a competent and compassionate staff team and led by a confident and inclusive manager.
Staff told us they felt supported by the newly appointed manager and attended regular meetings. Relatives told us they felt included in the service and felt confident to raise concerns.
The provider and staff worked in partnership with other health and social care agencies to deliver good outcomes for people and ensure their needs were met and reviewed.
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.
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 12 September 2022)
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
We undertook this inspection to check whether the warning notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met regarding the safe management of the home and to check they had followed their action plan to ensure they now met legal requirements.
In addition, we received concerns in relation to a high number of people experiencing a fall. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
We have found evidence that the provider needs to continue to implement their improvements over time. Please see the well led sections of this full report.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Barrowhill Hall on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.