Barton Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff were consistently reporting incidents and accidents. Staff described an open culture where they felt able to raise concerns and discuss incidents.

The registered manager and deputy manager had oversight of all incidents and reviewed events to ensure appropriate actions had been taken and to identify any learning. For example, the registered manager explained how they had noticed an increase in incidents that occurred around teatime. They decided to change the deployment of staff at that time to ensure people were receiving the support they needed. This change had led to a reduction in incidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Before admission to Barton Court, assessments were completed to ensure the service could meet people’s needs. The registered manager described how they worked with health and social care professionals to ensure safe care, for example when people were transferred from hospital. A relative confirmed they were involved in this process, they told us, “I phoned them and told them all about [Person] and following this they said they could meet their needs. Once [person] moved in, they did a full assessment, and I was involved in it all.”

The service worked with external professionals such as GP and district nursing teams to ensure people received joined up care and support.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living atBarton Court, and relatives we spoke with on people’s behalf confirmed they felt their loved one was receiving safe care and support.

Managers and staff understood how to safeguard people. Systems were effective in identifying safeguarding issues and appropriate referrals had been made. Staff had received training in safeguarding and demonstrated a firm understanding of their responsibilities. Staff were able to describe signs that might indicate abuse and knew what to do if they had concerns. One staff member said,“I would straight away go to [Registered Manager or Deputy manager], If anything happened at night or at weekends I would go to my team leader. I would record everything on our system.”

Records showed safeguarding incidents had been identified and raised with the local authority in line with the provider’s safeguarding policy. The registered manager had taken appropriate actions to address the concerns and to keep people safe.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In [care homes/hospitals], this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We foundthe registered manager had submitted Deprivation of Liberty Safeguards (DoLS) applications as required for people who were subject to restrictions upon their freedoms which amounted to a deprivation of their liberty, where they lacked capacity to consent to them. People’s records contained an alert to inform staff if a person had a DoLS in place.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessment records were not always detailed, holistic and personalised. Not all risks present had been assessed, considered or recorded appropriately. Despite staff knowing people well, Guidance was not always in place for example, for staff to monitor the risks of people having an epileptic seizure or low blood sugars. There had been no reported seizures or impact on people who were diabetic but we discussed this with the registered manager who took immediate action to assess and record these risks during inspection. Further work was needed to ensure this was fully embedded across the service.

Staff were aware of the potential risks people might face and the steps they needed to take to prevent or safely manage them. For example, staff closely monitored people who were at risk of falling, so they would be immediately available if their assistance were required.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The premises were kept free of obstacles and hazards which enabled people to move safely around the care home.

There were effective arrangements to monitor the safety and upkeep of the premises. Since our last inspection, the care homes environment has been significantly improved. This included the interior being refurbished to a high standard.

The service was having a new lift installed during the inspection visit. There were appropriate safety measures in place and people, and their relatives had been informed of the work and the progress of this. Staff were vigilant around the area and monitored it to ensure people who were freely accessing parts of the service remained safe.

Staff told us they had clear guidelines available to help them deal with emergencies. In relation to fire safety, we saw plans were in place to help staff evacuate people in an emergency. Equipment required to safely support people was regularly serviced and maintained. For example, visual checks were regularly completed on bed rails, window restrictions and other equipment.
 

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There were enough suitable staff to provide safe care. Safe staffing levels were in place to ensure people were supported safely and promptly and able to have their needs met. Rotas confirmed the service was staffed in line with people’s dependency level. The registered manager provided cover when necessary themselves or arranged for support from an external staffing agency to manage short-notice absences. The registered manager confirmed they had not had to use agency staff for a number of months. This reliable and consistent staffing approach ensured continuity of care and maintained safety standards.

Staff told us they felt well supported in their roles and received regular training to continue to update their knowledge and skills. This was a mix of online and face to face training.
There were safe systems in place for the recruitment and induction of new staff. One staff member spoke positively about their induction period and said they had shadowed experienced staff members until they felt confident.

The provider had not always assessed and managed the risk of infection. They had not always detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

There was a person who had a potential contagious infection. Although appropriate physical steps had been taken such as barrier care and specific staff supporting them, the registered manager had not fully assessed the infection risk to other vulnerable people, if they were to walk into the wrong bedroom or to the service as a whole. During the inspection we discussed this with the registered manager who took immediate action by updating their infection prevention control procedures and confirmed this had been communicated to all staff to ensure they were aware of what needed to be actioned to remain safe and protect people in the service.

Systems were effective in maintaining a clean environment and managing risks of infection. People told us staff supported them to keep their rooms clean and tidy.
People told us the service was clean and said staff wore personal protective equipment (PPE). We saw the service and equipment was clean and there were plentiful supplies of PPE and cleaning products which were stored securely. Staff had completed infection control training and the provider had appropriate processes in place to ensure infection control processes were audited.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Records, protocols and care plans to support safe management of medicines did not always contain enough information to guide staff or give assurance that medicines were managed appropriately.
Protocols for the administration of ‘when required’ (PRN) medicines in some cases lacked detail to support staff in the appropriate administration of medicines.

Care plans were in place, but some lacked important details. For example, one care plan for a person with diabetes did not include target blood glucose levels or instructions for managing and changing the blood glucose monitoring sensor. This meant uncontrolled blood glucose levels may not be recognised and managed. These care plans and risk assessments have been updated following our feedback and a plan is now in place to review all care plans to ensure they are up to date and complete.

People and their relatives told us they did not have any concerns with how their medicines were managed by staff at Barton Court. Medicines were administered by staff who had received specific training and were deemed as competent. Medicines were stored appropriately in secure rooms.