Barn Park Residential Home

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 inspection we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. The service remained in breach of the legal regulation in relation to safe care and treatment as people were not always protected from avoidable harm. However, improvements were found at this assessment in safeguarding and the service was no longer in breach of this regulation.​

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider consistently managed and monitored people’s safety. They promoted continuity of care.

Relatives confirmed an assessment took place before people moved to live permanently at the home, and care plans were based on this information. However, the records on the reablement side required further detail to make them more effective. Following feedback, the new manager sought advice on how to make the necessary improvements.

Staff told us if they noticed a person’s physical or mental health had deteriorated, they would inform senior staff and document any changes. They recognised this as their responsibility to highlight concerns and to continue to observe the person. Senior staff said they would contact external agencies, such as community nurses or GPs for advice, and we saw how they discussed what steps needed to be taken in the meantime to manage risk.

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.

Visitors said they were happy with the staffing level and the approach of staff, which they said kept their relative safe. People had access to call bells and relatives reported staff responded in a timely manner. There were fewer incidents between people living with dementia, for example due to people misunderstanding other people’s behaviour. However, the actions of one person living with dementia during a meal upset other people on their table and led them to make unpleasant comments towards the person. Staff intervened appropriately, but they were not always in the dining room to safeguard everyone as they were also serving meals to people in their rooms. We immediately fed back to the new manager who said they would review the staff cover arrangements for the dining room to help ensure everyone’s safety and well-being.

Staff understood their safeguarding responsibilities and were aware of internal and external reporting processes. They knew people well and therefore could take steps to intervene before situations escalated. A person who had previously challenged the staff group’s skills at the last inspection no longer lived at the home.

Safeguarding incidents were now routinely notified to the relevant authorities, such as the local authority safeguarding team and CQC. This meant there was added oversight from external agencies to ensure staff were responding appropriately and keeping people safe.

The provider did not always record how they had involved people to understand and manage risks. However, staff did provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

There was on-going work to improve the effectiveness of care plans and risk assessments. The provider had invested in an electronic care system, and staff had begun to input information from paper records, but this was still work in progress.

An improvement in how care plans addressed risks to people’s health and well-being benefited the safety of people living at the home. However, people were unable to remember if they had seen a care plan. Care plans did not routinely record who had been involved and who had agreed the content. People’s feedback on their involvement in their relative’s care plan was variable. For example, some said they could not remember reading a care plan, but they were confident their relative’s care needs were met because staff knew their relative so well.

Handovers and reviewing care records, which was good practice, kept staff updated on changes to people’s safety and well-being. For example, a staff member said, “So, we have a diary in the office if we have been off and that tells you which care plans to read.” Staff described how these handovers took place 3 times a day, and how they were encouraged to look back over care records to update themselves if they had been away. The new manager knew people’s needs well, including risks to their health.

The provider did not always detect potential risks in the care environment to the safety of people living with dementia. However, they did make sure equipment, facilities and technology supported the delivery of safe care.

During the inspection, we saw several environmental issues which posed a potential risk for the safety of people living with dementia. The provider and new manager were responsive to our feedback and action was immediately taken to address the concerns. For example, fitting a window restrictor in a room on the upper floor, which was accessible to people living with dementia.

Following the last inspection, investment continued to improve the appearance of the home, particularly on the residential side. This included an improved lounge area with an updated extension and the installation of a new window to improve the view and the light. Staff were positive about the changes to the environment and the improved space on people’s quality of life. People visiting the service also commented positively on the impact of further investment in the home’s appearance, which had previously been described as “tired.” The provider told us these improvements were on-going.

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

At the time of the inspection, recruitment was managed between the provider and deputy. Good practice was followed regarding checking applicants suitability to work in a care setting. We reviewed staff rotas to see how staff were deployed. We saw staff were busy, but their approach was less rushed than on our previous visit. A visitor commented staff did not rush their relative, they said, “They all seem pretty chilled. Busy but not silly busy. Ever so friendly.”

Since the last inspection, there was a noticeable improvement in the way the care team worked together. There was also a better working atmosphere which benefited people living at the service. The staff team had stabilised, and the team told us they worked well together. Staff were responsive to people’s care needs and there was an improvement in staff interactions with people living at the home. Staff were less task focused in their approach and chatted with people which increased people’s well-being. Records showed the provider had addressed poor staff practice and taken disciplinary action, where necessary.

The provider did not always assess or manage the risk of infection.

Visitors gave mixed feedback about the standard of cleanliness of the home, although some said there had been a marked improvement. On 2 out of the 3 days we visited there was a smell of urine in one area of the home. Since our last inspection, there had been an increase in housekeeping staff and new cleaning regimes implemented. However, we noted some furniture and areas were unclean.

The provider supplied us with notes from staff meetings where better infection control had been a topic to help staff understand their responsibility in this area. The provider said the role of the housekeeping staff was integral to safety and the well-being of the people living at the home. They instructed the new manager to use agency staff if there were staff shortages. Staff understood the importance of infection control in the laundry and how to prevent cross infection. Infection control equipment, such as gloves and aprons, were readily available, which staff wore appropriately.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences.

People received their medicines safely and as prescribed. They appreciated the approach by staff. For example, one person said to a staff member, “Thank you for making sure I took the tablets.” Staff ensured medicines and treatments were managed and stored safely. Staff had received relevant training, and their competency was checked to ensure they managed and administered medicines safely.

Since the last inspection, there had been an improvement in the management of medicines and how they were stored. For example, a suitable fridge had been bought to store medicines and temperatures were now checked regularly. Records were also clearer and provided a better audit trail. For example, in the use of ‘when required’ medicines. Staff worked in a person centred way on the reablement side of the home to support people’s usual medicine routine. This helped people keep to times which worked for them rather than imposing a routine which suited staff.