Barn Park Residential Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider was previously in breach of the legal regulation in relation to good governance. Further improvements were needed at this assessment, and the provider remained 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.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff worked alongside health and social care professionals to enable people to return home after a period of reablement at the home. In multi-disciplinary meetings, health and social care professionals confirmed this collaborative approach. The provider was clear in their vision for the service and recognised the importance of engaging the staff group in their strategy. However, they were not always able to be on site to lead their team. So, they employed an on-going consultant to support the new manager around quality assurance and the development of the service.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Since the last inspection, a new manager had been appointed who was an experienced senior member from the care staff team. The staff group were positive about the impact of the new manager’s appointment; they described her as approachable and willing to make changes. We were told the new manager was kind, which we saw in how they spoke with people living at the home, the staff group and visitors. After the inspection, the new manager submitted her application to register as a manager with CQC and were successful in their interview to become a CQC registered manager for the service.

The provider was in regular contact with the new manager but had to limit their visits and their contact with staff and people living at the home. A consultant was working with the new manager on the provider’s behalf to provide additional support and guidance. The local authority’s quality and improvement team also visited the new manager to offer guidance and support and review their progress in managing and introducing changes to the service. A staff member said, “At the moment, I think it is all good and everything is getting better and (improving) in a systematic way and I think if it can continue like this it will be good.”

People had the opportunity to speak up so their voice would be heard.

Staff meetings and supervisions were increasing, and staff were positive they could approach the new manager or the provider with concerns. The new manager said they could contact the provider for support and used the feedback from the consultant to help make changes.

Based on conversations with staff and staff records, staff supervision was increasing for all the staff, but this was work in progress.

Staff team meetings benefited the staff group to aid with learning and improve staff practice. For example, a staff member said, “We have things discussed with us when things have gone wrong or any incidents have happened so we have a staff meeting where we can also air anything we need to and suggest things to make things better.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

There was a friendly atmosphere, where staff worked together. The provider met informally with staff to build their confidence and skills. Staff acknowledged they were a diverse group but felt there had been a significant improvement in the way the staff group worked together. For example, a staff member said, “I do feel staff are treated fairly and equally and yes, I feel we have a good relationship.” There was more acceptance of difference, with better communication, so the staff group worked in a more cohesive manner for the benefit of the people living at the home.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance.

The new manager was working hard to implement and improve ways of working, including the quality of recording. The service had been supported by the local authority quality assurance team to create an effective service improvement plan and to establish an effective governance system. However, we saw systems and processes to assess and monitor the quality and safety of the service needed further improvement to ensure compliance with regulations.

Following the last inspection, the provider has shown a commitment to improve areas of the service such as how care was recorded. They had invested in an electronic care system to enhance the way in which people’s care needs were recorded, updated and reviewed. However, this work had not been fully completed at the time of the inspection.

The governance systems failed to identify there were areas and equipment which were unclean. For example, unclean furniture in people’s rooms which had not been identified in audits or spot checks. A system was not in place to review the cleanliness of pressure cushions, some of which were unclean and smelt unpleasant. The new manager took immediate action replacing these pressure cushions with new ones in stock.

Care records were not regularly reviewed with the person who received care, or where appropriate, their relatives. Further work was needed to improve recording, particularly daily records for people living on the residential side of the service to make them more meaningful to review each month. Governance arrangements had not identified there was contradictory information regarding how a person should be supported to move. Another person had been assessed as needing bed rails, but governance checks had not identified these were not being used safely. Additional work was also needed to ensure people’s legal rights were protected, for example checking relatives provided evidence of their approved legal standing such as a lasting power of attorney.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider, new manager and staff worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. This was particularly important as part of the service provided reablement beds to enable people to recuperate after hospital treatment and return to their own homes. External health professionals visited to support people’s reablement and worked with care staff to benefit people. A person on the reablement side said staff were helpful and supported them with exercises to build their strength with the aim to return to their own home.

The provider focused on continuous learning, innovation and improvement across the organisation and local system.

The provider oversaw the governance arrangements with the support of a consultant to monitor how the home was managed. We saw there had been improvements since our last inspection, for example in staff morale and changes to the environment, such as a new extension.

There was better oversight of staff training, and the new manager arranged for staff to attend face to face training with external health professionals, for example to aid their understanding of the nutritional needs of frail older people. There had been improvements in the way training was overseen and there was an increase in making effective use of external health training, which feedback from professional health trainers confirmed. A staff member said, “I am up to date with training. I had my moving and handling practical recently and I did the Restore 2 training and first aid. I would say, yes, training is quite thorough and does cover what we need.” Other staff were also positive about their increased access to training, with some taking pride in how much they had completed.