We carried out a review of the data available to us about Barleycroft Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Barleycroft Care Home, you can give feedback on this service.
Barleycroft is a care home that provides accommodation, personal and nursing care for up to 80 people across three separate floors, each of which has separate adapted facilities. One of the floors specialises in providing care to people living with dementia. At the time of the inspection, there were 58 people using the service.
People’s experience of using this service and what we found
People had their care needs assessed before they began to use the service. Staff received training to give them the necessary skills and knowledge to help them meet the needs of people who used the service. 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. People were supported to maintain good health. The management team worked with health care professionals to ensure people’s needs were met.
We have made a recommendation about staff supervision.
People's right to confidentiality was protected. Staff had built up good relationships with people and were familiar with their needs and preferences. They treated people with dignity and respect. People were encouraged to maintain their independence wherever possible. The provider was committed to challenging any form of discrimination it encountered. People were encouraged and had an opportunity to contribute and have their say about the care and support they received.
People received care that was responsive to their needs. Care plans provided staff with enough information to enable them to meet people’s needs. Information on how to communicate with people was included in their care plans. There was an effective complaints system available. Comments and complaints people and their relatives made were responded to appropriately. People took part in activities to help ensure they were not socially isolated. They were supported to maintain relationships with their relatives.
We have made a recommendation about people’s care records.
The manager had an open-door policy where people, relatives as well as staff could raise any issues or concerns they had. The provider was aware of when the CQC should be informed of events and incidents that happen within the service and the responsibilities of being a registered provider. There were systems in place to monitor the service and address any areas of improvement where needed. The provider had good links and worked closely with other health and social care professionals to ensure people received the care and support they needed.
Staff understood what abuse was and the actions to take if a person using the service were being abused. Risks to people were identified and care was planned to mitigate the risks. The provider had effective recruitment procedures to make safe recruitment decisions when employing new staff. There were enough staff working for the service to meet people’s needs. People were supported with their prescribed medicines by staff whose competency to administer medicines had been assessed. There were policies and procedures regarding the prevention and control of infection. The provider had a system in place to record and monitor accidents and incidents.
On the day of the inspection, the Wi-Fi connection at the service was working intermittently. This could have an impact on the care and support people receive. For example, there was a delay in people receiving their medicines on time as the provider used electronic medicine administration records. We discussed our concern with the nominated individual who acted immediately to rectify the issue. An appointment was brought forward with the IT company to visit the service and to resolve this on-going issue. The provider also sought advice from the GP as some people had not received their medicines on time.
We have made a recommendation about the provider’s business continuity in the event of infrastructure disruptions.
Rating at last inspection and update
The last rating for the service was requires improvement (published on 25 February 2022) and there were breaches of Regulations 12 (safe care and treatment), 9 (person centred care), and, 17 (good governance). 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.
This service has been in Special Measures since 2 June 2021. This meant we kept the service under review and, we re-inspected the service within 6 months to check for significant improvements. During this inspection the provider demonstrated that improvements have been made. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Barleycroft is a care home that provides accommodation, personal and nursing care for up to 80 people across three separate floors, each of which has separate adapted facilities. One of the floors specialises in providing care to people living with dementia. At the time of the inspection, there were 54 people using the service.
People’s experience of using this service and what we found
Quality assurance and monitoring systems in place were often not effective. This placed service users at risk of receiving unsafe care. The provider had an electronic system in place to check the stock balance of all medicines daily. However, the amounts recorded did not always match the actual amounts held in stock. This meant not all medicines could be accounted for.
Care records were not always personalised. We did not see records of people’s preferences regarding personal care or what people liked to eat or drink. Information on people’s sexuality and culture was also limited and generic. The registered manager had not maintained an accurate, complete and contemporaneous record for each service user regarding their preferences. Health and safety concerns were not always identified.
The service had safeguarding procedures in place and staff had received training in these. Risks associated with people’s care and support had been assessed and there was guidance in place to keep them safe. There were enough staff to meet people’s needs and the recruitment procedures were robust. The service had systems to manage accidents and incidents and learn from them, so they were less likely to happen again. There were processes in place for the prevention and control of infection.
Staff received appropriate training, support and development which enabled them to meet people’s needs. 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. Staff monitored people's health and welfare and reported any concerns to the management team who made referrals to health care professionals where required.
People had the privacy they needed and were treated with dignity and respect. They were supported to be as independent as possible. Confidentiality of people’s personal information was maintained. There was a complaints procedure which provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. Staff were aware of their roles and responsibilities and felt supported by the management team.
Rating at last inspection (and update)
The last rating for the service was inadequate, published on 2 June 2021 and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
This service has been in Special Measures since 2 June 2021. During this inspection the service remains in Special Measures.
The overall rating for this service is ‘Requires improvement’. However, the service remains in ‘special measures'. This is because, when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections they remain in special measures. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive, caring and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
We also looked at infection prevention and control measures. 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 coronavirus and other infection outbreaks effectively. Please look at the safe question of this part of the report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Barleycroft is a care home that provides accommodation, personal and nursing care for up to 80 people across three separate floors, each of which has separate adapted facilities. One of the floors specialises in providing care to people living with dementia. At the time of the inspection there were 71 people using the service.
People’s experience of using this service and what we found
Risks associated with people’s care and support had not been fully assessed. There was no detailed guidance in place in certain areas of people’s care for staff to follow, to keep people safe. People’s medicines were not always managed safely because we found shortfalls around the provider’s arrangements to make sure people received their medicines safely and as prescribed.
We noted that care records did not always contain information relevant to the person and were not individualised to reflect people’s needs and preferences. People’s end of life wishes were not always identified and recorded. The needs of people were not always assessed before they used the service. The registered manager had not maintained securely an accurate, complete and contemporaneous record in respect of the care and treatment delivered to people who used the service.
Accidents and incidents were recorded but not monitored to identify how the risks of reoccurrence could be minimised in future. Staff competency was not being effectively monitored to make sure people received safe care. The management team did not have a system to check if staff were supporting people safely. Staff received training but it did not cover all areas of people’s support needs. There were quality assurance and governance systems in place to drive continuous improvement; however, the systems were not always working effectively because the provider had not identified and improved the issues we found during the inspection.
Infection control procedures had been enhanced due to the risk of COVID-19 and we observed the service was clean and a cleaning schedule was in place. Personal protective equipment (PPE) was readily available and people and staff were tested regularly to help prevent the spread of infection. There were sufficient staff working for the service and safe recruitment procedures were followed. People were encouraged to be independent. There was a complaints policy and procedure in place which people and their relatives had access to. The management team had good links with the wider community and worked in partnership with other agencies to help ensure a joined-up approach to people’s support.
People 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.
Rating at last inspection
The last rating for the service under the previous provider (Festival Care Homes Ltd) was good, published on 7 June 2019. This service was registered with us under the current provider on 17/12/2019 and this is its first inspection.
Why we inspected
The inspection was prompted in part by notification of a specific incident following which a person using the service sadly died. This occurred in June 2019, under the management of the previous provider. The incident was subject to a criminal investigation which concluded in June 2020, with no action taken. However, the inspection did look at risks to people using the service, and specifically the management of head injuries, which the incident was related to.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive, caring and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
We also looked at infection prevention and control measures. 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 coronavirus and other infection outbreaks effectively. Please look at the safe question of this part of the report.
Enforcement:
We have identified breaches of regulations in relation to safe care and treatment, person centred care, staff training, safety of the premises and quality assurance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.