Archived: Barnett Wood Lane - Care Home Learning Disabilities

This inspection took place on 06 November 2018 and was unannounced.

Barnett Wood Lane - Care Home Learning Disabilities is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Barnett Wood Lane is registered to provide accommodation and personal care for up to six adults who have a learning disability. At the time of our inspection three people lived there. The service is delivered from a two-story house in a residential area.

It is a requirement of the provider's registration that they have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was present during this inspection.

Barnett Wood Lane continues to have a rating of outstanding in the care domains, with an overall good rating across the service.

People continued to be supported by kind and caring staff. Peoples independence was well promoted and supported by the staff team. Staff have worked here for many years, and have built caring relationships with people and enjoy their company. People are provided with the care, support and equipment they need to stay as independent as possible. People were supported to stay safe. Risks to people’s health and safety, including the risk of abuse were identified and well managed. People’s medicines were managed in a safe way, and they received them when needed. The home was kept clean by the staff team, with the help of the people who lived there. Accidents and incidents were reviewed by the registered manager and staff team to minimise the risk of them happening again.

Peoples needs were assessed before they came to the home, to ensure that the staff and environment could meet those needs. There are a sufficient number of staff deployed to meet people’s needs. A robust recruitment and selection process is in place. This ensures prospective new staff have the right skills and are suitable to work with people living in the home.

People have enough to eat and drink. People are involved in menu planning and food shopping, so they have the food they like. People have access to health care professionals when the need arises, as well as for routine check-ups to keep them healthy. Where people lacked the capacity to make specific decisions, the stuff understood and followed the requirements of the Mental Capacity Act 2005. This ensured that decisions made for people in their best interest and any restrictions put into place to keep them safe were done in a lawful way.

Care records were comprehensive and give a detailed description of the person, and their individual needs. Staff provide care and support that responded to these needs. People were supported at the end of their lives to have a dignified and as far as possible pain free death.

There was a robust complaints process in place, however this had not been needed as everyone we spoke with was happy with the service.

The home and staff team continue to be well led. The registered manager leads by example and staff are happy in their roles. However, the provider had not ensured that the service had continuously improved, nor had they taken the opportunity to learn from the what the registered manager and her team had done to achieve an Outstanding rating to develop their other services.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The inspection took place on 16 February 2016 and was unannounced. At our previous inspection in September 2013 we had identified no concerns at the home.

There was positive feedback about the home and caring nature of staff from people and relatives. One relative said, “Staff are all fantastic”. An advocate said, “They take into account residents views and make a great effort to make sure they enjoy life. It’s very residents focused.” A comment from a psychologist read, “I can honestly say that the care that (registered manager) and her staff provided to (resident) was the most outstanding I have ever witnessed.”

The registered manager had established a culture in the home that put people at the centre of the home. The registered manager was not present at the time of our inspection. However the staff were aware of, and understood, the high standard of care expected by the registered manager and ensured that they adhered to this despite her absence at the inspection. They were confident and knowledgeable in their ability to support and care for people and their passion for supporting people live a fulfilled life was evident throughout the inspection.

The staff were exceptionally kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff holding people’s hands and sitting and talking with them. Staff went out of their way to make sure people enjoyed life, or support them through times of illness. People were relaxed and happy with the staff and it was clear that caring relationships had developed between them. People could have visitors from family and friends whenever they wanted.

People were safe at Barnett Wood Lane. Although there was a small staff team there were sufficient staff deployed to meet the needs and preferences of the people that lived there. An advocate said, “They cover the home well.” The staff team had worked at the home for many years and were very positive about their enjoyment of the job and the people they support.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff worked on the premise of how people could be supported to do fun, but risky activities, rather than trying to stop people doing things they liked due to ‘health and safety’. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building, in a format people could understand. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Staff were heard to ask people for their permission before they provided care, and give people as much control over their lives as they were able, such as managing their own monies.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had a good choice of food and drink available to them. People could choose the meal they wanted, when they wanted it, and took part in making it. People received support from staff where a need had been identified. Specialist diets to meet medical or religious or cultural needs were provided where necessary, and staff had investigated how people could still have their favourite drinks where a risk from choking had been identified.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. People’s health was seen to improve due to the care and support staff gave.

Care plans were based around the individual preferences of people as well as their medical needs. People were really involved in their care plans, with some writing their own reviews. A relative said, “They involve him in everything and it feels like his home”. Plans were in a format that best suited the person they were for. They gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans. Details such as favourite foods, recorded in the care plans matched with what we saw on the day of our inspection.

People had access to activities that met their needs. Many of the activities were based in the community giving people access to friends and meeting new people. The staff knew the people they cared for as individuals.

People knew how to make a complaint. The policy was in an easy to read format to help people and relatives know how to make a complaint if they wished. No complaints had been received since our last inspection. Staff knew how to respond to a complaint should one be received.

Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. Records for checks on health and safety, infection control, and internal medicines audits were all up to date. Accident and incident records were kept, and would be analysed and used to improve the care provided to people should they happen.

People had the opportunity to be involved in how the home was managed. Regular house meetings took place to give people a chance to have their say. Staff worked with people to bring to make improvements to the home, even giving up their own time to do this. Surveys were completed and the feedback was reviewed, and used to improve the home and the people’s experience of living there.

People had a very positive experience living at Barnett Wood Lane. They were supported by staff that really enjoyed their job; who ensured that people lived in a safe home; which gave effective care; by caring and passionate staff; who responded to people’s needs and really involved them in their care and support. The registered manager gave an outstanding level of leadership to make people’s lives happy and fulfilled.

People told us they were 'happy' and they were 'safe'. We saw that people looked happy and relaxed in the presence of staff. Staff told us that three of the people had lived in the home for 18 years and another person had recently moved into the home.

We looked around the home which was clean, comfortably furnished and free from unpleasant odours. One person was happy for us to look at their room. Their bedroom was personalised with photographs, books, TV's and pictures.

We also spoke with three staff. We spent time observing how staff interacted and supported people. We saw staff treated people in a sensitive, respectful and professional manner.

One person told us that they made choices every day. They told us that they chose the activities they wanted to do and how they wanted to spend their days. They told us that they liked football and had recently been to Wembley with their key worker to watch England play. They said that they liked cooking and choosing their bed times. They were able to convey, 'I got to bed at 11 o'clock and get up at 10:00.'

One person who used the service told us that they were happy living at the home. They said they 'Would tell the manager' if any one had treated them badly. We observed staff interacting with people who used the service in a respectful manner, calling people by their first names and offering choices.

People's diversity, values and human rights were respected. We saw that the religious needs of people who used the service had been recorded in the two care plans that we reviewed during the inspection.