Archived: Barnetts

Updated 9 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was carried out on 26 and 27 May 2015 and was unannounced. The inspection team consisted of two inspectors, a pharmacist inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience who took part in the inspection had specific knowledge of caring for older people who live with dementia.

Before our inspection we looked at records that were sent to us by the registered manager and the local authority to inform us of significant changes and events. We reviewed our previous inspection reports and the action plan that we had requested following our last inspection. We consulted a district nurse, an occupational therapist and a community psychiatric nurse who oversaw some of the people’s care in the service. We obtained their feedback about their experience of the service.

We looked at records which included those related to people’s care and medicines, staff management, staff recruitment and quality of the service. We looked at ten people’s assessments of needs and care plans and observed to check that their care and treatment was delivered consistently with these records. We looked at the activities programme and the satisfaction surveys that had been carried out. We sampled the services’ policies and procedures.

We spoke with eight people who lived in the service and three of their relatives to gather their feedback. We also spoke with the registered manager, six members of care staff, one member of housekeeping staff and two catering staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 9 July 2015

The inspection was carried out on 26 and 27 May 2015 by two inspectors and an expert by experience. It was an unannounced inspection. The service provides personal care and accommodation for a maximum of 39 older people. There were 28 people living there at the time of our inspection, 27 of who lived with dementia. Most of the people living in the service were able to express themselves verbally, others used body language.

There was a manager in post who was registered with the Care Quality Commission (CQC) on 11 March 2015. A registered manager is a person who has registered with the CQC 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.

At our last inspection on 17 February 2015, we found that appropriate records for people were not always maintained and some records were not accessible. We asked the provider to take action to make improvements to the service’s records and documentation and at this inspection we have found that all remedial action had been taken.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how the risks of re-occurrence could be reduced. There were sufficient staff on duty to meet people’s needs. Staffing levels were calculated and adjusted according to people’s changing needs. There were safe recruitment procedures in place which included the checking of references.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

All fire protection equipment was serviced and maintained. People’s bedrooms were personalised to reflect their individual tastes and personalities.

Staff knew each person well and understood how to meet their support needs. People told us, ““The staff know what I like” and, “They [the staff] understand me”.

Staff’s training was renewed annually, was up to date and staff had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular one to one supervision sessions and were scheduled for an annual appraisal to ensure they were supporting people based on their needs and to the expected standards.

The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005 requirements.

Staff sought and obtained people’s consent before they helped them.

The service provided meals that were in sufficient quantity and met people’s needs and choices. Staff knew about and provided for people’s dietary preferences and restrictions.

Staff communicated effectively with people, responded to their needs promptly, and treated them with kindness and respect. People were satisfied about how their care and treatment was delivered. One person told us, “The staff are so kind they listen and are very respectful”.

People were involved in their day to day care. People’s care plans were reviewed with their participation and relatives were invited to attend the reviews and contribute.

Clear information about the service, the facilities, and how to complain was provided to people and visitors. Menus and the activities programme were provided for people in a suitable format which made them easy to read.

People were able to spend private time in quiet areas when they chose to. People’s privacy was respected and people were assisted in a way that respected their dignity.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.

People’s individual assessments and care plans were reviewed monthly with their participation and updated when their needs changed.

People were involved in the planning of activities. A broad range of activities and outings was available.

The service took account of people’s feedback, comments and suggestions. People’s views were sought and acted on. The registered manager sent annual satisfaction questionnaires to people’s relatives or representatives, analysed the results and acted upon them. Staff told us they felt valued under the manager’s leadership.

The registered manager notified the Care Quality Commission of any significant events that affected people or the service. The registered manager kept up to date with any changes in legislation that may affect the service and carried out comprehensive audits to identify how the service could improve. They acted on the results of these audits and made necessary changes to improve the quality of the service and care.