Barnet Grange Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulation in relation to promoting people’s right to consent to all aspects of their planned care.

This service scored 58 (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 did not always make sure people’s care and treatment was effective because they did not always check and discuss people’s health, care, and wellbeing with them.

Some people did not have assessments and plans in place about their needs, even when this connected to their safety. 1 person’s needs had not been re-assessed even though their situation had changed. People and relatives felt confident staff were responding to changes in people’s health needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People who were at risk of choking were being supported to eat food which they had been assessed by a food professional to eat. There was an effective process in place to ensure people received the correct modified meals. However, one person’s risk assessment and care plan was inconsistent regarding these instructions. A further person had disagreed with the professional’s recommendation of what they should eat. This was only corrected when the person complained to staff about this. No professional follow up referral was made even though there was a possible risk of choking. Staff had not initially reviewed this need with the person and made the necessary plans with them.

The provider made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

When people moved from the assisted living part of the home to Copperfield, staff there were informed about their needs and took the time to get to know them. We saw staff had formed friendly relationships with people in a relatively short time.

The provider supported people to manage their health and well-being to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Managers and staff responded to changes in people’s health needs. Plans were in place to support people to live healthy lives. However, 1 person had not received appropriate pain care, by not sharing their recent experiences of high pain levels with the GP. A manager had identified this and had started to take action.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The provider and managers were not always monitoring people’s care effectively to try and improve outcomes for people. For example, 1 person was at high risk of falls and had been waiting three months for a specialist piece of equipment. There was a lack of oversight and action taken to manage this need for this person who was living with dementia. There was also a lack of oversight and effective auditing regarding people’s dementia care experiences. There was a hidden door to Copperfield, which was not unlawful, but the inspection team felt this gave the impression people living with dementia were being hidden away, closed off from the home. It did not support best practice guidance about dementia care. Some staff also shared similar views with us and the provider felt uneasy with the hidden door to Copperfield saying they had inherited this from the previous owner. Some people found it difficult sharing space and social events with some people living with dementia. But no actions had been taken to deal with these issues.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

There was a lack of understanding by staff and managers about best interest processes when individuals lacked capacity to make certain decisions. For example, decisions were being made in relation to people receiving covert medicines. Additionally, decisions were also being made regarding people drinking socially acceptable amounts of wine, which people had previously enjoyed before moving to the home. These decisions were not in line with the principles and best practice guidance of the Mental Capacity Act. Decisions were also being made for 2 people who did not lack capacity, to override their own decisions. The accompanying documentation and records were not effective in exploring the process with the person to be clear they understood the risks or had agreed to make a different decision following the advice from staff. The provider was not auditing how consent to care was being promoted and managed by staff and managers at the home.