Archived: Baytree House

Updated 7 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was 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 took place on 3 and 4 February 2016. The first visit was unannounced, and both visits took place over the afternoon and evening to enable us to meet people coming to the service for care. We looked at the information we held about the service before the inspection visit and the provider completed a Provider Information Record or PIR. This gave us information about the service and improvements they had made since their registration. Following the inspection we contacted three relatives of people staying at the service for the views about Baytree House.

Some of the people staying at the service at the time of the inspection were not able to express themselves verbally about their experiences. We spent time observing the care and support people received, including staff supporting people with their moving and transferring, eating and being given medicines. We spent time with people over a mealtime and throughout the two visits when people were welcoming of this. On the inspection we also spoke with a visiting district nurse, a Trust infection control nurse and four members of staff. We spoke with the staff about their role and the people they were supporting.

We looked at the care plans, records and daily notes for five people with a range of needs, and looked at other policies and procedures in relation to the operation of the service, such as the safeguarding and complaints policies. We looked at three staff files to check that the service was operating a full recruitment procedure, and also looked at their training and supervision records. We looked at the accommodation provided for people and risk assessments for the premises, as well as for individuals receiving care and staff providing it.

Updated 7 June 2016

Baytree House was registered under Torbay and Southern Devon NHS Foundation Trust (the Trust) in October 2015 as a service providing respite care for up to eight people with learning disabilities. This was the first inspection of Baytree House under this provider, although the service has been established for many years as a location under the previous Care Trusts registration.

This inspection took place on 3 and 4 February 2016. The first visit was unannounced, and both visits took place over the afternoon and evening to enable us to meet people coming to the service for care. There were six people using the service on the days of the inspection, one of whom spent a night away between the two site visits.

Baytree House primarily provides a respite service for people with learning disabilities. People using the service may have complex needs including physical disabilities and difficulties with moving independently. Some of the people using the service have done so for many years and so are very familiar with Baytree House. One relative told us it was a “home from home” for their relation. We were told that people requested their favourite themed bedrooms when they booked a visit, and that consideration was given to who else might be staying at the time to ensure people got on well wherever possible. Some people using the service were familiar with each other as they used the same day services.

People or their relatives told us they were happy with the services provided by Baytree House. The service was used flexibly to provide respite support to carers who supported people in their own homes, which might be for a regular one night stay each week. Other people were staying for a longer period of a fortnight whilst their carers had a break. For some people the home had provided emergency longer term respite until a new permanent placement could be found for them.

We saw many examples of positive and supportive care being delivered. Systems were in place to protect people from abuse or report any concerns about people’s well-being. Staff respected people’s confidentiality, privacy and dignity, and were aware of people’s communication needs or methods. They were skilled in interpreting what these meant for people who were not able to express themselves verbally. People were encouraged to retain their independence and skills they used at home. People and relatives had been involved in making their care plans and sharing information about people’s needs and wishes in relation to their care. Care plans gave clear information about how people wanted their care to be delivered and were updated regularly.

There were enough staff to deliver care to people, and staffing levels were reviewed and changed every day to reflect the needs of people staying that day. Staff recruitment practices ensured that a robust process was being followed, including taking up of references and disclosure and barring (police) checks. Staff had received the training they needed, and this was updated regularly. Staff supervision and appraisal systems were in place, and the staff told us they felt supported.

Risks to people were assessed, and actions taken to reduce any risks where possible. Incidents and accidents were analysed to help assess how they could be prevented. Risk assessments in relation to the premises were up to date, and any concerns were raised with senior people within the Trust. Safe systems were in place for the management of medicines.

People‘s rights were being protected because the principles and implementation of the Mental Capacity Act 2005 (MCA) were understood and put into practice. People were asked for their consent before care was given and where there were concerns over people’s capacity to make decisions, best interest decisions were made and recorded appropriately on their behalf. No Deprivation of Liberty Safeguards were in place or needed.

People enjoyed their meals and people’s dietary needs and choices were respected.

The building, although not ideal was being reviewed to ensure it met people’s needs. We have made a recommendation in respect of taking specialist advice on the adaptation of the premises to support people with sensory impairment.

There were effective systems in place for good governance, quality assurance and safe care for people at the service. The service’s management demonstrated good leadership. There was an open culture and people were encouraged and enabled to have a say in the way the service was run. People told us the manager was approachable and a good leader, with a clear understanding of people’s care needs. Complaints management systems were robust.

People took part in regular resident’s meetings and had themselves elected a Champion to represent their views at staff and management meetings. Questionnaires were sent to people as part of a quality assurance exercise and changes made as a result. For example the service had purchased a tablet computer for people’s use.

Records were well maintained, although some were still in the process of being updated to reflect Torbay and Southern Devon NHS Foundation Trust as the provider.