This unannounced inspection of Barnfold Cottage Residential Home took place on 9 December 2014. Our previous Inspection was undertaken in June 2013 when we found that the service was meeting all of the outcomes we assessed. This inspection was undertaken by one Adult Social Care Inspector.
Located in a residential area and near to local facilities, Barnfold Cottage is registered to provide personal care and accommodation for up to fourteen people. There were fourteen people living at the home at the time of our inspection.
Because the registered person is an individual, under current legislation there is no requirement to have a manager registered with the Care Quality Commission to manage this service. The registered person has responsibility for the day to day operation of the service. They have the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People said they felt safe living at the home and were supported in a safe way by staff. Staff understood what abuse was and the action they should take to ensure actual or potential abuse was reported.
Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. There were enough qualified and skilled staff at the service. Staffing was managed flexibly to suit people's needs so that people received their care when they needed it. Staff had access to information, support and the training they needed to do their jobs well. The provider’s training programme was designed to meet the needs of people using the service so that staff had the specialist knowledge they required to care for people effectively.
People were provided with a range of activities in and outside the service which met their individual needs and interests. The service supported people to be as independent as possible.
Care plans contained information about the health and social care support people needed and records showed they were supported to access other professionals when required. People agreed to the level of support they needed and how they wished to be supported. Where people's needs changed, the provider responded and reviewed the care provided. Our review of a selection of care records informed us that a range of risk assessments had been undertaken depending on people’s individual needs.
People told us they received their medication at a time when they needed it. We observed that medication was administered to people in a safe way.
The building was clean, well-lit and clutter free. Measures were in place to monitor the safety of the environment.
People we spoke with told us the deputy manager and staff communicated well and kept them informed of any changes to their health care needs. People said their individual needs and preferences were respected by staff. They were supported to maintain optimum health and could access a range of external health care professionals when they needed to.
People spoke highly of the meals and the general meal time experience. They told us the food was very good and they got plenty to eat and drink.
People described management and staff as caring, considerate and respectful. Staff had a good understanding of people’s needs and their preferred routines. We observed positive and warm engagement between people living there and staff throughout the inspection.
Staff told us they were well supported through regular supervision and appraisal. They said they were up-to-date with the training they were required to undertake.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). We found the location to be meeting the requirements of DoLS. There had been no applications made in respect of an individuals under the DoLS process but we were informed that an application was being considered with respect to one person living at the home.
The culture within the service was open and transparent. Staff, people living there and a visiting professional said the registered provider was approachable and inclusive. They said they felt listened to and involved in the running of the home.
Staff were aware of the whistle blowing policy and said they would not hesitate to use it. Opportunities were in place to address lessons learnt from the outcome of incidents, complaints and other investigations.
A procedure was established for managing complaints and people living there were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with the complaints procedure.
Audits or checks to monitor the quality of care provided were in place and these were used to identify developments for the service.
Although records of events occurring within the home were well recorded we found that the registered provider has failed to notify CQC of certain reportable events. We found a number of breaches of the Health and Social Care Act 2008 (Registration) Regulations 2009. Youcan see what action we told the registered provider to take at the back of the full version of this report.