We inspected Barons Park Care on 13 February 2018. The visit was unannounced. This meant the staff and the provider did not know we would be visiting.Barons Park Care provides nursing and accommodation for up to 46 younger and older people with complex, challenging and advanced forms of dementia and significant mental health care needs. Long term nursing care is also provided. On the day of our inspection there were 44 people living at the service. At the last inspection in January 2017, the service was rated ‘Requires Improvement’. At this inspection we found the service was ‘Good’.
The service had a registered manager. 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.
People told us they felt safe living at Barons Park Care. Relatives we spoke with agreed they were safe living there. People were kept safe from avoidable harm because the staff team understood their responsibilities. They had received training in the safeguarding of adults and knew what to look out for if they suspected someone was at risk of harm.
People’s needs had been identified and the risks associated with their care and support had been assessed and reviewed. There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service.
Appropriate pre-employment checks had been carried out on new members of staff to make sure they were safe and suitable to work at the service. Staff members had been suitably inducted into the service and relevant training had been provided to enable them to appropriately support the people living there. Suitable numbers of staff were deployed to meet people’s needs.
The staff team felt supported by the registered manager. They were provided with the opportunity to share their views of the service through, day to day discussion, supervision and appraisals. Team meetings were also held on a monthly basis.
People were supported with their medicines in a safe way. Systems were in place to regularly audit the medicines held and the appropriate records were being kept.
People were provided with a clean and comfortable place to live and there were appropriate spaces to enable people to either spend time with others, or on their own. The staff team had received training in the prevention and control of infection and the necessary protective personal equipment was available.
Plans of care had been developed for each person using the service and the staff team knew the needs of the people they were supporting well.
People told us the staff team were kind and they were treated in a caring and respectful manner. Observations made during our visit confirmed this. We observed the staff team treating people in a friendly, caring and considerate manner. They knocked on people’s bedroom doors before entering and if someone declined their offer of help, this was respected.
The staff team supported people to make decisions about their day to day care and support. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people's human rights were protected. They supported people in making day to day decisions about their care and support. Where people lacked the capacity to make their own decisions, evidence was seen to demonstrate that decisions had been made for them in their best interest and in consultation with others.
People had access to relevant healthcare services and they received on-going healthcare support. Nutritional assessments had been carried out and people were supported to maintain a healthy, balanced diet. For people who had been assessed to be at risk of not getting the food and drink they needed to keep them well, appropriate records were kept so this could be monitored.
People were supported in a way they preferred because plans of care had been developed with them and with people who knew them well. The staff team knew the needs of the people they were supporting because appropriate plans of care were in place which included people's personal preferences.
A formal complaints process was displayed and people knew who to talk to if they had a concern of any kind. Complaints received by the registered manager had been appropriately managed and resolved.
People were appropriately supported at the end of their life. Staff had received training to enable them to provide the appropriate care and support and accommodation was available enabling relatives to stay with their family member during their last days.
Staff meetings and meetings for the people using the service and their relatives had been held. These meetings gave people the opportunity to discuss the service being provided and be involved in how the service was run.
The staff team felt supported by the registered manager and the management team. They felt able to speak with them if they had an issue or concern of any kind and they felt listened too.
Systems were in place to monitor the quality of the service being provided and a business continuity plan was available to be used in the event of an emergency or untoward event.
Further information is in the detailed findings below.