Pamela Barnett

Updated 19 August 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector.

Service and service type

Pamela Barnett is a ‘care home’ without nursing. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service, including notifications received from the provider. The law requires providers to send us notifications about certain events that happen during the running of a service. We sought feedback from the local authority, community professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We reviewed the provider’s website and used the information the provider had sent us in the provider information return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 members of staff including the registered manager, the operations manager, three assistant managers, four support workers, an agency support worker, the chef and the assistant chef. We spoke with a visiting health and social care professional.

We observed care during mealtimes, social activities and medicines administration rounds to help us understand the experience of people who could not talk with us. We reviewed a range of records. This included four people’s care records, medicine records and daily notes. We looked at three staff files in relation to recruitment, staff training and supervision. A variety of records relating to the management of the service were reviewed, including the provider’s policies, procedures, accidents and incidents and quality assurance audits.

After the inspection

After the inspection we continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with ten health and social care professionals and eight relatives of people who lived in the home about their experience of the care provided.

Updated 19 August 2021

About the service

Pamela Barnett is a residential care home registered to provide personal care for up to 16 people. The service provides care and support for people who live with learning disabilities and associated needs. The home is a large detached building situated on a village style development together with other similar care homes run by the provider. There are four self-contained flats and at the time of the inspection fifteen people were living in the home.

People’s experience of using this service and what we found

People experienced safe care and were protected from avoidable harm by trusted staff, who had completed safeguarding training and knew how to recognise and report abuse. Staff identified and assessed risks to people effectively and managed them safely. The registered manager ensured enough staff were deployed, with the right mix of skills to deliver care and support to meet people’s needs. Staff had completed a robust recruitment process, including their conduct in previous care roles to assure their suitability to support people living with a learning disability. People received their medicines safely from staff, in accordance with recognised guidance. Staff maintained high standards of cleanliness and hygiene in the home, which reduced the risk of infection, in accordance with the provider's policies and procedures, and government guidance.

Staff assessed all aspects of people’s physical, emotional and social needs and ensured these were met. Staff were effectively supported to develop and maintain the required skills and knowledge to support people with complex needs associated with their learning disability. Staff emphasised the importance of eating and drinking well and reflected best practice in how they supported people to maintain a healthy balanced diet. Staff worked effectively with healthcare professionals to make sure care and treatment met people’s changing needs and consistently achieved good outcomes. People's rooms were personalised to reflect their individuality and safe outside spaces with quiet areas accommodated family visits, including a sensory garden accessible to people who required support with their mobility.

People experienced caring relationships where staff treated them with kindness and compassion in their day-to-day care. People were supported to make decisions about their care and these choices were respected by staff. Staff consistently treated people in a respectful manner and intervened discretely to maintain their personal dignity. Staff knew how to comfort and reassure different people when they were worried or confused.

People experienced person-centred care, which consistently achieved good outcomes and had significantly improved the quality and longevity of their lives. People received information in a way they could understand and process, allowing for any impairment, such as poor eyesight or hearing. People were enabled to live as full a life as possible and were supported to take part in imaginative activities, which enriched the quality of their lives. People were supported to keep in touch with family and friends, which had a positive impact on their well-being. People knew how to make complaints and were confident the management team would listen and address their concerns. The service worked closely with healthcare professionals and sensitively explored people’s end of life care wishes.

The management team led by example and promoted a strong caring, person-centred culture where people and staff felt valued. Staff were passionate about their role and consistently placed people at the heart of the service, clearly demonstrating the caring values of the provider. The registered manager understood their responsibilities to inform people when things went wrong and the importance of conducting thorough investigations to identify lessons learnt to prevent reoccurrences. The governance structure ensured there were robust measures to monitor quality, safety and the experience of people within the service. Quality assurance was embedded within the culture and running of the service, to drive continuous improvement. During the pandemic, staff had used technical solutions to keep families up to date with events and activities going on in the home, which they found reassuring.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

New services should not be developed as part of a campus style development. Pamela Barnett was opened in 2008 prior to this guidance and has been the home of people for 13 years. At the time of inspection, the provider was completing a consultative process with all stakeholders, including people, their families, advocates and commissioners of care, demonstrating they were involved in the future development of the service. • Whilst the home was registered to support 16 people, the building comprised four fully self- contained flats with communal accommodation exclusive to the people living in the flat. Each person had dedicated keyworkers to ensure people experienced good continuity of care from staff with whom they shared a special bond. Relatives, health and social care professionals and commissioners praised the service for maximising the quality of people’s lives, through the consistent provision of choice and control and supporting their independence. People, relatives and commissioners consistently told us they thought Pamela Barnett was the best place for people to be, who considered it to be their home and where they wished to stay. People consistently experienced person-centred, individualised care, which respected their privacy, promoted their dignity and protected their human rights. The provider and management team demonstrated a comprehensive understanding of the Mental Capacity Act. The values and inclusive culture of the service leaders and staff ensured people were empowered to lead enriched and fulfilled lives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 July 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.