Baronsmede

Updated 28 March 2020

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.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Baronsmede is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We looked at notifications received from the service. A notification is how providers tell us important information that affects the running of the service and the care people receive. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. 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 six people who used the service about their experience of the care provided. We spoke with six members of staff including the provider, registered manager, support staff and volunteers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care 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 and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We observed three people participating in day activities away from the service. We received feedback from two people with a learning disability who have a close affiliation with the service but do not live there.

After the inspection

We sought feedback from five relatives about their experience of the care provided.

Updated 28 March 2020

About the service

Baronsmede is a care home that provides accommodation and personal care support for up to nine adults with learning disabilities. The service specialises in the care of people who have a learning disability and complex needs including communication, physical health and challenging behaviour. At the time of our inspection eight people were living at the service.

Baronsmede is a detached house located within Crowborough village. The service operates over two floors and had been fully adapted to meet the needs of people who lived there. People had their own bedrooms and bathrooms and shared the communal areas and garden.

The service had been open for over 30 years and therefore had not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The outcomes for people using the service reflected the principles and values of Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, inclusion and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s support focused on them having as many opportunities as possible to gain new skills and become independent. The provider supported people to develop skills that enabled them to have a more independent life style. Some people had successfully moved into their own accommodation, and the provider was in the process of changing the environment into a smaller residential service with separate supported living accommodation for five people.

The service was a large domestic style property. It was registered for the support of up to nine people. Eight people were using the service. This is larger than current best practice guidance. However, the size of the service did not have a negative impact on people. There was a large communal lounge, dining room and conservatory and people had their own personalised rooms. There was also a separate lounge with a kitchenette and dining area which people used to enhance their own independence. This facility enabled people to prepare their own meals and snacks and spend with friends. There was a self-contained flat upstairs that enabled people to prepare for their journey into independent living. An extension had also been built to provide a bespoke environment for one person. The building design fitted into the residential area and there were deliberately no identifying signs or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service

We received overwhelmingly positive feedback about the leadership of the service. There was a visible person-centred culture which was truly imbedded within the ethos of the service. The registered manager and staff team were highly motivated and proud of the service they delivered to people. There was a strong commitment to ensure the service was inclusive and people had the opportunity to develop new skills and community connections.

People received personalised care that was exceptionally responsive to their needs. There was a strong sense of leadership in the service that was open and inclusive. The provider focused on achieving exceptional outcomes for people and their staff.

There were high levels of satisfaction amongst people and relatives who used the service. Everyone we spoke with said they would recommend the service to others. Comments from relatives included “I am so lucky to have found Baronsmede, it is brilliant” and “I can’t speak highly enough of it, everything they do is just wonderful” There were consistently high levels of engagement with people using the service, families and other professionals.

People were treated with dignity and compassion by a kind, caring staff and management team who understood people's individual needs, choices and preferences well. People repeatedly told us that staff had made a difference in their lives and said that staff routinely went above and beyond to ensure people were happy and safe. There were enough staff to meet people’s needs.

Robust systems, processes and practices were followed and sustained effectively to safeguard people from situations in which they may experience harm. Risks to people's safety had been thoroughly assessed, monitored and managed so they were supported to stay safe. There was a flexible approach to risk management which promoted people’s independence and provided opportunities for new experiences.

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.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The last rating for this service was Good. (Published 9 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

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.