Barclay Services

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We found the service could not sufficiently demonstrate the safe recording of medicines. During this assessment we identified issues with missing or incorrect medicine information, and different medicine records being used across the service. The concerns demonstrate a breach of Regulation 12 (2) (g) Safe Care and Treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our recommendation below. People's risk assessments were not always completed fully, with detail about all of people's known risk factors. We also found inconsistencies in the quality and detail of guidance about people's communication needs. We found enough numbers of staff were deployed to meet people's needs, and staff received appropriate training and supervision. All staff had received safeguarding training. The registered manager was aware of reportable incidents, and incident records confirmed that local multi agency safeguarding procedures had been followed to report any safeguarding allegations, concerns and incidents. There was a positive culture within the service, where complaints were acted upon and lessons were learnt.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

A Local Authority visit found the service was providing people with care which met their standards.

We reviewed complaints and found they had been acted upon, and that lessons had been learnt. Relatives told us that any minor concerns which they raised had been dealt with effectively.

Relatives told us they were confident they would be informed of any accidents or incidents which occurred.

Staff spoke positively about the culture at the service. Staff reported an open door policy at the service, and told us that concerns they had would be taken seriously and acted upon. The registered manager understood of their duty to be open and honest when things went wrong, and understood their role, responsibilities and the actions required when mistakes occurred.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider kept a record of any safeguarding concerns and reviewed these on a monthly basis. The management team understood their roles and responsibilities to ensure any restrictions on peoples freedom were lawfully authorised.

People were protected from avoidable harm or abuse. Safeguarding information was provided in easy read for people using the service.

Staff had all received safeguarding training and could describe different forms of abuse, and the actions which they should take. Staff had monthly meetings with people whereby safeguarding and complaints was a standard agenda item.

People were observed to be supported by staff safely, and in a way which met their needs.

We found inconsistencies in the quality and detail of guidance about people's communication needs. There was a lack of detail and guidance for staff about how to effectively support some people to express their emotions or distress. Conversations with staff demonstrated they knew people well and were confident in supporting them to communicate, however people's records did not reflect this.

Risk assessments records were not always completed fully, with detail about all of people's known risk factors. For example, we found a person's file where a significant risk factor had not been documented within a care plan.

People and their relatives felt involved in discussions about risks relevant to the care they required.

Observations demonstrated staff knew people well. Positive risk taking took place and was well managed.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

During the assessment, we observed full staff numbers at each location we visited.

Staff spoke positively about the staffing levels across the service and confirmed there were always enough staff on each shift to ensure people's commissioned hours of care were fulfilled. Staff received 4 supervisions per year, and told us they found these sessions informative and supportive.

We reviewed the staff training matrix which demonstrated staff had all received training in areas of care such as moving and handling, first aid, safeguarding, autism awareness and epilepsy. Staff advised training was a mixture of face to face and online. Relatives were happy with the training of the permanent staff, however felt that agency staff, which were used to cover some shifts, would benefit from further training.

Sufficient numbers of staff were deployed to ensure the needs of people living at Barclay Services received the care and treatment they required. Relatives told us they knew the staff teams who cared for their loved one. One relative said, "Yes the staff are second to none, [staff member] is excellent."

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Different types of medicines administration records (MAR) were in use throughout the service. During the assessment we found information was either missing or incorrect. Documents to support the use of ‘when required’ (PRN) medicines were sometimes missing. We could not be assured people were receiving safe care and treatment as the risks associated with medicines were not always well managed. We made a recommendation that the provider must ensure MAR charts are completed accurately and information is consistent between records.

There were processes in place however we found these were not always followed by staff. Staff did not always do double checks on handwritten MAR charts. Audits were done by the provider but did not always identify the areas for improvement that we found on inspection.

Staff were trained in medicines administration and had competency assessments completed annually.

People were given their medicines how they preferred in a timely manner. The administration was recorded on a medicine administration record (MAR). People when asked about care responded positively including medicines administration received from staff at the service.