Archived: Barons Down Nursing Home

Updated 28 January 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 two inspectors, a nurse specialist and an expert by experience. The nurse advisor specialised in the care of older people. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Barons Down Nursing Home 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

Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. 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.

During the inspection-

We spoke with four people who lived at the service and three relatives. We observed the care and support provided to people. We also spoke with the registered manager and nine staff members. We reviewed a range of documents about people's care and how the home was managed. We looked at six care plans, five staff files, medication administration records, risk assessments, policies and procedures and internal audits that had been completed.

After the inspection

The registered manager sent additional information and updates relating to the care records and staff training.

Updated 28 January 2020

About the service

Barons Down Nursing Home is a care home with nursing and accommodates up to 30 people in a purpose-built building. The service supports adults whose primary needs are nursing care although some may also be living with dementia. At the time of our inspection there were 22 people living at the service.

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

There was a lack of robust management oversight in some areas of the service. Quality assurance systems did not always identify shortfalls in the service and the provider had not ensured there was a systematic approach to manage improvements. Risks to people’s safety were not always monitored, which meant there was a risk they would not receive the care they required. Safe infection control processes were not followed in all areas. In addition, we found that arrangements for activities did not always provide sufficient stimulation for people and opportunities to go out were limited.

People told us they felt safe living at Barons Down and staff understood their responsibilities in keeping people safe from abuse. People received their medicines in line with prescriptions and medicines were securely stored. There were sufficient staff available to meet people’s needs and safe recruitment processes were followed. Staff received training and an induction to support them in their roles.

People had access to healthcare professionals and advice provided was followed. People’s nutritional needs and preferences were known to staff and people told us they enjoyed the food provided. 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 were supported by caring staff who provided choices regarding their day to day care. People and their relatives were involved in making decisions regarding their care and people’s dignity and independence was respected.

The registered manager and senior staff were approachable and responded to any concerns or complaints promptly and in an open and transparent way. Staff were clear about the values of the service and told us they felt proud to work at Barons Down.

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 7 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the management of risks to people’s safety, person-centred care, the activities provided and the management oversight of the service. Please see the action we have told the provider to take at the end of this report.

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.