Barton Brook Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The home had recently implemented a new wider management structure- manager, unit leaders; team leaders, senior care and care staff, with support received from regional and quality roles within the wider company. At the time of the assessment, the manager was awaiting registration with CQC. Since our last assessment of the service audits had improved, team meetings took place more regularly and communication had improved with all levels of staff. Flash meetings were in place for senior staff and management completed daily walk round checks and audits. The service had introduced new processes such as Resident of the Day, however not all key staff were aware of their role in this process and some residents were unaware of the new initiative. We found formal supervision of staff to be limited, however staff felt supported and listened to. Staff told us they felt comfortable in approaching the manager and wider management. Improvements had been made in systems and processes, however more work was needed regarding medicines management and monitoring of conditions within DoLS. The service engaged with residents and relatives. Evidence of this was viewed during our onsite assessment. Staff had access to policies and procedures and knew where to find them. The service worked in partnership with stakeholders for the benefit of people living in the home. Feedback from partners was positive and included positive comments on the management of the service and the recent improvements that had been made. Sustainability of these on-going improvements needs to be demonstrated going forward.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since our last inspection a new management team had been appointed by the provider. The new manager and other leadership team staff promoted the values of the provider, “family, honesty and respect”. They had worked hard to improve the culture of the service. Staff told us they felt the home was better managed and were glad to be on the home’s ‘improvement journey’.

The provider’s statement of purpose reflected the aims of the service. There were mechanisms in place to ensure a positive culture within the home; some of these were new and needed developing further. Any poor practice or complaints were investigated, using established processes. Senior management teams met regularly and any decisions were shared with staff so they remained involved and informed.

The manager was awaiting registration at the time of this assessment. They had daily support from both on site staff such as nurses and unit leaders and regular visits from regional manager and clinical support staff. The company worked hard to ensure staff felt involved in the improvement journey the home was going through and staff we spoke with recognised this. Staff felt more invested in, however on some units, staff felt more could be done to ease the pressure, for example higher staffing levels to better manage people’s high needs. Staff were able to offer thoughts, ideas and opinions in meetings and felt comfortable in doing so.

Processes were in place for leaders to develop staff and offer them increased opportunities within the home. Since the last inspection the provider had created new roles such as Unit Manager and Activities Co Ordinator Lead, to provide increased oversight and help support staff. Supervision and appraisal of staff had started and were documented; supervision of all staff was a priority for the manager. New unit managers had met with staff to discuss their role and help identify any training or development needs. The new manager was well-respected by other staff members and had previous relevant experience in managing other large care homes. They worked well with the new regional director in the best interests of people living at the home and the staff.

There was a more open and transparent culture within the service. Staff were aware of mechanisms in place for speaking up; for example, via the whistleblowing policy, in supervisions, staff meetings or by approaching either the home manager or unit managers. Staff told us they were confident they would be listened to.

There were mechanisms in place for staff to speak up and a culture in place to encourage them to do so. Good communication was in place with an improved staff structure and team meetings. Some formal supervision sessions had taken place, and the manager was rolling these out to all staff. Staff were given the opportunity to engage with senior leaders and were further supported by policies and information that enabled them to raise concerns externally if required. Staff we spoke with were aware of these policies and who to contact should they need to speak up.

Staff felt more empowered and considered morale had improved. The new manager had invested time in having lots of staff meetings when they first started; staff felt more included and informed. A staff member told us, “Staff can raise things as well and bring to the attention of management. This manager listens and tries to resolve.”

Staff were given regularly opportunities as a group and on a one-to-one basis to share feedback and identify new learning opportunities. Mechanisms in place included unit meetings, staff meetings, and supervision, although these needed to be completed for all staff.

The manager and other senior staff had improved the governance systems that were in place and introduced new processes for the benefit of people and staff. We spoke to various members of staff, including nurses, carers, catering, maintenance and activities staff. All understood their roles and responsibilities and were positive about the direction of the home. One staff member considered management had much improved, were more open and that staff were better informed.

The management team had worked extensively with the local authority, the Care Quality Commission, people, their families and staff to improve the delivery of care and the culture of the home from after the previous inspection. A home improvement plan was in place which was regularly reviewed by the management team and the local authority. Audits were being completed to ensure the management team had oversight of the home and people’s well-being, with quality reviews being completed by the regional director and clinical support staff, highlighting areas to improve upon and by when. Audit schedules, policies, procedures and systems in place meant that oversight and governance of the home had improved and was more consistent. We identified there was room for further improvement. For example, a Resident of the Day programme had been introduced. This mean that specific people would be a focus on a certain day; their views on aspects of the home and their care would be sought. We checked this with key members of staff and some people, who were not aware of the process. This needed to be better communicated to all involved and the manager took this on board to address.

People benefited from the relationships and partnerships with stakeholders and health professionals that the provider had worked hard to establish. Managers continued to work with external agencies and professionals so that people were appropriately supported. They continued to involve families and sought feedback from them. Relatives were given information about how they could raise any concerns, including contacting the CQC.

Commissioners met with the management team to review the improvement plans in place. Visits by local authority representatives checked on improvement plan progress and the quality of care delivery. Staff were regularly communicating with health and social care professionals, acting in people’s best interests.

The provider and new manager had forged good networks and partnerships with a range of stakeholders, including local authorities and health and social care professionals. A health professional involved with the home commented, “We regularly complete reviews of patients at Barton Brook; management and senior staff are all receptive to any feedback we may provide regarding the provision of care.” Feedback from partners was positive about the management of the service and they shared the improvements the service had made since the last inspection. Sustainability of these on-going improvements is key going forward.

Appropriate referrals were made to other agencies when necessary. The management team and staff were starting to build relationships with the local community, for example the local church. The management team was in the process of obtaining feedback from people and relatives; management welcomed feedback on the care people received as this helped drive improvement.

Staff told us the service had improved; the improvements were down to the new manager and the wider management support. They had introduced unit managers, and this meant the staff team had more structure. Staff now felt more involved in improving the home and people living at Barton Brook care home benefitted from this.

Staff meetings were more regular, and supervision of staff had started. Clinical support was available from wider management. Staff were more involved in the operation of the home and welcomed this. Staff we spoke with told us they were glad they were on the home’s improvement journey.