Archived: Hunters Oak Barn

Updated 2 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 7, 8 and 14 December 2016 and the first day was unannounced. The inspection was carried out by one adult social care inspector.

The provider sent us a Provider Information Return (PIR). This is a form that asks the provider to give some key information to us about the service, what the service does well and any improvements they plan to make.

Before the inspection we reviewed the information we held about the service such as notifications, complaints and safeguarding information. We reviewed the provider’s action plan, which had been regularly updated with actions they had taken to meet legal requirements We contacted the local authority contract monitoring team and commissioning team for information about the service. We received positive feedback from one social care professional.

During the inspection we spoke with the registered manager, deputy manager and four support workers. We also spoke with three people using the service.

We looked at a sample of records including care plans, risk assessments and other associated documentation, training records, a selection of staff files, minutes from meetings, medication administration records, policies and procedures, service user guide and records of audits. We looked around the premises.

Updated 2 February 2017

We carried out an announced inspection of Hunters Oak Barn on 7, 8 &14 December 2016. The first day was unannounced.

We last visited Hunters Oak Barn on the 6, 7, and 11 April 2016 and found breaches to legal requirements. These breaches related to the environment, staffing, person centred care and quality monitoring. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to Regulation 9, 12, 15 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

During this inspection we found the provider had taken action and significant improvements had been made. However further improvements are required and we have made recommendations regarding this.

The service Hunters Oak Barn is registered to provide nursing and personal care and support and accommodation for 12 people who have a mental health diagnosis. The property Hunters Oak Barn is a converted barn situated in a rural area of Burnley. Facilities include single occupancy bedrooms, lounge and recreational areas and a swimming pool. There are two bungalow type properties on site for people preparing for independent community living. At the time of our visit there were 4 people accommodated at the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We noted risk assessments had been carried out on the environment. Action had been taken to reduce the level of risk through modification of the environmental hazards identified at our last inspection.

People living in the home said they felt safe with the staff who supported them. There were enough staff on duty; however there were times when support from a Nurse was provided by a two tier contact system for out of hours.

Safeguarding adults’ procedures were good and staff understood how to safeguard the people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

People's medicines were managed appropriately and people received their medicines as prescribed by health care professionals. People were supported to manage their medicines safely.

Risk assessments were in place to keep people safe and these were kept under review. Staff had a good understanding of risk management. People were encouraged to live their lives the way they chose and were supported to recognise this should be done in a safe way.

People were cared for by staff who had been recruited safely and was trained and supervised in their work.

The registered manager and staff had training on the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was familiar with the process to follow should it be necessary to place any restrictions on a person who used the service in their best interests.

People were encouraged to take control in meeting their nutritional needs. They were involved in menu planning, food preparation and cooking as part of their rehabilitation. Staff had been trained to care for people with an eating disorder.

We saw significant improvements in respecting people’s privacy. People could no longer access other people’s rooms and the management of people’s property in their absence was good. Therapeutic one to one sessions were held in private.

Each person completed a Values and Planning in Social Care, referred to as VALS planner, with staff. This acknowledged people as individuals and helped them to plan their support in a holistic way and placed them at the centre of their care and support. These were kept under review.

We found staff were respectful to people, attentive to their needs and treated people with kindness and respect in their day to day care. Care plans were written with sensitivity to reflect and to ensure basic rights such as dignity, privacy, choice, and rights were considered at all times. Staff were knowledgeable about people’s individual needs, backgrounds and personalities

Confidentiality was a key feature in staff contractual arrangements. This helped to make sure information shared about people was on a need to know basis.

People told us about the type of activities they took part in with staff support. The range of activities on offer was impressive and staff helped people to acquire new skills that would prepare them for independent living and give them confidence. For example, workshops were arranged to support people to apply for jobs and charity work was encouraged.

People considering moving into the home had an assessment of their needs prior to staying at the home. We found improvements were needed to ensure that care is given when determining the suitability of a person referred to the service to avoid a breakdown of the placement.

People were given additional support when they required this. Referrals had been made to the relevant health and social care professionals for advice and support when people’s needs had changed.

People told us they were able to raise any issue of concern with the manager and staff and that issues they raised would be looked at. People were not always confident issues they had raised were taken seriously, however we saw evidence the registered manager followed the complaints procedure to resolve the issues they had raised. People had also been encouraged to express their views and opinions of the service through regular meetings, care reviews, and during day to day discussions with staff and management.

We found significant improvements in how the systems in place to monitor the quality of the service to ensure people received a good service that supported their health, welfare and safety were conducted. We found regular quality audits and checks were completed to ensure any improvements needed within the service were recognised and appropriate action taken in a timely way.

Policies and procedures needed updating to include first aid that included a mental health focus and an admission policy. The service user guide needed updating to reflect accurately as to the arrangements in place for nursing care being provided.

The registered manager expressed commitment to the on-going improvement of the service. Issues we found as concerns during this inspection were acknowledged and the action planned to bring about an improvement was discussed.