Barford Court

Updated 3 December 2020

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.

As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.

This inspection took place on 19 November 2020 and was announced.

Updated 3 December 2020

This inspection took place on 12 October 2017 and was unannounced. Barford Court provides accommodation for up to 40 people, who have residential or nursing needs, and people living with dementia. There were 39 people living at the service on the day of our inspection. The service was adapted to provide a safe environment for people living there. Bathrooms were specially designed and doors were wide enough so people who were in wheelchairs could move freely around the building. Accommodation was provided over two floors and split into four units.

This is the first inspection of the service since there was a change in legal entity.

Barford Court belongs to the organisation (provider), The Royal Masonic Benevolent Institution Care Company (RMBI). The Royal Masonic Benevolent Institution Care Company has many care homes throughout England, providing dedicated care to the Masonic community.

There was a registered manager for the service. 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.

Staff told us the service had been through a significant period of change, with a new registered manager and deputy manager, a number of changes of staff working in the service and difficulties in recruiting care staff, which had resulted in a high use of agency staff. There was an open culture in the service and this was promoted by the management team who were visible and approachable. One member of staff told us, “It’s a great team I really enjoy it here.”

People's individual care and support needs were assessed before they moved into the service. People and their relatives told us they had felt involved in making decisions about their care and treatment and felt listened to. Care and support provided was personalised and based on the identified needs of each individual. Personalisation and person centred care focuses on people having choice and control in their life was at the forefront of the delivery of care. There was an outstanding focus on providing care and support that focused on the need of the person but empowered their individuality and identity. The service had achieved an accredited award from Dementia Care Matters. With pride, staff told us how they had implemented the Butterfly approach and provided high quality care to people living with dementia. People’s care and support plans and risk assessments were detailed and reviewed regularly giving clear guidance for care staff to follow. People’s healthcare needs were monitored and they had access to health care professionals when they needed to.

People told us they felt safe. When asked what the service did well one person told us, “Ensure medications are given on time, they keep me safe, they are good listeners and they give me drinks frequently.” Another person told us, “I feel safe we are looked after very well.” They felt it was somewhere where they could raise concerns and they would be listened to. Policies and procedures were in place to safeguard people. Staff were aware of what actions they needed to take in the event of a safeguarding concern being raised. Medicines were stored correctly and there were systems to manage medicine safely. Audits and stock checks were completed to ensure people received their medicines as prescribed. There was a maintenance programme in place which ensured repairs were carried out in a timely way, and checks were completed on equipment and services. There was an ongoing improvement plan in place to maintain and develop the environment. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

Consent was sought from people with regard to the care that was delivered. All staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Staff told us they always asked for people’s consent before they provided any care and support.

People, relatives and staff felt staffing levels were sufficient but there could be room for improvement. The management team monitored people’s dependency in relation to the level of staffing needed to ensure people’s care and support needs were met. People were cared for by staff who had been recruited through safe procedures. Recruitment checks such as a criminal records check and two written references had been received prior to new staff working in the service. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff. Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They felt they knew people’s care and support needs and were kept informed of any changes. They confirmed that they felt valued and supported by the managers, who they described as very approachable. They told us the team worked well together.

People were treated with respect and dignity by the staff. They were spoken with and supported in a sensitive, respectful and professional manner. One person told us, “Yes, people around are very caring.” People’s nutritional needs had been assessed and they had a selection of choices of dishes to select from at each meal. People said the food was good and plentiful. Staff told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted about their food preferences.

People and their representatives were asked to complete a satisfaction questionnaire, and people had the opportunity to attend ‘residents and relatives’ meetings. We could see the actions which had been completed following the comments received. The registered manager also told us that they operated an 'open door policy' so people living in the service, staff and visitors could discuss any issues they may have. One member of staff told us, “I had a feeling there was something special here and it stands out in a crowd. I am happy here it’s a good home and it’s improving. She (the registered manager) is trying to make sure it is working properly.”