Bernhard Baron Care Home

Bernhard Baron Cottage Homes is a residential care home providing accommodation and support for up to 60 older people. At the time of the inspection there were 55 people living at the home. People were living with a range of needs associated with the frailties of old age.

The home includes 24 self-contained cottages and a main building with 36 bedrooms. The service is a registered charity and managed by a board of appointed trustees.

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

People received an exceptionally personalised service that met their specific needs, preferences and wishes. The service was led by people who lived at the home. They had forums which they led to consistently improve their day to day lives and other people’s lives. They developed, promoted and engaged in a wide range of activities that were meaningful to them and that they enjoyed. The activities ensured people continued to live useful and productive lives when they moved into the home. They also ensured people were able to develop new friendships, interests and hobbies.

Staff were kind and caring. They embraced the home’s Quaker ethos of treating everyone as an individual and fully respecting their choices and wishes. People praised staff for their kindness and support.

Staff understood the risks associated with the people they supported. Risk assessments provided further guidance for staff about individual and environmental risks. People were supported to receive their medicines when they needed them.

People were protected from the risks of harm, abuse or discrimination because staff knew what actions they should take if they identified concerns. There were enough staff, who had been safely recruited, working to provide the support people needed, at times of their choice.

Staff received training and supervision to help them meet the needs of people living at the home. Staff told us they were well supported by the registered manager and their colleagues.

People's health and well-being needs were met. They were supported to receive healthcare services when they needed them. People were supported to eat a wide range of healthy, freshly cooked meals, drinks and snacks each day.

The management team were well thought of. They were proactive in developing and improving the service. They ensured that changes and improvements were for the benefit of people and staff.

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.

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 20 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

The home had a registered manager. 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.

People who used the service said they were safe. Staff knew how to recognise the signs of abuse and what to do if they thought someone was at risk. However, not all of the appropriate recruitment checks had been completed before volunteers began work. A legionella risk assessment had not been completed and there was a potential of risk to the safety of people’s medicines management.

People gave us very positive feedback about the care they received. People were able to express their views and preferences about their care and these were acted on. People were treated with respect and their privacy was protected.

The provider, registered manager and staff made sure they supported people to live fulfilled and meaningful lives in the way they wanted to. An extensive range of meaningful and enjoyable activities was offered, and people gave us enthusiastic and positive feedback about the quality of their lives living at the home.

People’s care needs were regularly assessed and people were involved in making decisions about their care. People’s support needs were assessed and care plans were developed to detail how these needs should be met. Care plans were detailed which helped staff provide the individual care people needed. People knew how to make a complaint or raise concerns with the registered manager and told us these were acted on when they did so. There was an appropriate complaints system in place and any concerns raised had been thoroughly investigated.

People were asked for their consent appropriately and staff and the registered manager had a good understanding of the Mental Capacity Act 2005 (MCA). This legislation provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make decisions for themselves. Care workers knew that any decisions made on someone else’s behalf must be in their best interests.

There were enough staff to meet people’s care needs and staff had regular training, supervision and appraisal to support them. Staff gave positive feedback about the quality of the training and people who use the service said staff were well trained.

Incidents and accidents were thoroughly investigated and action taken to reduce the risk of them being repeated. The registered manager and staff understood the importance of learning from incidents so they could make improvements to the service.

People who needed it were supported to eat and drink enough and food was nutritious and well made. Staff knew what to do if they thought someone was at risk of malnutrition or dehydration. People gave us positive feedback about the food. People’s day to day health care needs were met.

The service was well led by a dedicated registered manager and management team. There was a commitment to provide high quality care which was tailored to people’s individual choices and preferences. Feedback from people who use the service, relatives and staff was positive, and staff felt well motivated and supported in their role.

The provider carried out audits to ensure people experienced safe and good quality care. People were asked for their feedback about the quality of the service, and where areas for improvement were identified appropriate action was taken.

The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us, "The care is excellent. I can't express the tender loving care that they give each one of us.' Another person who used the service told us, "The staff are lovely people and I have not had a moment of regret coming here.'

Staff we spoke with had a good understanding of the support needs of the people who used the service. One member of staff we spoke with told us, "I think the residents are happy with the care we provide.'

The people who use the service were supported to have adequate nutrition and hydration. People were given choices of food and drink to meet their diverse needs.

We saw evidence that the provider had an effective recruitment and selection procedure in place to ensure that staff were qualified to do their job.

The service had a system in place to effectively deal with comments and complaints.

We also saw that care plans, staff records and other records relevant to the management of the home were accurate, fit for purpose and held securely.

We found that comprehensive and well maintained person centred support plans enabled care workers to meet people's assessed needs in a structured and consistent manner.

Risk assessments and safeguarding policies and procedures ensured that people using the service were safe.

In accordance with their individual care plans, people were supported to make choices about their daily lives. They had input into how the home was run and were able to influence decision making processes.

Positive comments from people using the service and their relatives indicated a high level of satisfaction with the home and the services provided:

'It's just lovely here, everyone is so kind, they can't do enough for you. I have everything I need, including my family nearby'.

'My mother loves living here and she is so happy with her room. We are delighted with the care that she receives There's nowhere else like it'.

Appropriate arrangements were in place in relation to storing, administering handling and recording medicines.

We found that there were enough qualified, skilled and experienced staff in place to meet people's needs.

Care workers had developed awareness and a sound understanding of each individual's care needs. This was evident from direct observation of individuals being supported in a professional, sensitive and respectful manner.