We carried out a review of the data available to us about Barlavington Manor on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Barlavington Manor, you can give feedback on this service.
We found the following examples of good practice.
The provider had followed current guidance in relation to infection prevention and control (IPC). The service had an IPC champion who ensured staff maintained effective IPC measures and accessed current guidance.
The provider facilitated safe visiting arrangements; a variety of visiting areas were available. Visitors were requested to wear PPE and show proof of a negative lateral flow device (LFD) test prior to entering the service.
Staff had received training which included infection prevention and control, how to safely put on and take off personal protective equipment (PPE) and hand hygiene. Staff were observed to wear their PPE appropriately.
The registered manager had implemented enhanced cleaning schedules to incorporate regular cleaning of high touch areas and additional deep cleaning.
The registered manager told us they had been well supported by the provider. The registered manager belonged to local healthcare professional and management support groups to share ideas and provide mutual support.
We found the following examples of good practice.
The service was clean and tidy and specific processes were followed to ensure all cleaning tasks were consistently completed. This included frequent disinfection of areas which were regularly touched, for example, door handles and hand rails.
Hand-washing facilities were available, and visitors had their temperatures taken and completed either a questionnaire, or signed in to an online track and trace device before entering the service. Personal protective equipment (PPE) was available throughout the service.
The registered manager and staff completed detailed risk assessments for both people living at the service and staff to ensure their safety. In depth analysis of COVID-19 testing was in place, so that the registered manager had a full record of test results for people and staff. The registered manager also worked closely with other stakeholders, such as the Local Authority and Public Health England.
Staff were wearing appropriate PPE in-line with government guidelines. Staff had completed infection prevention and control (IPC) training. The registered manager had undertaken additional IPC training to support staff with best practice.
Further information is in the detailed findings below.
Barlavington Manor is a residential care home providing personal care for up to 57 people aged 65 and over. At the time of our inspection, 53 people were in residence. The home consists of two parts: residential care in the 'Main House' and specialist dementia care in the 'North Wing'. For the purpose of this inspection, we focused on only the North Wing.
People’s experience of using this service and what we found
People received kind and compassionate care. We observed people being well-supported, happy and engaged in a variety of activities.
Risks to people were managed safely. We saw risk assessments were in place and provided guidance to staff as how best to support people. For example, risk assessments around falls were in place alongside measures to minimise this risk. These risk assessments and measures were effective in reducing the number of falls people experienced. Staff knew people well and demonstrated a good knowledge of how to keep people safe. Suitable quality assurance systems were in place to identify and address any areas of concern.
Staff were appropriately trained in administering medicines. We saw a specific system was used to monitor the use of as and when (PRN) medicines. The service had good working relationships with external services, e.g. the GP, to ensure that people’s needs were met.
The service was clean and tidy, including people’s bedrooms. There were good infection control measures in place and staff were seen to be using Personal Protective Equipment (PPE) appropriately.
People, relatives and staff spoke positively about the leadership in the service. One relative told us, “I always get updates. The manager is proactive and a good communicator. I’m 100% happy and wouldn’t want [relative] to be anywhere else.” One staff member told us, “I feel very supported here, the registered manager is really approachable.”
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 25 October 2019).
Why we inspected
We undertook this targeted inspection in light of some specific concerns we received about people’s care and cleanliness of the home. Concerns included assessment of risk around falls, use of as and when (PRN) medicines and personal and oral care. We also had concerns around quality assurance and management oversight of the service.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. Due to this, the overall rating for the service has not changed following this targeted inspection and remains Good.
We looked at infection prevention and control measures under the key question, Safe. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Well-led sections of this full 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.
Barlavington Manor is a residential care home providing personal care for up to 57 people aged 65 and over. At the time of our inspection, 53 people were in residence. The home consists of two parts: residential care in the 'Main House' and specialist dementia care in what is known as the 'North Wing'. There are also a number of bungalows located in the grounds, but these did not form part of our inspection since people living there do not receive personal care from the service. The home is situated in a rural location, close to the town of Petworth.
People’s experience of using this service and what we found
Without exception, everyone we spoke with talked about the outstanding care they received at Barlavington Manor. Everyone was happy to be living there and spoke positively about all aspects of the service.
Staff had excellent knowledge of people and there was a focus on the individual and on tailoring care and providing activities which were meaningful to them. One relative told us, “They know my Mum, they know her quirky ways and what she wants”. Group and individual activities were supported, according to what each person enjoyed. People we spoke with were clearly delighted by the activities and outings they had been a part of.
People received high quality care that improved their wellbeing. Staff actively supported people to remain independent and to retain their mobility. One relative spoke emotionally about how much better their loved one was since moving to the home earlier in the year.
People's communication needs were identified and planned for. People expressed confidence they could raise any issues or concerns with any member of staff or the management team and these would be addressed.
People could spend the rest of their lives at the home, if their needs could be met and this was their wish. Staff worked proactively with healthcare professionals to facilitate this.
Strong relationships were formed between staff and people due to the continuity of staff and the very caring approach of staff members. There was a homely welcoming atmosphere at the service and we observed very positive and caring relationships between people and staff. People were encouraged to be involved in decisions relating to their care and were treated with dignity and respect.
People spoke positively about the staff who supported them and had confidence in their skills and experience. A community nurse said, “The residents speak highly of the team and love the staff. Staff are always friendly”. Staff had regular supervisions and an annual appraisal. People enjoyed the food and were able to make suggestions for changes to the menu. Snacks and drinks were readily available throughout the day.
Care staff were well informed about risks to people's health or wellbeing and knew how to deliver their care safely. Staffing levels were enough to meet people's needs. Medicines were managed safely. The home was clean, and staff had been trained in infection prevention and control. Lessons were learned if things went wrong.
People had access to a range of healthcare professionals and support. Premises were suitable and comfortable and met people's needs. The environment in the North Wing was carefully adapted to support the needs of people living with dementia. People spoke enthusiastically about the gardens and we saw people enjoying the outdoor space.
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.
There was strong and effective leadership and everyone we spoke with said they would recommend the home. Staff said it was the best place they had worked. The service was well organised and had a range of systems in place to ensure its smooth operation and to support good communication. Feedback from health and social care professionals who worked closely with the service consistently indicated that staff went the extra mile to deliver person centred care.
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 2 February 2017).
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 reinspection programme. If we receive any concerning information we may inspect sooner.
Barlavington Manor is a care home registered to provide accommodation and personal care for up to 64 people. The home consists of two parts: residential care for 35 people known as the ‘Main House’ and specialist dementia care for 21 people in what is known as the ‘North Wing’. There are also a number of bungalows located in the grounds but these did not form part of our inspection since people living there do not receive personal care from the service. The home is situated in a rural location, close to the town of Petworth. At the time of our visit, there were 56 people living at the home. The registered manager explained that they would be able to accommodate a maximum of 58 people. We will work with the provider to ensure that their registration information is updated to reflect this change.
At the last inspection, in October 2014, the service was rated ‘Good’. At this inspection, we found that the service remained ‘Good’. Furthermore, the registered manager had overseen improvement in the two areas we found in breach of regulations at our last inspection. The first was to ensure staff acted in line with the Mental Capacity Act 2005 (MCA) in gaining consent from people or acting in their best interests. The second was in how people’s care needs were recorded. We found that action had been taken in both areas and that the requirements were met.
The service has 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.
Feedback from people, relatives and professionals was very positive. People told us they felt safe at the service, that they enjoyed support and friendship from a regular staff team and that they were regularly asked for their views and opinions. One person told us, “I love it here. The staff are so good and it makes me feel safe”.
People told us that they felt safe at the service and that staff treated them respectfully. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed. People received their medicines safely.
People had developed good relationships with staff and had confidence in their skills and abilities. There was an established team of staff at the home, which offered continuity of care for people. Staff had received training and were supported by the management through supervision. Staff were able to pursue additional training which helped them to improve the care they provided to people.
People were involved in planning their care and staff understood what was important to them. Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).
People enjoyed home-cooked food and were offered a varied menu. Staff were attentive and supported those who required assistance to eat or drink.
Staff responded to changes in people’s needs and adapted care and support to suit them. Where appropriate, referrals were made to healthcare professionals, such as the GP, community nurses or CPN and their advice followed.
People were supported to participate in activities that interested them. There was a full activity programme on offer at the home which people told us they enjoyed. People who were not able to join in group activities were supported on a one to one basis by staff.
There was strong leadership within the home. The registered manager monitored the delivery of care and had a system to monitor and review the quality of the service. Suggestions on improvements to the service were welcomed and people’s feedback encouraged through regular meetings and surveys.
The inspection took place on 27 October 2014 and was an unannounced inspection.
Barlavington Manor is a care home providing accommodation and personal care for up to 64 people. The home consists of three parts: residential care for 35 people, specialist dementia care for 21 people and eight places in bungalows located on the site. Personal care is not provided to people living in the bungalows. The focus of this inspection was on the residential and dementia care parts of the service. At the time of our visit, there were 63 people living at the service.
The service has 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 living in the dementia care part of the service may have been unlawfully deprived of their liberty. A deprivation of liberty occurs when the person is under continuous supervision and control and is not free to leave, and the person lacks capacity to consent to these arrangements. The door to this part of the service was secured using a key coded lock. The registered manager was aware of a revised test for deprivation of liberty following a ruling by the Supreme Court in March 2014 but told us they had not yet taken action in respect of this. As the registered manager had not carried out assessments in line with the Mental Capacity Act (MCA) there was a risk that people could be deprived of their liberty without appropriate safeguards in place.
Where people lacked the capacity to consent to decisions relating to their care or treatment, the registered manager was unable to demonstrate that best interest decision making procedures had been followed. This is a breach of the regulations because suitable arrangements to establish and act in accordance with people’s wishes were not in place. You can see what action we told the provider to take at the back of the full version of the report.
There was a regular team of staff, some of whom had worked at the service for many years. Staff knew people well and understood how they liked to be supported. New and temporary staff told us that they received clear information on how to support people and were kept up to date at regular handover meetings. At our inspection in December 2013, the provider had recently introduced electronic care records. These were not yet fully completed. We informed the provider that the lack of clear guidance could put people at risk of not having their needs met in the most appropriate way. People’s care records still did not always include details of people’s preferences or detail on how staff should meet their needs. This is a breach of the regulations. The lack of accurate records meant that people were at risk of receiving care that was inappropriate or unsafe. You can see what action we told the provider to take at the back of the full version of the report.
People, their representatives, staff and visiting professionals spoke positively about the service. One person said, “There’s nothing compares with this one”. Two professionals told us that they wouldn’t hesitate to choose Barlavington Manor should they or a loved one require residential care. The atmosphere was warm and friendly. People and staff knew each other well and had developed friendships.
People felt safe. A range of staff, including domestic and activities staff, were employed. There were enough staff on duty to promote people’s safety. Staff were also able to spend time with people on a one to one basis, to share a drink or have a chat. Risks to people’s safety were assessed and reviewed. Any accidents or incidents were recorded and reviewed in order to minimise the risk in future. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse. People received their medicines safely and at the right time.
People had access to healthcare professionals, such as the GP, physiotherapist and dietician. Staff made timely referrals to these and other services to ensure their healthcare needs were met.
People were treated with kindness and respect. We observed staff as they supported people to move around the service, participate in activities or eat their meals. Support was given in a caring way that helped people to maintain their independence as far as possible. One person said, “For kindness you can’t beat them”.
The service was well organised. Staff, including agency staff, were clear on what was expected of them. There were clear schedules of work to ensure that people received the care and support they needed. Staff were satisfied with the training that they received and felt confident to approach the registered manager or provider if they had any concerns or ideas to share.
People told us that they enjoyed the gardens and that they were also able to access the local town and join trips out to other places of interest. The premises and facilities were well maintained. In the dementia care part of the service, action had been taken to promote people’s independence by providing visual references such as memory boxes and brightly coloured handrails to aid visual perception.
There was a varied activity programme. On the day of our visit people were engaged in organised activities such as Pilates or pumpkin carving, as well as routine daily tasks such as folding napkins or wiping place mats. While there was plenty going on, we found that some people with particular interests could have been better supported to pursue these.
People, their representatives and staff were asked for their views on how the service was run and were invited to make any suggestions for improvement. When the registered manager received feedback, they took appropriate and timely action to rectify any problems and to evaluate suggestions. The registered manager kept a record of compliments received. In one card sent following the summer barbeque, we read, ‘The event was really splendid and a great credit to the teamwork of the staff’.
The registered manager had a system to monitor and review the quality of care delivered. This included audits on areas such as premises and medicines, along with spot checks on staff as they supported people. When we provided feedback after our inspection, the registered manager took immediate action to make improvements in the areas we had identified.
We gathered information from a variety of sources. These included talking with five people who lived at the home and three relatives. We spoke with the unit manager and four members of staff. We also spoke with the home manager by telephone following our visit. As some people were unable to tell us about their care and support we completed a 30 minute observation using our Short Observational Framework Inspection (SOFI) tool. This tool is designed to help us understand the quality of care that people receive. We also left comment cards for people to complete if they wished to inform us of their views on the home. Seven people returned completed comment cards.
Everyone told us that they were happy with the care and support they received. One said, 'Staff are very friendly and the food is good'. Another told us, 'I feel free'. Relatives were complimentary about the home. One said, 'All the staff are extremely pleasant and very helpful, I'd give it an 'A star'. A member of staff who had worked at the home on a temporary basis commented, 'I have found Barlavington one of the best homes for people with dementia. They have good activities and stimulate them, have a good chat and live in a comfortable, safe environment'
People told us that they were happy with the support they received from the home to access healthcare professionals.
The provider had an effective system to regularly assess and monitor the quality of dementia care that people received. This included seeking the views of people who used the service and acting upon their wishes.
During our observation we saw that staff interacted well with people when they were supporting them. We saw that staff were knowledgeable about people's needs and preferences. We found staff were respectful and maintained people's dignity, privacy and independence. For example staff knocked on people's door before entering and they checked that their choice of food remained the same.
Staff told us that people in the dementia unit were asked which colour they wished their door to be painted in order to help them find their way back and retain their independence.
We were shown examples of person centred care records which were well organised into separate sections. This provided clarity for staff. These have been developed for each individual and documented their wishes and preferences in relation to how their care was provided. A relative's assistance was sought with this where the person was unable to fully contribute themselves.
Equality and diversity had been considered in the service by looking at each individual's needs. Any equipment or adaptations needed were provided.
We spoke with a member of the community nursing team and we were informed that the home was very organised and called quickly if they were concerned about any person. She summed up by saying 'They are brilliant'
We visited both units in the home. In the unit which provided care for people who have dementia, people were not able to tell us about their experience.
To help us to understand the experiences of these people we have used our Short Observational Framework for Inspection (SOFI) tool. This tool allowed us to spend time watching what was going on in the service and helped us to record the type of support people get and whether they have positive experiences.
We spent 30 minutes watching care provided to five people in the dining room during lunchtime. We found that overall people had positive experiences.