Barton Brook Care Home

Barton Brook is a care home in Salford which is registered with CQC to provide care for a maximum of 120 people, across 4 separate ‘Houses’. These include Monton (EMI Nursing), Moss (Residential Dementia), Brindley (Nursing) and Irwell (Nursing). There were 110 people using the service at the time of the inspection.

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

Not all risks were well managed at the home including those relating to falls, skin integrity and the environment. Staff did not always respond appropriately when physical and verbal altercations occurred between people living at the home. We have made a recommendation about staff receiving further safeguarding training. Actions following incidents weren’t always followed through. We received poor feedback about staffing levels within the home and observed staff weren’t always available to respond to people’s needs. There were a number of environmental concerns observed on some of the units which could place people at risk of harm.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. There were a number of restrictions in place for people including 121 care, the use of covert medication and sensor mat/chair alarms. We also observed people’s movements around one of the units being prevented. MCA assessments were not? completed to ensure this was in people’s best interests.

People’s bedrooms were not always personalised and some felt unhomely. The external grounds of the home were not well maintained, with lots of stray litter scattered around and overgrown grass. There were a number of instances where people’s dignity was compromised where staff did not always respond accordingly.

People’s care plans contained contradictory details and this posed the risk of staff not having the correct information regarding the care people needed. Activities and stimulation for people was limited. Nobody was receiving end of life care at the time of the inspection, although we received feedback from the local authority that attendance at their training sessions could improve. People’s communication needs were not always met.

There had been a lack of leadership at the home in the past 12 months, with 5 different home managers in post. Leadership on each of the individual units was also a concern. Meetings for resident/relatives and staff had not been taking place consistently, although had now been scheduled to take place. Staff supervisions and appraisals did not always take place consistently. There had been a failure to ensure compliance with regulations and the ratings for each of the key questions had declined.

Rating at last inspection

The last rating for the service was requires improvement (Published July 2022).

Why we inspected

We carried out an unannounced focused inspection of this service on in May 2022 and a breach of regulation 17 regarding good governance was identified. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance systems within the home.

We undertook this inspection to follow up on specific concerns which we had received about the service including staffing, safeguarding, falls management and leadership. A decision was made for us to inspect and examine those risks.

We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements. We inspected and found additional concerns which could impact people’s safety, so we widened the scope of the inspection to become a comprehensive inspection which included the key questions of effective, caring and responsive (in addition to safe and well-led).

The overall rating has changed from requires improvement to inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Barton Brook Care Home on our website at www.cqc.org.uk.

Enforcement and recommendations

We identified breaches regarding dignity and respect, consent, safe care and treatment, safeguarding, good governance and staffing. We have also made recommendations regarding safeguarding training, activities and complaints.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Barton Brook Care Home is a nursing and residential home located in Salford, Greater Manchester and can accommodate up to 120 older people. The home is operated by Ultimate Care Limited, part of the We Care Group. At the time of this inspection there were 94 people living at the home. There are four units at the home known as Brindley, Irwell, Monton and Moss.

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

Accurate and contemporaneous records were not always maintained regarding people’s care. This included medication records, food/drink and re-positioning charts. This meant we couldn’t always determine if people were receiving the care they required. We have also made a recommendation regarding governance systems within the home.

People who used the service and relatives said they felt the service was safe. Staff were recruited safely and there were enough staff to provide people’s care. Staff carried out routine COVID-19 testing and there was enough personal protective equipment (PPE) available which people confirmed was always worn.

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. People received enough to eat and drink and said provided assistance as needed. Staff told us enough training was available to support them in their roles, with ongoing supervision also provided.

We received positive feedback from people who used the service and relatives about the care provided. People said they felt treated with dignity, respect and had their independence promoted as required.

People had detailed care plans in place regarding the care and support staff needed to deliver. There was an appropriate complaints system. We received mixed feedback from people about the provision of activities within the home.

There were systems in place for people who used the service and staff to provide feedback about their care through audits, surveys and meetings. Staff spoken with during the inspection told us they felt the service was well-led and enjoyed their roles.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 13 April 2022 and this is the first inspection. The last rating for the service under the previous provider was good, published on 22 October 2018.

Why we inspected

The service had not received a rating since registering with CQC on 13 April 2022. The inspection was also prompted in part due to receiving a number of safeguarding concerns about the home, although these had occurred under the previous provider. A decision was made for us to inspect and examine those risks, as well as the safety of other people living at the home.

We looked at infection prevention and control measures under the Safe key question. 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 COVID-19 and other infection outbreaks effectively.

The overall rating for the service is requires improvement. This is based on the findings at this inspection.

We identified a breach of good governance and found evidence that the provider needs to make improvements regarding record keeping. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.