Barton Lodge

Updated 13 March 2021

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 looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 11 February 2021 and was announced.

Updated 13 March 2021

About the service

Barton Lodge is a care home that provides personal care for up to 11 older people. At the time of the inspection nine people were living at the service. Some of these people were living with dementia.

The service was last inspected on 28 November 2018. At that inspection the service was rated as Requires Improvement overall and for the key questions of Safe, Effective, Responsive and Well Led. Six breaches of regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were found.

Following the inspection in November 2018, we asked the provider to complete an action plan to show what they would do and by when to improve. This was completed and informed us what actions they would take and when these actions would be completed by.

At this inspection we found some improvements had been made. However, we continued to find issues of concern. Therefore, the service has remains as requires improvement.

The registered manager had been working with the local authority quality improvement team to embed positive changes. The registered manager said they had been supported by the provider. The registered manager was also the registered manager of the provider’s other service situated in the same town.

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

The service was still not always safe. Some improvements had been made including improving risk assessments for people and staffing levels at night. However, we found people did not always received their medicines safely, staff still had not completed safeguarding or infection control training, the hallway carpet presented a trip hazard, and some rooms had an odour.

The service rating certificate was displayed in the main entrance hallway. However, this was from the inspection completed in 2016, rather than for the last inspection in 2018. This stated the overall rating was Good. Where the last inspection, dated 2018, the service received an overall rating of Requires Improvement.

We were concerned about the level of activities available at the service. For example a relative said there was very little in the way of activities carried out. During our two days at the service no activities where completed until the final hour of our visit. An activity coordinator had been employed since the last inspection but was currently off. No other arrangements had been made to cover activities.

People and their relatives told us they were happy living in the home. Staff told us they enjoyed working at the service. Many people chose to spend time in their bedrooms. Staff were caring, however spent little time chatting and enjoying their time with people as they moved around the service.

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.

Improvements to the environment were still ongoing. For example, a new chair lift had been fitted. However, this left a carpet on the main stairway with holes in which could be dangerous for people due to multiple trip hazards. The registered manager confirmed a new carpet was on order.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. A visiting professional said the service contacted them appropriately and completed all actions requested.

Records of people's care were individualised and reflected each person’s needs and preferences. The service was in the process of introducing a new computerised care planning system. Some records were not available on the day of inspection due to the changes taking place.

Some risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. Staff were responsive to people’s requests and gave people choice and control over their care.

People were involved in menu planning and staff encouraged them to eat a well-balanced diet and make healthy eating choices.

People received support from staff who cared about them. People were supported to express their views in the way they wanted to. People and their families were given information about how to complain and details of the complaint’s procedure were displayed at the service. The management and staff knew people well.

People, their relatives and staff told us the management of the service were ‘hands on’, approachable and listened when any concerns or ideas were raised. However, we found there was a lack of oversight and sufficient knowledge regarding the regulatory requirements of the service, this placed people at risk of avoidable harm.

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 Requires Improvement (published 6 February 2019) and there were multiple breaches of regulation. The provider was required to send us an action plan detailing the improvements they had identified and what action they had taken as a result. We have reviewed this report.

At this inspection not enough improvement had been made and the provider was still in breach of regulations. The provider therefore remains as Requires Improvement.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment, premises and equipment, notifications, displaying ratings, and good governance.

Please see the action we have told the provider to take at the end of this report.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good and request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.