Smugglers Barn

Updated 1 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by two inspectors. One inspector was present on the second day of the inspection.

Service and service type

Smugglers Barn is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Smugglers Barn is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was not a registered manager in post. A new manager has recently started at the service.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service since the last inspection. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 4 relatives about their experience of the care provided. Some people were unable to communicate with us directly, so we undertook a number of observations to see how staff supported and interacted with them. We spoke with 8 members of staff including the new manager, interim manager, 2 area directors and 4 support workers. The interim manager was in place to support the new manager who, at the time of the inspection, had been in post for two weeks.

We reviewed a range of records. This included 6 people's care records and medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. After the inspection, we contacted 2 professionals who have a working relationship with the service.

Updated 1 April 2023

About the service

Smugglers Barn is a residential care home providing personal care to 9 people at the time of the inspection. The service can support up to 9 people. The home is comprised of 2 separate houses in close proximity, Smugglers Barn and Little Smugglers, these are both under the same registration with CQC.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support

Staff supported people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests. Whilst some people were supported to achieve goals, staff did not always focus on people’s strengths or promote what they could do, so people could have a fulfilling and meaningful everyday life. There were missed opportunities to apply active support approaches. 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.

Right Care

People’s needs and preferences were known by caring staff, but inconsistencies in the oversight of peoples care plans meant that information was not always updated and correct. People were supported by staff who delivered kind and compassionate care. Staff promoted equality and diversity in their support for people. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff understood how to apply the principles of safeguarding people, and how to recognise and report abuse. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Right Culture

Managers and staff were working together towards improving the culture of the service. The service had experienced a number of management changes since the last inspection. Whilst staff and people’s relatives said that positive elements had resulted from the current management, the inconsistency and uncertainty of leadership since the last inspection had impacted on the service fully addressing concerns previously raised about people’s support. Positive steps had been taken by leadership to address these concerns although this required consistent management to be in place to fully implement and embed them.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 5 July 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, although some improvements had been made and the provider was no longer in breach of regulations, some improvements were still needed.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We carried out an unannounced focused inspection of this service on 11 and 15 February 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. 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 Smugglers Barn on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.