This inspection took place on 28 August 2018 and was unannounced. We last inspected the home on 7, 8 and 20 February 2017. We found the provider was meeting the regulations and rated the home as overall ‘Good’.

Barnes Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates 89 people on three floors in one adapted building. When we inspected there were 54 people living at the home.

When we last inspected the home, we found it was not always well-led as there was no registered manager. We found the home now 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 and staff gave us mostly positive feedback about the management of the home.

Sufficient staff were deployed at the home to meet people’s needs. People told us staff responded quickly when they needed help. Staff also confirmed staffing levels were appropriate. We observed staff were available throughout the home to assist people should they need help. The registered manager monitored staffing levels to ensure they remained at a suitable level.

Medicines were managed safely. Records confirmed people received their medicines on time. Staff had completed specific training and checks were carried out to ensure they remained competent. The registered manager completed checks of the medicines systems to quickly identify and resolve any issues.

People and staff felt the home was a safe place. Staff had a good understanding of safeguarding and knew how to raise concerns if required. Staff told us they would not hesitate to use the whistle blowing procedure if they had concerns about a person’s safety. Previous safeguarding concerns had been referred to the local authority safeguarding team and thoroughly investigated.

Potential risks were managed and regular health and safety checks carried out to maintain safety in the home.

The registered manager analysed incidents and accidents that happened in the home. They had acted to ensure robust action had been taken to keep people safe and identify lessons learnt.

There were regular opportunities for people and staff to give feedback about the home. For example, regular meetings and formal consultation. The provider had a structured approach to quality assurance. Action plans were developed and progress was monitored.

Further information is in the detailed findings below.

Barnes Court Care Home is a purpose-built home with three floors. It provides care for people with complex physical and neurological needs on the ground floor, dementia care on the first floor and nursing care on the second floor. The home is registered for 89 places but only 66 places were available across the three units because the home no longer uses shared rooms. At the time of this inspection there were 57 people living at the home.

At the last inspection, on 8 October 2014, the service was rated Good. At that time we recommended the decoration was improved in one part of the building. During this inspection we found improvements had been made and were continuing in other parts of the home.

At this inspection we found the service remained Good.

People said they felt safe living at the home and were comfortable with the staff who supported them. Risks to people’s well-being were managed and health and safety checks of the premises were carried out. There were sufficient staff to meet people's needs and they were vetted to make sure they were suitable. People were supported with their medicines in a safe way and a new electronic system was being introduced to reduce the chance of any mistakes.

Staff said they were well trained and supported in their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People received the right support with their nutritional and dietary needs. They were assisted to access health services when they needed them.

People and relatives told us all the staff were friendly, caring and helpful. They said staff treated them with dignity and respect. People told us staff protected their privacy when supporting them with personal care.

People received care that was individual to their needs and wherever possible they were involved in planning their own care. Staff were knowledgeable about people’s needs and preferences. There was a range of activities for people to join in if they wanted.

At the time of this inspection the manager had been providing relief management cover for five months since the previous manager left. The manager was in the process of applying to the Care Quality Commission to be registered as manager.

People, relatives and staff felt there an open and friendly culture within the service. They were asked for their views about the home and these were used to improve the service. The provider had thorough quality assurance checks to make sure the service was safe for people.

Further information is in the detailed findings below.

We visited Barnes Court after receiving information suggesting that people were being made to rise early and then put back into bed fully dressed to make it easier for the day staff. We arrived at 5:30am and spoke with night staff then day staff during the visit as well as people living in the home and visitors.

Some people could not give us their views but we spoke with a number of people during the visit both individually in their bedrooms and in groups who could tell us what they thought. Those people we spoke with said they were happy with the service and the staff were "Really nice and helpful” and "Approachable".

We saw people making choices in their day to lives, including when they wished to get up and what they wanted for breakfast. The care records showed peoples preferences and the staff showed knowledge of peoples usual habits although they still asked them for their choices on the day.

A relative told us they were confident their family member was being looked after; they said the staff were "Really good and always do their best", another said they were “Pleased with the changes made recently".

Peoples care records were detailed, up to date and gave the staff information on how they could meet their needs. They were written in a way that described how a person would want their needs to be met and focused on them as individuals. The staff told us about the care they provided to people and this matched with the care records and the care we observed.

One person who we spoke with told us “they manage medicines well” and “they always ask me if I need a new inhaler”. One relative who we spoke with had no concerns regarding management of healthcare or medicines.

Overall, we found that medicines were managed in a safe way.

We carried out an inspection in January 2013 and found improvements were needed. People were not protected from the risk of infection, they did not have an effective quality assurance system and appropriate records were not maintained. The provider sent us an action plan outlining the steps they would take to address these shortfalls and at this visit we looked at what improvements had been made.

We spoke with two people living in the home, they said its “Much nicer”. One relative we spoke with described some of the redecoration as being “Brighter and cleaner looking”.

Staff had completed infection control training and understood what they needed to do. Cleaning schedules used by staff were checked daily by the housekeeper and then signed off by senior staff. A program of deep cleaning had been completed. Barnes Court was clean tidy and odour free on our visit. The manger told us he was confident checks and audits would identify areas not being maintained to acceptable standards.

Care plans were up to date, detailed and specific to the persons individual needs, they were reviewed at least monthly and more frequently if needs or circumstances changed. We found short term needs, such as infections were also included.

We spoke with a visiting healthcare professional who commented positively on the improvements. They said, “It’s a joy to read the care records (on the first floor) because they give such a good picture of how the person has been and how they are now.

We undertook a visit as part of a compliance review for Barnes Court Care Home on 16 May 2012.

Due to the physical and mental health needs of the people living in the home it was not possible to get some people’s views. However we were able to speak to a number of the people living there and we spoke to visiting relatives, representatives and visiting professionals.

All of the people living in the home who we spoke with said they were happy with the service provided by the staff. A person living in the service told us that the staff were “lovely.” A visitor said, “things are much better than they used to be, it nice here for people now.“

One person said “its great here, I’m going to live her for the rest of my life. if they’ll let me”.

One visiting relative told us they were confident that their family member was being looked after but they thought that there could be a bit more for them to “do” although there were some things going on and that they acknowledged that some of the people did not want to participate in the organised activities. When we asked about the care being given to their relative, another person said, “the staff are really good with her.”

Barnes Court Care Home is a purpose-built home with three floors. It provides care for people with complex physical and neurological needs on the ground floor, dementia care on the first floor and nursing care on the second floor. It is situated in a residential area with good access to local shops and community amenities. The home is registered for 89 places but only 66 places were available across the three units because the home no longer uses shared rooms. At the time of this inspection there were 51 people living at the home.

This inspection took place over two days. The first visit on 1 October 2014 was unannounced which meant the provider and staff did not know we were coming. Another visit was made on 8 October 2014 to speak with the manager as she was unavailable on the first visit.

The last inspection of this home was carried out on 30 July 2013. The service met the regulations we inspected against at that time.

There was a registered manager for the home. 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 were positive about the service they received. People and their relatives felt the care service was safe. People felt they received attention in a timely way and that there were enough staff to meet their needs.

Staff were clear about how to recognise and report any suspicions of abuse. Staff told us they were confident that any concerns would be listened to and investigated to make sure people were protected. The provider made sure only suitable staff were employed. People were assisted with their medicines in the right way. The small number of people who looked after their own medicines were helped to do this in a safe way that promoted their independence.

People felt the standard of accommodation on the ground floor was good, but the second floor accommodation was in need of redecoration. The provider agreed this was an area that needed to be improved and had plans to do this in 2015.

People and visitors had confidence in the skills of staff to meet people’s needs.  Staff had the relevant training and support to care for people in the right way. Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision. People’s safety was protected without compromising their rights to lead an independent lifestyle.

People’s health care needs were continually assessed, and their care was planned and delivered in a way that met their individual needs. Staff were knowledgeable about people’s individual care needs and how they wanted to be assisted. People said any changes in their health needs were referred to the relevant health care services. Health care professionals said the home responded quickly to any changes in people’s well-being.

People were supported to eat and drink enough and they had choices about their meals. People and relatives felt staff were caring and kind. People were encouraged to make their own decisions and choices in a way that was meaningful to them. Staff understood what was important to each person and were familiar with their preferences. There was a sociable atmosphere in the home and there were warm and friendly interactions between people and staff. People had opportunities to join in activities or go out with staff from time to time. There were plans for this to be improved with new activity staff.  

People were asked for their views about the home and these were used to improve the service. People had information about how to make a complaint or comment and these were acted upon. People, family members and staff felt they could approach the manager at any time and said she was “helpful” and “supportive”. The provider had an effective system for checking the quality and safety of the service.