This inspection took place on the 17 August 2017.

Barrington Lodge is registered to provide residential and nursing care for up to 44 older people, some of who are living with dementia. There are seven places in the service for people requiring rehabilitation. This intermediate care service provides people with additional support on discharge from hospital, before returning home; or sometimes as an alternative to a hospital admission. Accommodation is arranged over three floors and there is passenger lift access. There were 35 people using the service at the time of our inspection which included seven people staying for rehabilitation.

At the last inspection in 2015, the service was rated Good. At this inspection we found the service remained Good. The provider demonstrated they continued to meet the regulations and fundamental standards.

The service continued to be kept clean, safely maintained and furnished to comfortable standards.

People continued to feel safe and well cared for at Barrington Lodge. Relatives shared similar confidence in the service. Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse.

Assessments and care plans included person centred information about people’s needs and explained the support people required for their physical, emotional and social well-being. Risks to people’s health and safety were managed and staff took action to minimise these. People’s care records were updated to reflect any changes and ensure continuity of their care and support.

At the time of our inspection there were enough staff to meet people’s needs and keep them safe. Appropriate recruitment checks were completed to make sure staff were suitable to work at the home. Staff received a planned induction and ongoing training to fulfil their roles and keep their knowledge and skills up to date.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff showed understanding, patience and treated people with respect and dignity.

People's wishes, choices and beliefs were reflected in their care plans. They were supported to make decisions and staff promoted their independence as far as possible.

Activities were varied and arranged according to people’s needs and interests. There were meaningful activities for people living with dementia and staff understood the importance and benefits of social interaction for everyone using the service.

The service promoted and supported people's contact with their families. Relatives visited regularly and were encouraged to share their views and opinions. People and relatives felt involved in the way the home was run. They knew how to complain and make suggestions, and were confident their views would be acted upon.

People were supported with their dietary and health needs. There was a varied daily choice of meals and people were encouraged and supported to eat and drink well. Staff took prompt action when people became unwell or were at risk from poor nutrition. They consulted other healthcare professionals to ensure that people received the additional support they needed. Medicines were managed safely and people had their medicines at the times they needed them.

The atmosphere in the service continued to be welcoming, open and inclusive. The registered manager showed effective leadership and people, relatives and staff told us the home was well run. Staff were clear about their roles and responsibilities and felt supported by management and each other.

The provider continued to use effective systems to monitor the quality of the service and make improvements when needed.

We had previously undertaken a scheduled inspection of Barrington Lodge in May 2013. At that time we judged that the home was meeting the essential standards of quality and safety. We undertook this additional inspection of the service because, since that time, some concerns had been raised. These included concerns that people were being not being able to choose how they spent their days, about the numbers of staff available to support people and the meals that people were served. We also shared this information with the local authority who undertake their own inspections of the services that they use.

We were able to speak to the registered providers, four other members of staff, six people who were using the service and three relatives who were visiting. All of the feedback we received was positive. People told us that they were free to spend their days as they wished to. Relatives confirmed that they were always welcome in the home and kept informed of any changes in people’s healthcare needs. People told us that staff were ““lovely”, “very approachable” and “very kind”. They told us they never had to wait long for help when they needed it. Relatives confirmed that staff were always visible in the home and there seemed to be enough of them.

All of the people we spoke with told us that they enjoyed the meals they were served, there was always a choice and any special dietary preferences were catered for.

When we visited Barrington Lodge Nursing Home there were 35 people living there. Some of them were not able to communicate with us due to their frailty or dementia however, we were able to speak with 10 people. We also spoke with six relatives who were in the home. Everyone we spoke with was positive about their experience. They told us “staff are so kind, really lovely” and “they’re all so caring”. One visitor we spoke with told us “I am so impressed; nothing is ever too much trouble for them, even when they are really busy”. People who were not able to contribute to the inspection process were engaged with the staff and their surroundings and showed signs of positive wellbeing

The home was acquired by new providers last year and there had been a significant programme of redecoration and refurbishment. People and relatives commented on how nice the home looked now.They told us that the providers, one of whom is the manager, were frequently in the home and very approachable. They had no concerns about going to them if they had any problems or suggestions.

There was a continuing programme of staff development in place to ensure that staff all had the necessary skills to support the people living in the home.

We carried out this inspection on the 30 June and 8 July 2015. The aim of the inspection was to carry out a full comprehensive review of the service and to follow-up on the eight requirement actions made at the previous inspection on 28 and 29 October 2014. After this inspection, the provider wrote to us to say what they would do to meet the legal requirements by the 29 May 2015. At this inspection we found the provider had followed their action plan and improvements had been made in the required areas.

Barrington Lodge is registered to provide residential and nursing care for up to 44 older people, some of who are living with dementia. There are 12 places in the service for people requiring rehabilitation. This intermediate care service provides people with additional support on discharge from hospital, before returning home; or sometimes as an alternative to a hospital admission. Accommodation is arranged over three floors and there is passenger lift access. There were 35 people using the service at the time of our inspection which included nine people staying for rehabilitation.

The home had a registered manager who was also one of the registered providers. 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 protected against the risks associated with the unsafe use and management of medicines. Improved arrangements were in place for the recording, safe keeping and administration of medicines. New audit systems had been introduced and regular checks were being carried out.

At this inspection we found improvements in care planning. Care plans were up to date and reflected the needs of people whose care we focused on. Individual plans were more personalised and detailed, meaning that staff knew what was important to people and how they preferred to receive their care and support. People’s health, care and support needs were assessed and reviewed in a timely manner. External professionals were involved in people’s care so that individuals’ health and social care needs were monitored and met.

Staff recruitment practices had been strengthened and appropriate procedures were followed to make sure suitable staff were employed to work at the home.

More activities were provided for people that met their needs and choices. A new activities coordinator had been employed to facilitate this.

People spoke positively about the quality of the food and choices available and were provided with homemade, freshly cooked meals each day. Menus had improved and included visual prompts to assist people living with dementia in choosing meals.

At the last inspection the provider was not meeting the requirements of the Mental Capacity Act 2005 including the Deprivation of Liberty Safeguards (DoLS). This provides a legal framework to help ensure people’s rights are protected. Staff had completed training about this and understood their responsibilities where people lacked capacity to consent or make decisions.

Action had been taken to make the complaints system more effective. The procedure had been updated and was prominently displayed in the reception area. Complaints had been investigated and there was monthly auditing to make sure that lessons could be learnt. People could therefore be assured that complaints would be investigated and acted on as necessary.

The provider had also strengthened the arrangements to monitor the quality of the service and involved the people using the service, their relatives and staff to make improvements. The provider listened and acted upon their feedback.

There was more openness and transparency in how the home was managed. People and their relatives were comfortable to raise any issues and felt they were listened to. Staff were clear about their roles and responsibilities and felt supported by management.

There were positive and caring relationships between staff and people who lived in the home and this extended to relatives and other visitors. Staff treated individuals and their guests with respect and courtesy and maintained people’s privacy and dignity at all times.

The provider worked in partnership with key organisations to support care provision and service development. There was effective communication between the home and community intermediate care service team and the manager had been working with the local authority to enhance staff training.