About the service: Barton House is registered to provide care with nursing to 15 people with mental health conditions including people with dementia and complex behaviours. At the time of our inspection, there were 14 people using the service.

People’s experience of using this service:

•Staff had received safeguarding training and knew how to keep people safe protecting them from harm or abuse.

•People’s risks to safety and well-being were assessed, recorded and reviewed to reduce the risk of avoidable harm occurring.

•Medicines were managed safely.

•Staff were suitably skilled to meet people’s needs.

•Assessments and care plans were person-centred.

•People received enough food and drink to meet their dietary requirements.

•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.

•People told us that they enjoyed living at Barton House and that they were cared for by staff who treated them with kindness.

•Staff supported people to maintain their independence.

•Complaints were dealt with in a timely way and in line with the service’s policy.

•There were mechanisms in place to monitor the quality and safety of the service.

The service met the characteristics of Good in all areas; more information is in the full report

Rating at last inspection: At the last inspection, the service was rated as Good (Report published 25 June 2016)

Why we inspected: This was a planned inspection based on the date and the rating of the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

This inspection was unannounced and took place on 16 May 2016. Our last inspection took place in November 2013 and at that time we found the provider was meeting the regulations we looked at. The service was registered to provide accommodation for up to 15 people. The people who used the service had a wide range of complex needs. Some were living with enduring mental health issues; others were living with dementia that is often associated with younger people; and there were people who also needed support regarding their physical health needs. At the time of our inspection 15 people were using the service.

There was a registered manager in post. 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 safe and staff knew how to protect people from potential harm and abuse. Risks to individuals were managed and this was done in a way that enabled people to have control and freedom in their lives. There were enough staff to meet people’s needs and keep them safe. Guidelines were followed to ensure staff were suitable to work with vulnerable people and medicines were managed safely.

People were supported to make their own decisions and when people were not able to make certain decisions for themselves, we saw that decisions had been made in their best interests. When people who lacked capacity were being restricted to keep them safe, we saw these restrictions had been legally authorised.

Staff had the knowledge and skills needed to support people and meet their needs. People were supported to have enough to eat and drink and their health was maintained.

People were treated in a kind and caring way and their dignity and privacy were promoted and respected. Their independence was promoted and they were encouraged to make choices in their lives. Relatives were encouraged to take part in the planning of people’s care and visitors were made to feel welcome.

Staff knew people well and they received support that was individual to them. People were able to occupy themselves in activities that they were interested in. People were listened to and the provider had encouraged feedback and dealt with complaints when they arose.

People spoke positively about the home and felt that the management team were approachable and supportive. There were systems in place to monitor the quality of the service and the provider sought to drive continuous improvement.

We inspected Barton House Nursing home on a planned, unannounced inspection which meant the service did not know we were coming. We spoke with people who used the service, their relatives, the manager and staff throughout the inspection.

We found that people who used the service had consented to their care, treatment and support or had been supported to do so by significant others.

We saw that people’s care and welfare needs were being met and their cultural diversity was respected. One person told us: “I am happy here”.

We checked that the service was managing medication appropriately. We found the service had systems in place to ensure that medication was handled safely and securely.

We found that the service was following the correct recruitment procedures when employing new staff.

The service had a complaints procedure for people who used the service or their relatives to use if they felt the need to complain about the service.

We visited Barton House on a planned unannounced inspection which meant the service did not know we were coming.

When we arrived people who used the service were getting up, having breakfast alone or supported by staff. Everyone appeared happy and relaxed and dressed appropriately in their individual style.

The manager told us that they are new in post and not yet registered with CQC but has worked at the home for 12 months as a deputy manager. The proprietor joined us throughout the inspection.

We looked at four peoples care plans and risk assessments and identified that they were not written in a person centred format although on talking to the people that used the service and the staff, people were involved in the care they received and were given choices and their independence promoted. The manager showed us that she is currently in the process of changing the format of the care plans to evidence a person centred approach.

People who used the service told us they liked living there. One person told us '' They look after me properly and I have no complaints about anything''.

Relatives we spoke to spoke highly of the service. One relative told us '' They are looked after well'' and another told us '' The staff are very caring''.

People who used the service told us they went out, one person told us '' I go to the pub''. The manager told us they had been given extra staffing hours so people could access the community.