Barrington Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People’s relatives told us they thought their family members were safe living at Barrington Lodge. Comments included, “[Family member] has to be hoisted at all times and I have watched staff in action. They always make sure [family member] is safe and comfortable first and foremost,” “I can honestly say they are safe and well looked after,” “I think there are sufficient staff numbers, together with staff who know people well, to ensure they are safe and well cared for.” Throughout our inspection we noted people looked safe, happy, content and well cared for. We saw staff were supporting people appropriately and there were always staff members in the communal areas to support people. Relatives confirmed people were all treated with respect and supported in their lifestyle choices.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s feedback and that from their relatives was used to identify improvements to the service. Annual feedback surveys were carried out and action plans drawn up to inform what improvements were necessary.

Staff and the managers told us comprehensive audits were regularly carried out across a range of activities in the home and where lessons needed to be learned they were discussed in staff meetings and in staff supervision. Staff told us they were encouraged to contribute their views as to how the service could be improved to ensure it was safe and effective.

There was a system for recording and acting upon significant events, accidents and incidents. There was evidence of learning from these and action plans and reviews were in place to ensure improvements were sustained.

People told us they felt safe living at Barrington Lodge, they told us if they felt insecure, staff assistance was always there to help and support them. People were complimentary about the staff team. Relatives of people confirmed this and they told us they felt there family members were safe because of the systems of care established and operating in the home by staff.

Staff told us they received good, useful training that prepared them for the work they undertook in the home. This included safeguarding, moving and handling, person centred care, effective communication and health and safety amongst other topics that helped to ensure people’s safety. The managers confirmed the training as described by staff and this was also evidenced in the training matrix and in the log of incidents and accidents.

Organisations the service worked in partnership with told us liaison with the service was excellent and they were kept informed and involved at every stage.

The home had appropriate policies and procedures in place that staff were required to read and sign to say they understood their responsibilities within the policies and procedures.

People told us they felt safe and would be able to speak to staff or to the managers if they were worried or concerned. People were happy, comfortable, and relaxed in their interactions with staff. Comments included “ I do feel safe, they are very good,” and “I would talk to manager she is always here or one of the other staff members,” and “I don’t have a problem telling staff if things aren’t right but I haven’t had to.” Comments from relatives included, “I never have a worry in this respect, [family member] has been safe to date,” and “I can’t praise the staff enough, staff handle [family member] well, they accept the challenge of looking after a person with dementia”.

Staff were aware of their responsibilities to safeguard people from abuse and any discrimination and knew of the signs of abuse and how to report safeguarding concerns. They were confident the managers would address any concerns regarding people’s safety and well-being and make the required referrals to the local authority. A staff member said, “We get safeguarding training, we also get updates of any changes, the training is good.” Another staff member said, “I’d inform the managers and document everything. I have never seen anything that worried me," and "If I witnessed abuse, I would report to manager and then safeguarding, and a meeting would be held. I would feel comfortable raising issues." Staff were aware of the different types of abuse regarding people with fluctuating capacity, One staff member said " We make sure they have care when they need it, if they refuse, we offer it later, everyone is accepted and I have had never witnessed any discrimination in the home."

There was a safeguarding and whistleblowing policy which set out the types of abuse, how to raise concerns and when to refer to the local authority. Staff confirmed that they had read the policies as part of their induction and training. Staff received training in equality and diversity awareness to ensure they understood the importance of protecting people from all types of discrimination. The provider had an equalities statement, which recognised their commitment as an employer and provider of services to promote the human rights and inclusion of people and staff who may have experienced discrimination due to their ethnicity, religion, sexual orientation, gender identity or age.

Risks to people’s safety were managed well, with no unnecessary restrictions. One person said, “Staff keep an eye on me, they are looking out for me and to make sure I am safe.” A relative told us, “They closely monitor [family member]. The staff are very alert. I think that helps people to move about safely.” Another relative said, “I know from coming here there are a few people that move around a lot. But the staff are always close by and keeping an eye on people when they are moving, so all areas are covered.”

Staff received relevant training to help them keep people safe at the service. This included training on equipment used to support people, for example, hoists to help people move and transfer safely. The registered nurse said, “I observe people and use this to inform people’s care records and risk assessments and our plans for how people will be supported to reduce these. For example, we are getting in the right equipment and staff know how to use this properly. We have regular training on the equipment and on moving and handling.” Staff understood risks posed to people and explained to us in detail, the action they would take to reduce the risk of injury or harm, so that people could do the things that mattered to them.

We observed people were supported to do the things they wanted to do and staff helped them to do this safely. For example, when one person wanted to take part in an activity, staff made sure they could move safely to where this was taking place. Staff were kind and patient and explained to the person what they were doing and made sure the person understood they did not have to rush and could move at their own pace.

People’s care records contained current information about identified risks to their safety. This meant staff had up to date information about the action they should take to manage these risks and keep people safe. Changes in people's risks were promptly identified and referrals to health care professionals were made in a timely manner. Processes and systems such as handovers, care record reviews, ‘residents’ meetings and keyworker support helped ensure risks continued to be managed safely and were effective in enhancing people’s lives. In addition, the service worked alongside families, significant others and health and social care professionals to help provide a holistic approach to risk management. Written accident and incident documentation records were completed. There was evidence of learning from incidents and changes were implemented. Monthly audits helped staff identify trends to avoid further recurrences.

People felt the environment was safe. One person commented on how they had regular fire drills. People’s relatives told us they thought the environment was safe and well maintained.

Staff received regular training in fire prevention, they confirmed there were regular fire drills and fire alarm tests. Staff felt the home was safe for people and they told us they carried out risk assessments for people to help maintain their safety both in the environment and out in the community. We saw evidence in people’s care plans and risk assessments that supported this.

We noted the home was safe, well maintained and comfortable for people to live in. People were happy and there was a comfortable and friendly atmosphere in the home when we visited. Some people’s rooms were personalised to suit their wishes but others could be improved in this respect. The deputy manager told us this would be addressed immediately and by the second day of our inspection some of the rooms identified had been personalised as required. The managers told us they would ensure peoples rooms would be decorated in this way going forward.

There were audits and checks taking place to ensure the environment was safe. A fire risk assessment was in place and fire drills were held so that staff were able to support people appropriately in the event of an emergency. Fire equipment was regularly maintained and serviced. Some fire extinguishers had recently been replaced following a maintenance check. Environmental audits took place to check for areas requiring improvement. People had personalised evacuation plans in place so that staff knew how they needed to be supported to safely evacuate the building.

People and their relatives told us there were always enough staff who were knowledgeable and well trained and who provided safe and effective care for people living at Barrington Lodge. We observed there were good numbers of staff on duty who knew people well. Relatives told us when they visited their family members there were sufficient numbers of staff on duty to meet people’s needs. Comments received from relatives were positive and reflected a caring and responsible attitude that staff had in caring for their family members. Staff were seen to answer call bells promptly and there was always staff in the communal areas to support people if they needed it. People and relatives told us they felt staff were equipped with the necessary skills to support people safely and effectively. Comments included, “They are competent and know what is needed to help people” and “They [staff] know what to do and seem to be well trained.”

A training matrix was in place that evidenced staff received all the training referred to above. Accident and incident reporting processes were in place, understood by staff and maintained to date. There was evidence of robust recruitment procedures. All potential staff were required to complete an application form and attend an interview, so their knowledge, skills and values could be assessed. The provider undertook checks on new staff before they started work. This included checking their identity, their eligibility to work in the UK, obtaining at least two references from previous employers and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable people. There were systems in place to review staffing levels against people’s dependency, these were reviewed regularly and inline with people’s changing needs.

There were sufficient numbers of staff on duty to meet people's needs safely. Staff rotas evidenced there were enough staff on duty at all times.

A training matrix was in place that evidenced staff received all the training referred to above. Accident and incident reporting processes were in place, understood by staff and maintained to date. There was evidence of robust recruitment procedures. All potential staff were required to complete an application form and attend an interview, so their knowledge, skills and values could be assessed. The provider undertook checks on new staff before they started work. This included checking their identity, their eligibility to work in the UK, obtaining at least two references from previous employers and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable people. There were systems in place to review staffing levels against people’s dependency, these were reviewed regularly and inline with people’s changing needs.

People’s relatives told us they thought the home was clean and well maintained. They said they were happy that their family members were kept safe in this respect. Comments from relatives included: “The building is fairly old and needs constant maintenance, but the care provided is excellent,” and “People are kept as safe as possible in the home. Staff use PPE, such as gloves and hand sanitizer and seem [as far as I can tell anyway] to follow infection control guidance”, “It [the home] always seems clean. I haven’t noticed any bad smells and I visit each week” and “People are kept as safe as possible by staff.”

Staff told us they received good training in infection control and food hygiene that was regularly refreshed and which helped them maintain good practices in these areas of infection control. Staff were well aware of their responsibilities to ensure good practice and adherence to the policies and procedures in place.

We undertook a tour of the premises and found them to be well maintained and tidy, clean and free from infection. Inspection of fridges and freezers demonstrated food was labelled with opening dates as required.

There was an up-to-date infection control and food hygiene policy in place that staff were aware about. Barrington Lodge recently received a 5 star rating from Environmental Health for food hygiene. Staff received training in infection control and food hygiene that was refreshed regularly. Appropriate cleaning schedules were in place and carried out to help minimise the risk of infections.

People told us that staff supported them with their medicines and as prescribed by their GP. Registered nursing staff told us they were responsible for administrating people’s medicines and were fully aware of the actions they were required to take when there were specific considerations such as with people's PRN medication. Staff told us they regularly liaised with health professionals for advice. Health professionals we spoke with confirmed this. We spoke with 2 GPs who supported people at Barrington Lodge and both were very positive about staff practices to do with people’s medicines. They also told us staff in the home liaised appropriately with them and this they said contributed to good coordinated joint work. This has helped to keep people healthy and safe.

Staff were aware of the actions to take when there were particular considerations with people's medication. For example, the action required after a person had a fall when a person was taking anticoagulants. Staff were able to describe the action they had taken when a person's medicines had run out. This included speaking with medical professionals for advice.

Appropriate policies and procedures were in place for staff to follow to ensure the safe administration of medicines to people. Staff received appropriate training. Regular medicines audits took place to identify any areas for improvement. We reviewed the most recent of these audits. Competency checks were completed for staff responsible for administering medicines.