About the service Barling Lodge is registered to provide accommodation and personal care for up to a maximum of 47 people. The service is set over two floors, with a large courtyard garden. On the day of our inspection, there were 11 people living at the service who required support with their physical and mental health needs.
People’s experience of using this service and what we found
At this inspection, we looked at all of the key questions and checked whether the provider had made the necessary improvements to ensure people were safe and received good quality care.
Improvements had been made to the service. This included people’s risk assessments and care plans, the environment, staff skills and training, people’s nutrition and hydration, access to healthcare and specialist services, staff communication and engagement with people and audits and quality assurance. However, further improvements were needed.
A quality assurance processes was in place and being monitored. However, the provider had introduced a significant number of new systems and processes which needed to be fully embedded to evidence that these new systems would continue to work effectively, be sustainable and improve the quality of life for people using the service.
We made a recommendation in the last report that the provider source the provision of training for staff in the Mental Capacity Act 2005. Whilst staff had undergone training in areas relating to their role, the provider was still in the process of sourcing this provision so the recommendation we made at the last inspection remains.
We made a recommendation in the last report that the provider seeks guidance from a reputable source in relation to end of life care. Whilst staff had undertaken training in end of life care, care plans were in the process of being updated with relevant details. This recommendation is to remain until improvements have been made.
There were limited opportunities for people to participate, engage or be involved in group or individual social and leisure activities and for them to access resources in the community.
We made a recommendation that the provider consider best practice guidance and resources to support people to pursue social and leisure interests of their choice.
People told us they were safe using the service. Risks to people’s health and safety were assessed and recorded and staff knew how to manage them to keep them safe. People were supported by enough staff who had been safely recruited. People’s medicines were safely managed by staff who were trained and competent. People were protected from the risk of infection as prevention and control measures were in place.
Staff received an induction, training and supervision and had relevant skills and knowledge to do their job. Improvements to the environment continued to be completed through an ongoing improvement plan. People had access to a range of food and drink which met their needs and preferences. Referrals to health care professionals were made in a timely way to maintain people's health and wellbeing.
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. People who required support with decision making had access to advocacy services if required.
Staff were kind and caring and knew people well. Staff treated people with dignity and respect and maintained their privacy. People were encouraged to be as independent as possible and were supported to maintain important relationships.
People’s care are plans had been reviewed and updated and were more person centred. They outlined people’s physical, health and mental health needs, their wishes and preferences. Work was ongoing in updating and exploring people’s life histories. A complaints process was in place, with no outstanding complaints.
The director and their deputy manager were aware of their role and responsibilities and supported a consistent team of staff well.
Rating at last inspection
In November 2018, we undertook a comprehensive inspection and looked at all key questions. There were multiple breaches of the regulations. The service was rated as Inadequate and the report was published on 10 January 2019. We returned in February 2019 to follow up some concerns and Safe and Well led remained Inadequate. The report was published 14 May 2019. When we visited in June 2019, improvements had been made and Safe and Well led was rated as Requires improvement. The report was published 22 August 2019.
The provider completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The overall rating for the service has changed from Inadequate to Requires improvement. This is based on the findings at this inspection.
This service had been in Special Measures since 10 January 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk