CQC report explained · a residential care home
What the CQC found at Barley Brook
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staff knew how to report abuse, medicines were managed safely and there were enough staff. Some emergency evacuation plans needed more detail, and the manager said these would be updated.
- Effective?
- Good
- People's needs and choices were assessed, staff were trained and supported, and legal safeguards were managed effectively. People received food, drink and healthcare support, although some food and fluid records were incomplete or inaccurate.
- Caring?
- Good
- This question was not inspected during this focused inspection. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused inspection. The previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- The home had audits and improvement plans, but these did not always find problems in care records and supplementary charts. The service had not completed its planned resident and relative survey during 2022.
What inspectors found, December 2022
Barley Brook was rated Good overall; inspectors found safe, effective care, but leadership and record keeping needed improvement.
This was a focused inspection after concerns were received about medicines, equipment, legal safeguards, nutrition and personal care. Inspectors visited on 16 and 21 November 2022, spoke with people, relatives and staff, and checked care, medicines and management records.
People said they felt safe and were supported by staff they knew. Inspectors found safe medicines management, enough staff, suitable safeguarding training, good infection control and support with food, drink and healthcare. They found no evidence that the reported concerns had put people at risk of harm.
The main weakness was management oversight of records. Some care plans contained incorrect or conflicting information, and food, fluid, repositioning and personal care charts were not always completed properly. The overall rating stayed Good, but Well-led fell from Good to Requires Improvement. Safe and Effective remained Good.
People felt safe
People and most relatives said the home felt safe and that staff were approachable and supportive.
“People told us they felt safe living at Barley Brook and received support from staff they felt comfortable with.” from the report
Safe medicines
Trained staff administered medicines safely. Records showed medicines were given at the right time, including controlled medicines.
“Medicines were managed safely by staff who had received training and had their competency assessed.” from the report
Food and healthcare
People were happy with the food and received support to eat and drink. Staff arranged medical and specialist support when needed.
“People told us they were happy with the food provided and received enough to eat and drink.” from the report
Good infection control
The home was clean, staff used protective equipment and infection control procedures were in place.
“The home was clean with effective cleaning and infection control processes in place.” from the report
Staff training
Staff received training and supervision to help them work safely and effectively. Training completion was monitored.
“Staff received enough training and supervision to ensure they could carry out their roles safely and effectively.” from the report
Incomplete care records
needs fixingSome care plans contained incorrect or conflicting information. Food, fluid, repositioning and personal care charts were not always completed consistently, making it harder to confirm that care was provided as planned.
“Supplementary charts had not been completed consistently. The provision of modified diets was not recorded on food charts consistently, as such we were unable to confirm food was always prepared in line with guidance.” from the report
Checks did not find recording problems
needs fixingAudits and action plans were in place, but the checking systems had not identified the record-keeping problems found by inspectors. CQC recommended that governance processes be reviewed.
“Although these processes had identified a number of shortfalls, and action plans were in place, audits viewed had not identified issues we noted on inspection with record keeping.” from the report
Resident and relative surveys missed
minorSurveys had been completed in 2021, but none had taken place during 2022 at the time of inspection. The manager said this had been an oversight.
“However, none had occurred so far in 2022. The manager stated this had been an oversight and would ensure a survey was circulated as soon as possible.” from the report
- 01How are you now checking that food, fluid, repositioning and personal care charts are complete and accurate?
- 02How do you confirm that modified diets are prepared and recorded correctly for each person?
- 03What action has been taken since the inspection to correct inaccurate or conflicting care plan information?
- 04Has the resident and relative survey that was missed in 2022 now been completed, and what were the results?
- 05Has the manager's application to become registered been completed, and who currently oversees the home's quality checks?
This was a focused inspection of Safe, Effective and Well-led only; the other key question ratings were carried forward from the previous inspection when calculating the overall rating. This explanation was written from the published report of 29 December 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2021
Rated Good overall; inspectors found kind, personalised care and better management, but food and fluid records needed improvement.
This was an announced focused inspection on 17 June 2021. Inspectors spoke with people living at the home, relatives, staff and managers. They reviewed care records, monitoring charts and management records, and checked infection control.
People said they enjoyed living at the home. Staff knew people well, supported their choices and met their health needs. The home was clean, infection control was effective, and activities helped people stay socially involved.
Inspectors found that staff training, care planning and management systems had improved since the previous inspection. Food and fluid records were not always accurate or detailed enough, and oral care records also needed strengthening.
The overall rating changed from Requires Improvement to Good. Effective, Responsive and Well-led were rated Good. Safe was inspected only for infection control and was not re-rated, so its previous Good rating was carried forward.
Trained and supported staff
Staff received induction, training and supervision, and the provider monitored completion. Inspectors found the previous staffing breach had been resolved.
“Staff received the necessary induction, training and support to enable them to meet people's needs.” from the report
Personalised care
Care plans recorded people's life histories, likes, dislikes and preferences. Staff used this information to support people in line with their wishes.
“Care plans explained how people wished to be cared for and supported and included personalised information about people's life history, likes and dislikes.” from the report
Activities and relationships
People had access to varied activities and were helped to keep in touch with relatives during COVID-19 restrictions.
“During the inspection we observed people engaging in art & crafts, completing jigsaws, singing and playing bingo.” from the report
Improved management
Audits identified actions, which were added to an improvement plan and reviewed. Earlier governance and reporting breaches had been resolved.
“Actions identified through auditing had been added to the home's continuous improvement plan and addressed timely.” from the report
Infection control
Inspectors were assured that the home had suitable infection prevention arrangements, including PPE, testing, cleaning and visiting procedures.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Food and fluid records
needs fixingCharts did not always accurately show what people had eaten and drunk. Inspectors recommended using best practice so staff could clearly monitor daily fluid targets.
“We found these were not always reflective of what people had eaten and drank and needed to be more specific and detailed” from the report
Oral care records
needs fixingInspectors found that records did not always show when oral care had been completed, even though staff understood people's oral care needs.
“However, records of oral care completion required strengthening, to reflect the care provided.” from the report
Care plan review evidence
minorThe records did not always clearly show that people or relatives had been involved in reviewing care plans. The manager agreed to review this process.
“People and/or relatives' involvement in the review process was not always clear or evidenced on the electronic record.” from the report
- 01How do you record and check each person's daily food and fluid intake, including their target amount of fluid?
- 02How do you make sure oral care is completed and accurately recorded for each resident?
- 03How are residents and relatives involved in creating and reviewing care plans?
- 04What actions have been completed in response to the inspection's recommendation about food and fluid records?
- 05How do you check that updates in the electronic care planning system are easy for staff to find and read in the correct order?
This was a focused inspection of Effective, Responsive and Well-led, with infection control checked under Safe; Caring was not separately rated and other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 15 July 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Barley Brook
7 rated inspections over 8 years: the service has improved, from Inadequate to Good.
- December 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2021GoodSafe: Inspected but not ratedEffective: GoodWell-led: Good
- December 2020Inspected but not ratedSafe: Inspected but not rated
- February 2020Requires improvementdown from GoodSafe: GoodEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2014InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- October 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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