CQC report explained · a residential care home
What the CQC found at Barley Close
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found safeguarding concerns, unexplained bruising that was not always investigated, medicine errors and risk plans that had not always been followed. They also found that safety practices and medicine administration had improved recently.
- Effective?
- Good
- This question was not inspected during this focused visit. Its rating carried over from the previous inspection.
- Caring?
- Good
- This question was not inspected during this focused visit. People spoken with said they were happy, and inspectors saw respectful and compassionate interactions.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its rating carried over from the previous inspection.
- Well-led?
- Requires improvement
- Inspectors found inconsistent leadership and ineffective quality checks. A new management team had stabilised the home and most actions in its improvement plan had been completed, but further work remained.
What inspectors found, June 2023
Rated Requires Improvement; inspectors found serious safety and leadership problems, although improvements were under way.
This was an unannounced focused inspection. Inspectors visited on 12 May 2023 and reviewed Safe and Well-led because of concerns about safeguarding, risks, medicines, staffing and management. They spoke with people, relatives and staff, observed care and checked records.
The home was not always safe. Inspectors found unexplained bruising that had not always been investigated, medicine errors, poor medicine records and occasions when people's risk plans were not followed. The service was also in a whole-service safeguarding process led by the local authority.
Leadership and checks on quality were not effective. There had been four home managers since 2022, and problems had not been identified or dealt with quickly enough. The provider had brought in a new management team and had completed most of an improvement plan, but 42 actions were still in progress or being monitored.
The overall rating fell from Good at the previous inspection to Requires Improvement. Only Safe and Well-led were inspected at this visit. The other question ratings carried over from the previous inspection.
Kind relationships
People said they were happy, and inspectors saw warm, respectful interactions. People appeared relaxed and trusting with staff.
“People clearly trusted staff; they were happy and relaxed in their company.” from the report
Recent improvements
The provider had brought in a new management team, added staff support and mentoring, and completed most of a large improvement plan.
“The provider had taken action to mitigate the risks and these were effective.” from the report
Safe recruitment
New staff had the required pre-employment checks, including criminal record checks and references. The home also provided a formal induction.
“All required pre-employment checks were carried out including criminal record checks and obtaining satisfactory references from previous employers before new staff started work.” from the report
People's choices
Staff supported people to make decisions and respected their preferred ways of communicating. Relatives were involved in best-interest decisions when needed.
“People were supported to make as many of their own decisions as possible.” from the report
Safeguarding and unexplained injuries
seriousPeople had not always been protected from avoidable harm, abuse or neglect. Records about unexplained bruising were poor, and some bruising had not been investigated.
“There were examples where unexplained bruising had not been investigated to find out the cause.” from the report
Medicine safety
seriousThere had been repeated medicine errors over a sustained period. People had sometimes missed medicines, received the wrong dose or been put at risk by poor practice.
“This had led to numerous errors being made over a sustained period of time.” from the report
Leadership and oversight
seriousFrequent management changes and ineffective quality checks allowed poor care and unsafe practice to continue. The provider still needed to complete and monitor improvement work.
“The provider had failed to ensure effective governance and oversight of the service.” from the report
- 01What evidence can you show that all remaining medicine improvements are complete and that errors have not recurred?
- 02How are unexplained bruises, accidents and safeguarding concerns now recorded, investigated and reviewed?
- 03What is the current plan for appointing and retaining a registered manager?
- 04Which of the 42 improvement actions were still in progress or being monitored, and what are their completion dates?
- 05How are staff checked to make sure they follow each person's risk assessment, including eating, drinking and bathing plans?
This was an unannounced focused inspection of Safe and Well-led only; the other question ratings carried over from the previous inspection. This explanation was written from the published report of 16 June 2023 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, January 2019
Rated Good, down from Outstanding; inspectors found kind, personalised care, with some records and planning needing attention.
Inspectors visited without warning on 14 December 2018 and returned on 17 December 2018 with notice. They spoke with relatives, staff and professionals, observed care, reviewed four people's care plans and checked medicines, staffing, recruitment and management records.
The home supported eight people with learning disabilities and autism, although it was registered for up to 10 people. Inspectors found enough trained staff, safe medicines arrangements, personalised support and respectful care. People were supported to make choices, stay independent, keep relationships and take part in activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Safe and Effective remained Good. Caring, Responsive and Well-led fell from their previous ratings, and the overall rating fell from Outstanding to Good. Inspectors found no evidence of serious risks or concerns.
Kind and respectful care
Inspectors saw warm, patient support and a relaxed atmosphere. Staff understood people's communication and emotional needs.
“Staff interacted with people in an extremely kind, inclusive and caring way.” from the report
Personalised support
Care plans recorded people's preferences, abilities and routines. Staff used this information to support everyday choices and independence.
“People had person centred care plans that included their needs, abilities, life history, preferences and people important to them.” from the report
Meaningful activities
People took part in activities at home and in the community that matched their interests and abilities.
“Staff supported people to enjoy a wide range of activities both in the home and the community.” from the report
Skilled staff
Staff received induction, supervision and training related to people's individual needs, including autism, diabetes and behavioural support.
“Staff were trained to meet people's specific needs.” from the report
Safe arrangements
Inspectors found suitable staffing, recruitment checks, medicines procedures and individual risk assessments.
“There were enough staff to meet people's needs in a timely way.” from the report
One expired legal authorisation
needs fixingOne person's authorisation for restrictions on their liberty had expired two weeks before the inspection. The manager said a renewal application would be made, and the report says this was later applied for.
“When we raised with the registered manager that one person's DoLS authorisation had expired two weeks prior to the inspection they told us they would apply to have this renewed.” from the report
Some communication plans needed review
minorSome communication plans were due to be reviewed. The manager said this would be actioned.
“Some of the communication plans were due for review and the registered manager said they would action this.” from the report
End-of-life planning had not been fully considered
minorThere was no one receiving end-of-life care during the inspection. The report says this had not been actively considered for most people, although planning had started for one person.
“Given the age of most people at the home end of life care had not been actively considered” from the report
Recent management changes
minorThe home had been without a deputy manager for about seven months. A deputy had been in post for six weeks when inspectors visited.
“The home had been without a deputy manager for approximately seven months” from the report
- 01Have all current Deprivation of Liberty Safeguards authorisations been renewed and checked for expiry dates?
- 02Which communication plans were due for review, and have they now been updated?
- 03How are you developing end-of-life plans and recording each person's wishes?
- 04How has the new deputy manager affected staffing, leadership and continuity of care?
- 05What changes were made after the rating fell from Outstanding to Good?
This was a planned inspection covering all five quality areas, including care practice, people's records, medicines, staffing, the building and how the home was managed. This explanation was written from the published report of 25 January 2019 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 Close
3 rated inspections over 7 years: the service has slipped, from Outstanding to Requires improvement.
- June 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Gooddown from OutstandingSafe: GoodWell-led: Good
- June 2016OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- July 2014
Registered with the Care Quality Commission on 21 July 2014.
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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