CQC report explained · a residential care home
What the CQC found at Barton House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2021
Requires Improvement; inspectors found kind and effective care, but medicines, care records and quality checks were not reliable enough.
This was an unannounced focused inspection on 5 and 7 May 2021. Inspectors spoke with people, relatives, staff and professionals. They reviewed care records, medicine records, staff recruitment files, training information and quality checks.
People generally said they felt safe, happy and well cared for. Staff knew people well, healthcare professionals were involved quickly, food and communication were viewed positively, and infection control had improved. The service had not experienced COVID-19.
However, some care records did not contain important information about people's needs. There were also gaps in medicine management, staff training for specific health tasks and checks on visitors and new admissions. The manager took action during the inspection, but the systems had not yet been fully put into practice.
The overall rating stayed at Requires Improvement. Safe was Requires Improvement, effective improved to Good, and well-led improved from Inadequate to Requires Improvement. Caring and responsive were not assessed during this focused inspection, so their previous ratings were carried forward.
Staff knew people well
People said they were happy, safe and well looked after. Staff showed they understood people's needs and worked to support good outcomes.
“People described being happy, safe and well looked after by the staff.” from the report
Food and drink
People and relatives liked the food and said there was plenty to eat and drink. Staff offered choices and recorded food and fluid intake.
“People told us they had enough to eat and drink and liked the food.” from the report
Improved consent and staff support
The home had addressed earlier concerns about consent, staff supervision and training. People were involved in decisions, and staff received regular supervision.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 11.” from the report
Clean home and improved laundry
The laundry had been refitted and the home was clean. Cleaning of frequently touched areas was taking place regularly.
“The home was clean and free of any adverse odours.” from the report
Incomplete care records
seriousSome care plans did not reflect important current needs. This included missing information about a catheter and a person's skin care needs.
“Some people's care plans had not been updated to ensure they were accurate and reflected people's specific needs.” from the report
Medicine management
seriousSome instructions and records for medicines taken when needed were missing or incomplete. Stock checks also did not initially account for medicines given by community nurses.
“The folder that contained people's medicine administration records (MARs) was missing several protocols” from the report
Specific training gaps
seriousStaff taking blood sugar readings had not received the necessary training or competency checks. Training for catheter care was also still being arranged.
“Staff were taking the above person's blood sugar but had not received any training or had their competency checked.” from the report
Quality checks missed problems
seriousThe new auditing system had not yet become reliable. The manager did not have enough oversight to identify the care record and medicine problems before the inspection.
“We found the registered manager did not have sufficient oversight of audits relating to care plans and medicines.” from the report
Admission and visitor checks
needs fixingInspectors found that full protective equipment was not initially used for a new person in quarantine. Checks on visiting professionals were also not always completed.
“Robust checks were not always applied before visiting professional entered the home.” from the report
- 01Have all care plans been checked and updated so they include current needs such as catheter care and skin care?
- 02How are 'as required' medicines now recorded, including when they should be given and how staff know whether they were effective?
- 03Which staff have completed training and competency checks for blood sugar monitoring and catheter care?
- 04How does the manager now review care plan and medicine audits to make sure problems are found promptly?
- 05What checks are completed for new admissions and visiting professionals, including COVID-19 testing and protective equipment?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed and their previous ratings were carried forward. This explanation was written from the published report of 9 June 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.
What inspectors found, March 2020
Barton House rated Requires Improvement; inspectors found kind, responsive care but unsafe medicines management and inadequate leadership.
This was an unannounced inspection following the previous Requires Improvement rating. Inspectors spoke with people, relatives, staff and professionals. They reviewed care plans, medicines records, staff files and management records.
People said they felt safe and were happy with the care, cleanliness and food. Staff were kind and there were enough staff. Care planning and the way the home responded to people's needs had improved.
However, medicines records and stock checks were not reliable. There were safeguarding concerns, gaps in staff training and supervision, and weak checks by the management team. Some best-interest decisions were not properly recorded.
The overall rating remained Requires Improvement. Safe and Effective were Requires Improvement, Caring and Responsive were Good, and Well-led was Inadequate. The home had been rated Requires Improvement at the previous inspection and remained in breach of regulations.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw warm, good-humoured and respectful interactions.
“People told us staff were kind and caring.” from the report
Enough staff
Inspectors found enough staff to meet people's needs and spend time with them. People said staff were available when needed.
“There were enough staff to meet the needs of people.” from the report
Personalised support
Care plans had improved and included more information about people's preferences. Staff supported people to follow their interests and avoid loneliness.
“staff made efforts to engage them in the things they enjoyed.” from the report
Improved risk assessments
The home had improved its assessment of health and care risks identified at the previous inspection. Equipment and building checks had also improved.
“At this inspection we found there had been an improvement in the assessment of risk in the areas we identified at our last inspection” from the report
Medicines were not reliably managed
seriousRecorded medicine stocks did not match the actual amounts. There were missing administration entries, incorrect dates and one medicine had run out. This could make it unclear whether people received medicines as prescribed.
“People's medicines were not being managed safely.” from the report
Safeguarding gaps
seriousA suspected abuse allegation was not reported to the safeguarding authority. Not all staff had completed safeguarding training, which meant they might not recognise or report concerns properly.
“The service had failed to report to the safeguarding authority when an allegation of suspected abuse was made regarding a person living in the service.” from the report
Staff training and supervision
seriousTraining records showed significant gaps, including safeguarding and diabetes training. Staff had not received the second supervision expected under the home's arrangements.
“The provider monitored staff training on a training matrix. The training matrix provided to us identified significant gaps in the training staff had received.” from the report
Weak management checks
seriousThe home's audits had not identified several important safety and care concerns. The CQC found that provider and manager oversight was not effective enough.
“Quality assurance processes were not robust enough to identify areas of concern and then act to improve them.” from the report
Best-interest decisions
seriousFor some people who could not make particular decisions, records did not fully explain how decisions about measures such as sensor mats or bed rails had been made.
“The service did not fully record how these decisions had been made in their best interests.” from the report
Laundry infection control
needs fixingThe laundry had no clear separation between clean and soiled items. An overflowing bin of soiled linen created a cross-contamination risk, although the issue was corrected during the inspection.
“There were no clear boundaries for where clean and soiled items should be stored.” from the report
- 01What has been done to make sure medicine stocks and administration records are accurate every day?
- 02How do you now report suspected abuse and make required notifications to the safeguarding authority and the CQC?
- 03Which staff still need training, especially in safeguarding and diabetes, and how is completion checked?
- 04How are best-interest decisions about sensor mats, bed rails and other restrictions now recorded?
- 05What changes have been made to management audits so that medicines, infection control and safeguarding problems are found quickly?
This was an unannounced planned inspection covering the home's premises and care, with ratings assessed across all five CQC questions. This explanation was written from the published report of 18 March 2020 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 Barton House
4 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- June 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015
Registered with the Care Quality Commission on 1 July 2015.
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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Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
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