CQC report explained · a nursing home
What the CQC found at Barton Place Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2022
Rated Good overall; inspectors found safe, person-centred care, but staffing, family communication and audits still needed attention.
This was an unannounced focused inspection on 4 and 10 October 2022. Inspectors looked at Safe and Well-led because concerns had been raised about staffing, risk management, moving and handling, abuse, infection control and management. They spoke with people, relatives, staff and professionals, and checked care records, medicines records, recruitment files and training records.
The home was rated Good for Safe. Inspectors found that people felt safe, risks were assessed, medicines were managed safely and safeguarding systems were in place. Staff were recruited with checks, and infection prevention arrangements were in place. Staffing had been difficult, but recruitment problems were beginning to resolve.
The home was rated Good for Well-led. The registered manager knew where improvements were needed and was working to improve quality checks and family involvement. Relatives' meetings were being restarted after Covid-19 restrictions, but some relatives still felt communication with management could be better.
The overall rating was Good. The previous overall rating was also Good, published in May 2019. The Well-led rating improved from Requires Improvement to Good.
Care planning and risk management
Care plans were detailed and person-centred. Staff were updated daily about people's needs and risks, including risks involving nutrition, falls and moving and positioning.
“Risks to people had been assessed, including risks related to mental health, nutrition, falls, skin breakdown, and moving and positioning.” from the report
Safe medicines support
Medicines were checked, administered as prescribed and recorded properly. Staff received training and audits were used to check medicines remained safe and in date.
“Medicines administration records were appropriately signed by staff when administering a person's medicines.” from the report
Respecting choices
Staff supported people to communicate their wishes and make choices. Inspectors found the service worked within the Mental Capacity Act and used the least restrictive approach.
“Staff effectively supported people's communication which meant they could express their views and make choices about how they wished to be supported.” from the report
Partnership working
Health and social care professionals gave positive feedback about the home's communication, cooperation and willingness to learn.
“Feedback from external health and social care professionals showed the management team worked effectively in partnership with them.” from the report
Staffing changes
needs fixingThe home had experienced recruitment and retention problems. Established staff said new and agency staff did not always know people or the care planning system, which meant they needed extra support.
“Established staff told us it could be challenging working with new and agency staff, who were unfamiliar with the people they were supporting and the care planning system.” from the report
Family communication
needs fixingSome relatives felt they had not been kept involved and that communication with management could improve. Meetings and care plan involvement were being restarted.
“Overall relatives felt they were not engaged and involved with the service, and that communication with the management team could improve.” from the report
Quality audits
needs fixingThe home had not been able to complete the full range of audits during a difficult period. Key checks were completed, and the provider was improving and streamlining its systems.
“It had been challenging to complete the full range of audits over recent months due to the day to day challenges facing the service.” from the report
- 01How many permanent, agency and newly recruited staff are currently working in the home, and how do you make sure temporary staff know each person's needs?
- 02How are relatives now involved in care plan reviews and relatives' meetings?
- 03What changes have been made to communication with relatives since the inspection?
- 04Which quality audits are now completed regularly, and how are actions from those audits followed up?
- 05How will you make sure staff practice is formally observed and reviewed?
This was a focused inspection of Safe and Well-led, including infection prevention and control; Effective, Caring and Responsive were not assessed during this inspection. This explanation was written from the published report of 18 November 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, May 2019
Rated Good overall, but inspectors found the home was not always well-led and its quality checks needed improvement.
Inspectors made an unannounced visit on 21 March 2019. They spoke with people, relatives, staff and managers. They observed care, looked around the home and checked care records, medicine records, staff files, complaints, accidents and quality checks.
People were safe and received effective, kind and responsive care. There were enough staff, medicines were mostly managed safely, and people had care plans covering their needs. Staff treated people with patience, dignity and respect.
The main weakness was management oversight. Quality checks had lapsed while the home was without a registered manager. This meant issues such as incomplete training records, gaps in cream records and incorrectly set pressure-relieving mattresses had not been identified quickly enough. A new manager had started shortly before the inspection and had begun making improvements.
The overall rating was Good, the same as at the previous inspection in October 2017. However, the well-led rating was Requires Improvement, meaning the inspectors found weaknesses in how the home was monitored and managed.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw gentle and respectful interactions, with staff giving people time and supporting their dignity.
“All interactions between staff and people were gentle, kind and respectful.” from the report
Enough staff
Inspectors saw enough staff available across the home, including for people needing one-to-one support. The use of agency staff was beginning to reduce after new recruitment.
“There were enough staff available to support people according to their changing needs and individual preferences.” from the report
Personalised care information
Care plans contained information about people's health, personal care needs and preferences. Staff were able to explain the support each person needed.
“Care plans contained sufficient detail to ensure staff had good understanding of people's needs and preferences.” from the report
Prompt action by the new manager
The new manager quickly identified gaps in training, supervision and safety checks. Actions were taken immediately in some areas and further improvements were planned.
“The new manager had quickly identified areas where improvements were needed.” from the report
Quality checks were not reliable
needs fixingFormal checks had lapsed while the home was without a registered manager. As a result, some weaknesses in training, records, care plans and safety checks were not identified promptly.
“Weaknesses in the quality monitoring systems by the provider meant there was a risk that, in the absence of a registered manager, the provider may not have adequate systems in place to ensure the home is running smoothly or safely.” from the report
Pressure mattress settings
seriousSome pressure-relieving mattresses were set incorrectly for people's current weights. The new manager corrected the settings and introduced twice-daily checks and further training.
“However, we found the settings for the mattresses were incorrect, and did not reflect people's current weight.” from the report
Training and supervision gaps
needs fixingTraining records were incomplete and staff had not received regular supervision for the previous year. The new manager had restarted supervision and arranged further classroom training.
“Over the last year staff had not received supervision on a regular basis.” from the report
Limited meaningful activity
minorAlthough there was a weekly activities programme, inspectors saw some people without meaningful activity. People were also not regularly supported to go out for walks, outings or local events.
“However, we also observed some people sitting during the day without meaningful activity.” from the report
- 01How do you now check that pressure-relieving mattresses are set correctly for each person's weight?
- 02How do you check that topical medicines and creams are given and recorded every time?
- 03Have all staff completed the required training, supervision and any outstanding Care Certificate work?
- 04What activities and outings are now available for people who want to go out or need one-to-one support?
- 05How often are care plans, daily records and the overall quality of the home reviewed?
This was an unannounced inspection covering all five quality areas; the overall rating remained Good, while the well-led rating was Requires Improvement. This explanation was written from the published report of 8 May 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 Barton Place Nursing Home
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- November 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2019Goodstayed GoodSafe: GoodWell-led: Requires improvement
- March 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 15 December 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
17 live-in carers within about an hour of Devon
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
“She is such a warm and gentle person while being professional and competent at the same time.”
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.