What the CQC found at Barnfield

There were enough staff to meet residents' needs, including supporting outings, interests and life skills. The use of agency staff had reduced since the previous inspection.

“There were enough staff to support people to go out, pursue their interests or to help them improve their life skills.” from the report

Staff knew residents well, understood their communication styles and supported privacy, dignity and independence.

“Through our visit, we saw staff apply these skills and staff had time just to sit, talk and be with people.” from the report

Residents were supported to make daily choices using their own forms of communication, including gestures, eye movements and picture cards.

“Staff said even though people could not express themselves vocally, they could through eye movement or body language.” from the report

Staff helped residents develop daily living skills and, in some cases, move towards services offering less support.

“Through the setting of goals and objectives, people's daily life skills and experiences were increased” from the report

Managers used audits, action plans and staff discussions to monitor care and make improvements. Staff said communication and teamwork had improved.

“Quality assurance audits appropriate for the size of the service were completed, with provider oversight.” from the report

Care plans were personalised but sometimes duplicated information or did not match staff knowledge. Some records did not explain residents' communication methods in enough detail.

“Care plans were personalised, but needed improvements to reduce duplication and to make sure they corresponded with staff's knowledge about each person.” from the report

Medicines were given safely, but records for medicines given when needed and topical creams needed improvement.

“Improvements were needed to 'as and when' medicine protocols and introducing topical cream charts to demonstrate people received these medicines as prescribed.” from the report

Records did not always show clearly whether people had reached their individual hydration targets.

“Improvements were needed with the recording of people's fluid intake as it was not always clear if people had reached their target hydration goal.” from the report

Not all residents had their wishes and preferences for the final stages of life recorded because these discussions had not taken place.

“Not everyone's wishes and preferences in the final stages of their life was recorded as those conversations had not taken place.” from the report