People's experience of using this service

People were not consistently protected from potential harm. The registered manager and provider had completed some audits and checks. However, people were not always protected from the risk of harm because processes in place were not consistently managed and were not robust. Risks to people's safety were not always acted on in a timely way. These included risks relating to fire safety, the environment and access to the building.

As a result of our findings we found that the provider was in breach of Regulation 17 of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. You can see what further action we have taken at the end of this report.

People had access to equipment that reduced the risk of harm and medicines were stored and administered safely. There were sufficient numbers of staff on duty to meet people’s needs. Staff knew how to recognise potential abuse and who they should report any concerns to.

People had a good choice of food which they enjoyed and were supported to maintain a healthy diet in line with their needs and preferences. Staff were trained to meet people’s needs and acted promptly to refer people to healthcare professionals when required.

People enjoyed positive and caring relationships with the staff team and were treated with kindness and respect. People’s independence was promoted as staff were careful not to do things for people that they could do for themselves.

People were supported by staff who knew about their needs and routines and ensured these were met and respected. Staff and relatives knew how to complain and were confident that their concerns would be listened to.

People and staff were happy with the way the service was led and managed and the provider worked well with partners to ensured people’s needs were met.

More information is in the detailed findings below.

Rating at last inspection:

Good (report published 29 January 2016)

About the service:

Barkat House is a care home that provides personal care for older people, some of whom are living with dementia. At the time of the inspection, 26 people lived at the service. Most people lived there permanently and some people spent short periods there to provide respite to their main carers. The home was established over two floors with a range of communal areas included dining spaces, a large garden and smaller lounge spaces.

The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At this inspection we found the service had changed to Requires Improvement.

Enforcement:

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 10 December 2015 and was unannounced. We last inspected this service on 21 October 2013 when all the regulations inspected were being met.

Barkat House Residential Home can provide care and support to up to 27 people who have enduring mental health issues. At the time of our inspection there were 26 people in the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe using the service and staff were knowledgeable about the signs of abuse. Staff were trained to identify the possibility of abuse occurring and knew what actions to take to protect people. There were sufficient numbers of appropriately recruited staff to provide care to people.

People received effective care because they had been involved in planning their care and staff knew how to meet their individual needs. People were supported to remain healthy because they received food and drink at regular intervals during the day and on request. People were supported to see a variety of health care professionals when needed and received their medicines as prescribed. Equipment available and staff support protected people from developing skin damage.

People were supported by staff that cared for them and treated them with care and compassion ensuring their privacy and dignity was maintained. People were supported to make day to day decisions and choices about meals, activities they were involved in and the treatments they received.

People were able to choose group or individual activities that best suited their needs.

People’s views about the service were sought and systems were in place to monitor the quality of the service. There was an open and inclusive environment where people were able to express their opinions about the service they received. People were able to raise concerns and felt they were listened to and issues addressed.

At our inspection of July 2013 we found that the provider had a quality assurance system in place and found that improvements had been made to the system. However, we found that there were some auditing systems that were lacking because the appropriate records were not in place.

At this inspection we saw that there were appropriate systems in place to monitor that medicines were used as prescribed and there was appropriate monitoring of blood sugar levels, people's weights and accidents and incidents. This was because the appropriate systems had been put in place. This meant that people were protected from harm.

We spoke with four people living in the home and they all said they were happy.

At the time of our visit there were 26 people living in the home. We spoke to eight people, one relative, one staff member, the manager and one of the providers.A relative told us they were very happy with the care provided.

We saw that people were treated with dignity and respect. People received care and support that met their individua needs and we saw that people were dressed in styles that reflected their preferences and cultural backgrounds.

People's health needs were met. One person told us they were taken to the hospital so that they could attend their appointments.

People's nutritional needs were met. They were offered choices at all mealtimes and specific dietary needs were met. Eastern and western meals were available to meet people's needs. One person told us, "The food is good."

People living in the home were protected from the risks of abuse and unsafe care.

The management of medicines ensured that people received their medicines as prescribed.

People were supported by staff who were present in sufficient numbers and with the required skills to meet their needs.Staff were knowledgeable about people's needs and able to support people in the way they wanted.

There were some systems in place to get the views of people using the service so that improvements could be made.

Records did not always ensure that people were protected from unsafe and inappropriate care.

At the time of our visit there were 27 people living in the home. We spoke to seven people, three staff and one of the providers.

People were treated with dignity and respect. We saw that staff explained to people what they were going to do when they were assisting them.

People told us they were happy in the home. One person told us, “It’s a good home. Staff help me keep my room tidy and do my laundry”. People received care and support that met their individualised needs so that their health care needs were met.

People living in the home were protected from the risks of abuse and unsafe care. People were relaxed in their environment and systems were in place to keep them safe from harm. Two people we spoke with told us they felt safe in the home. One person said, It’s a good home, I feel safe”.

The premises met people’s needs. There was an ongoing maintenance system in place so that the accommodation was continually upgraded and maintained.

Staff were supported to carry out their roles safely. Staff told us they liked working in the home. Staff were knowledgeable about people’s needs and able to support people in the way they wanted.

There were some systems in place to monitor how the home was run and to ensure people received a quality service but improvements needed to be made.

Not everyone in the home could speak to us due to health reasons but we spoke to eight people who lived in the home who gave positive feedback. One person told us ‘Yes, I like it here, I’ve been here many years now.’ Another person said ‘yes it’s alright here, the staff are very friendly.’ Another put their thumbs up when asked if they were happy in the home.

We spoke to a relative of a person who lived in the home. They said, “Dad is happy here, the staff are wonderful, the place is spotless.”