Barley Court is a 'housing with care' service that provides people with personal care in their own flats (accommodated in one large building). At the time of the inspection, 50 older people and 4 people with a learning disability were using the service.

This announced inspection took place on 07 December 2016 and was carried out by one inspector.

At the time of the inspection there was a registered manager in place. However, at the time of the inspection they were working in a different position for the registered provider so were not in day to day charge of the service. A new manager had been appointed and was applying to the Commission to become the registered manager. 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.

The Care Quality Commission (CQC) is required by law to monitor the Mental Capacity Act (MCA) 2005 and to report on what we find. The provider was acting in accordance with the requirements of the MCA. The provider was able to demonstrate how they supported people to make decisions about their care. Where people were unable to do so, there were records showing that decisions were being taken in their best interests. This meant that people did not have restrictions placed on them without the correct procedures being followed.

People told us they felt safe. Risk assessments were in place which gave staff the information they needed to minimise risks to people. Staff had an understanding of how to protect people from harm and knew what action they should take if they had any concerns.

Staffing levels ensured that people received the support they required at the times they needed it. The recruitment practices were thorough and protected people from being cared for by staff that were unsuitable to work at the service. Staff received the training and support they required to carry out their role.

Staff were kind and caring when working with people. They knew people well and were aware of their preferences, likes and dislikes. People’s privacy and dignity were upheld.

People were supported to take their medicines as prescribed. Records showed that medicines were administered as prescribed. People were supported to maintain good health. This was because staff had the knowledge and skills to support them and there was prompt and reliable access to healthcare services when needed. When needed people were supported to ensure they had adequate food and drink that they enjoyed.

Care plans were in place detailing how people wished to be supported and these had been produced in conjunction with people using the service.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the manager if they needed to.

People had confidence in the manager and the way the service was run. The manager ensured the staff team were well supported. In addition, there were opportunities for people and staff to provide feedback about any improvements that could be made, and these were listened to and acted on.

This inspection was carried out by a single inspector. 51 people were using the service at the time of our inspection. As part of our inspection we spoke with six people who were receiving support, two relatives, the manager and six staff working at the service. We also observed people receiving support and looked at the support plans for six people. We used the evidence collected during our inspection to answer five questions.

Below is a summary of what we found.

Is the service safe?

People who we spoke with told us they felt safe and they liked the staff.

People were protected from the risk of infection because appropriate guidance had been followed. One person said, “I feel safe. The staff are very hygienic. They always put their aprons and gloves on.”

There were effective recruitment and selection processes in place. Appropriate checks were undertaken before staff began work.

The provider had a system in place to demonstrate that they had given consideration to whether each person using the service had the capacity to make decisions about their day to day care under the Mental Capacity Act (2005). The Mental Capacity Act is a law which requires an assessment to be made to determine whether a person can make a specific decision at the time it needs to be made. It also requires that any decision made on someone’s behalf is recorded, including the reasons why it has been made, how the person’s wishes have affected the decision and how they were involved in the decision making process.

Is the service effective?

People’s privacy, dignity and independence were respected. One member of staff said, "Respecting people is about knocking on their door before you go in. It’s about respecting their space and their dignity.”

One person who used the service said, “The staff speak to me respectfully.”

People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People we spoke with told us that they were happy with the service which they received. The relatives we spoke with told us that the service met the needs of their family members. Care plans were personal to each individual and were reviewed on a regular basis. Assessments of any potential risks to people had been carried out and measures put in place to reduce risk.

Is the service caring?

We spoke with six people who used the service. People told us that the staff were kind, caring and helpful. One person said, "The staff are very understanding.” We spoke with two relatives. One relative said, "The staff are very friendly.” Staff told us they enjoyed working at the service. One person said, "I enjoy working here. I love my job.”

Is the service responsive?

People were supported by suitably trained and experienced staff who were able to meet the needs of people who used the service.

People’s needs and care plans were regularly reviewed by the staff and management at the service. Support plans included information on people’s likes and dislikes and their preferences, to ensure care and support was delivered taking into account their personal preferences. The staff we spoke with told us they were trained to do their job and knew how to meet the needs of people using the service.

Referrals were made to health professionals to ensure that people received appropriate support by people with the most appropriate knowledge and skills. Staff worked closely with professional health staff to ensure that people’s needs were met by staff with the most appropriate, knowledge, skills and experience.

Is the service well led?

People using the service and their relatives told us they thought the service was well-led. One person said, "The manager is very good.”

Staff told us they received regular supervision and appraisals. They told us they received guidance from the management team. One member of staff said, "The management are always there to support and guide me.”

The provider had effective quality assurance and audit systems in place to monitor all aspects of the service and ensure improvements were made where necessary.

People we spoke with were satisfied with the complaints process. They felt confident to raise any concerns with the manager. One person said, "I would be happy to speak with the manager if I had any concerns.”

On the day of our inspection 57 people were living in Barley Court. We spoke with the registered manager, three staff members, five people who used the service and three relatives.

Staff sought consent from people before undertaking care or support. For example, we saw staff members asking people if they needed help with activities such as using the laundry. This showed us that staff respected people’s human rights and took them into account when delivering care.

People we spoke with told us that they were happy to live in Barley Court. They told us that staff were caring and supportive and that it was a pleasant environment. One person said “…the attention is terrific.” Another person said they felt “…very lucky…” to live there. Staff members we spoke with showed a good understanding of the care and support needs of people and could tell us how they helped to meet these needs.

The people who used the service, and their relatives, told us that Barley Court was a safe place to live. The provider had a policy on safeguarding, dated October 2012. They also had a policy on ‘cash and property handling,’ which showed us that the provider took steps to prevent financial abuse.

The provider had a system of staff supervision and appraisal in place. Staff members we spoke with told us that they had undertaken specialist training courses. The provider assessed and monitored the quality of service provision. This enabled them to effectively manage risks.

One person told us that, “When I moved in here the other tenants were friendly and the staff made me feel welcomed.” This showed us that people who use the service were given appropriate information and support. Everybody we spoke with told us that if they required any assistance staff would respond in a supportive manner. One person told us that, “I know that the staff will come to help me if l need them.” This demonstrated to us that people’s needs were assessed and care was planned and delivered in line with their individual care plan.

One person told us that, “I am happy here and feel safe because the staff will always come if I need them.” Visitors told us that if their relative needed any support or care they could rely on the staff to provide this. This showed us that the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People told us that they were well cared for and that if they needed assistance staff would respond in a prompt manner. This demonstrated to us that there were enough qualified, skilled and experienced staff to meet people’s needs. We saw completed service feedback forms from tenants, family members and visiting professionals. The feedback was generally positive and any concerns had been addressed through the provider's action plans. This showed us that the provider had an effective system to regularly assess and monitor the quality of service that people receive.