This was the first time the service had been inspected which resulted in a CQC rating. The service was first registered with CQC on 4 February 2016. In July 2016, we received a concern which related to poor care practice at the service. This included how medicines were managed and how decisions had been made for two people, which impacted on their privacy and dignity. As a result we undertook an unannounced focused inspection on 22 July 2016. During the inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regards to medicines, safe care and treatment, seeking consent, person centred care, dignity and respect and good governance. Following the inspection, we met with the registered manager and the provider in September 2016 to discuss their action plan to address the breaches. We were satisfied they had made improvements.

This comprehensive inspection was unannounced and took place over two days on 22 and 28 June 2017. We judged they were now compliant with the breaches identified from the focussed inspection

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.

Barnhaven Residential Home provides accommodation for 17 people, including people living with dementia. There were 15 people living at the home and one person on a respite stay; one person who lives at the home was in hospital.

People said they felt safe and secure living at the home. They were positive about their relationships with staff. People were complimentary about the way the home was run; a person living at the home commented how hard the registered manager worked. Many felt the positive atmosphere was due to the good team work. Staff said they would recommend it to others as a good place to work. People and staff repeatedly used the words “happy” and “friendly” to describe their experience of living and working at the home.

People were cared for by well trained staff who were supported to develop their skills and understanding to benefit people living at the home. People benefited from range of food and drink in a calm atmosphere with staff who supported their individual nutrition and hydration needs.

People told us the home was “friendly and happy”, “staff are happy and helpful” and they described the staff team as “a charming lot.” Staffing levels met people’s emotional and physical needs. People said they knew the staff well as there had been few changes since the home had opened in early 2016. We saw people were at ease with the staff and they shared jokes with each other. Staff spoke about the people they cared for in respectful manner. People looked well cared for. People expressed satisfaction with the standard of the laundry and how their clothes were care for.

A health care professional ‘I was left with an overwhelming sense that your staff are kind, compassionate and dedicated to deliver the best care ... as possible.’ Written feedback to the service included comments such as ‘thank you all so much for the care, kindness and compassion’ and ‘Nothing is too much trouble.’

People living at the home spoke positively about the events and activities had been arranged. A group of people were engaged in an art activity during our inspection; the atmosphere was relaxed and light hearted with care staff assisting people to participate.

People received personalised care that responded to their individual needs. Care records were clear and easy to follow. Records showed staff monitored changes in the person’s health and worked with health care professionals to reduce risks.

There were effective recruitment and selection processes in place. Staff had the knowledge a

Barnhaven was registered with the Care Quality Commission on 4 February 2016. We have not yet carried out a comprehensive inspection and therefore the service does not have an overall quality rating.

We received a concern which related to poor care practice at the service. This included how medicines were managed and how decisions had been made for two people, which impacted on their privacy and dignity. As a result we undertook an unannounced focused inspection on 22 July 2016. This report only covers our findings in relation to the concern.

We judged improvements were needed in the management of medicines, how consent is sought from people and how their capacity to consent is assessed. One area of concern identified did not respect the dignity of two people and did not respect the privacy of a third person. During the inspection, we also found two areas of concern in relation to the quality of pre-admission assessments and care plans. There were not effective systems to monitor the quality of care and support that people received.

During this inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regards to medicines, safe care and treatment, seeking consent, person centred care, dignity and respect and good governance. You can see what action we told the provider to take at the back of the full version of the report. We contacted commissioners at the local authority about our concerns on the same day of the inspection.