About the service: Barton House is a residential care home that was providing personal care to 15 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

Improvements needed to be made in the building so people could access the communal areas easily and safely. There was no hot water on the upper floors and the lift was out of order.

Risks were not fully assessed or reviewed regularly. The service could not mitigate the risks people faced because they did not have current information on people’s needs.

The service was not acting within the principles of the Mental Capacity Act 2005. People were offered some choices in their day but not others.

There was not a robust quality monitoring system in place. Gaps in records and maintenance issues were not identified by quality processes.

The registered manager was open and showed a willingness to improve. They had begun to implement some changes but identified they needed further support to embed them.

People said they felt safe. Staff knew how to identify potential abuse and what to do if they suspected someone was at risk of harm.

Medicines were being managed safely, staff were patient when administering medicines. People’s health needs were being met with timely referrals to health services.

Staff felt supported through supervisions and training and the flexibility the registered manager and provider offered them. Staff supported each other and challenged each other to support people to reach their goals.

Some activities were taking place but improvements were needed to ensure people were having their preferences met in how they spent their time.

The menu had been changed recently to include more home cooked meals. People said they enjoyed the food.

People said staff were kind and caring. The service encouraged visitors and wanted to engage more with the wider local community.

We found breaches in four legal requirements relating to premises, safe care and treatment, consent, and good governance. Further information is in the detailed findings sections below.

Rating at last inspection:

The rating for the last inspection on 13 and 20 May 2016 was good. The report was published on 18 July 2016.

Why we inspected:

This inspection was a planned inspection based on the previous rating.

Follow up:

We have asked for a report of actions within a specific timeframe relating to the issues we found during the inspection and linked the service with local authority quality support. We will meet with the provider and registered manager after they have sent us this report to discuss how they plan to improve the service.

Barton House is a registered care home in Dawlish for up to 15 people who require accommodation and support. It does not provide nursing care; this is provided by the community nursing team. This was the first inspection the home has received as the home reregistered in July 2015 as a limited company.

At the time of the inspection there were 14 people living at the service. Some of these people were living with Dementia. During our inspection we observe red a calm and relaxed atmosphere in the home and we saw staff interact with people in a friendly and respectful way.

People, staff and health care professionals told us they were happy with the care being provided at the home. People’s needs had been assessed prior to them moving into the home. Each person had a care plan which had been developed by staff with their and their relatives’ input. These care plans contained information about each person’s needs and how staff should meet these. Staff spoke confidently about people’s individual care needs and how they met these. Staff were knowledgeable about the people they were caring for. They described people past histories and their preferences.

People were treated with kindness, compassion and respect. Relatives said they felt the home was safe and secure. Staffs knew people well and were friendly and supportive. People received care and support at a pace and time convenient for them because staffing levels were sufficient. Staff sought people’s consent for their day to day care.

Staff knew how to recognise and report the signs of abuse and had received training in safeguarding people. They were confident about how to raise concerns if they were concerned about anyone.

Staff received relevant training for their role and there were opportunities for on-going training, support and development. There was enough staff on duty when we inspected to care for the people who lived there.

Recruitment systems were in place; new employees underwent the relevant pre-employment checks before starting work. Staff had completed an application form. One of these did not contain a lot of detail relating to the dates that the person had worked. The registered manager had not explored these gaps. However this was actioned immediately when we pointed this out .

There was a good system in place for ordering, storing and returning medicines, although no checks were carried out to ensure medication was being stored at the correct temperature.

Chemicals were not always being stored in a safe way. However this was actioned immediately when we pointed this out as a potential risk

A number of different activities were provided by the service and included activities which met people’s specific interests.

Meals were appetising and people were offered a choice in line with their dietary requirements.

People told us they enjoyed the food.

People and the relatives we spoke with were aware of how to make a complaint and all felt they would have no problem raising any issues. There was a management structure in the home which provided clear lines of responsibility and accountability. The registered manager showed a great enthusiasm in wanting to provide the best level of care possible. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they cared for people.

The premises and equipment were maintained to ensure people were kept safe. There were infection control measures in place to protect people and the home was clean and hygiene People living at the home, their relatives and the staff all told us they felt there were sufficient staff on duty to meet people’s care needs. At the time of the inspection we found there were sufficient staffs on duty. In addition to the registered manager, there was three care staff on duty as well as housekeeping and catering staff.