Baytree Court is a purpose built care home registered to provide accommodation and personal care for up to 34 older people in single occupancy rooms with en-suite facilities located over two floors.

This unannounced inspection took place on 13 and February 2017. The last inspection of the service took place in December 2014. The service was rated as ‘Good’ overall and ‘Outstanding’ for the key question ‘Is the service Responsive?’

The service had a 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.

People who used the service were supported by staff who had been recruited safely following the completion of appropriate checks. Assessments of people’s care and support needs were undertaken regularly to ensure staff were deployed in suitable numbers. Staff had been trained to protect people from abuse and avoidable harm and knew what action to take if the suspected abuse had occurred. The registered provider had developed plans to deal with foreseeable emergences which included guidance to enable staff to evacuate people safely in an emergency. People received their medicines as prescribed and suitable arrangements were in place to manage medicines safely.

People who used the service received care and support from staff who had completed a range of training to ensure they had skills and abilities to support them effectively. Staff received effective levels of supervision, appraisal and professional development. The principles of the Mental Capacity Act 2005 were followed within the service and staff were aware of how to gain consent from people. People ate a healthy and balanced diet of their choosing. When concerns with people’s health and welfare were identified relevant professionals were contacted for their advice and guidance.

People’s needs were met by caring, attentive and considerate staff. Staff and the registered manager took practical action to achieve meaningful outcomes in people’s lives. The staff team had worked within the service for a number of years which meant they knew people well and had built a trusting and supportive relationship with them. People were treated with dignity and respect by staff and encouraged to express their views. People, relatives and healthcare professionals were complimentary about the service and the support people received.

Pre-admission assessments were completed before people moved into the service and the information was used to develop person centred care plans. As people’s needs changed or developed their care plans were updated to reflect their needs and provide up to date guidance for staff. People were encouraged to take part in activities and follow their hobbies and interests. The registered provider had a complaints policy in place that was displayed within the service; records showed very few complaints had been received.

The registered provider’s quality assurance system included audits, checks, observations and service user feedback. During the inspection it was apparent the system did not review monitoring records which had not always been completed appropriately. We discussed this with the registered manager who was receptive and took immediate action to rectify the shortfall. The manager understood and fulfilled their responsibilities to report accidents, incidents and other notifiable incidents to the CQC as required. Meetings were held with staff and people who used the service to ensure their views were known and could be acted upon. People, their relatives, staff and healthcare professionals spoke positively about the registered manager.

People confirmed that their care and treatment options were discussed with them and they were asked for their consent. One person said, “I made the decision to stay and gave my consent to be here.” Another person told us, “My consent is in place. They ask for your agreement to the care plan.”

People’s comments about their care were mainly positive. Comments made to us by relatives included, “I am very happy with how they care for my mother,” and “She is settled and loves her room and has been doing very well.”

People spoke very positively about its cleanliness. Comments included, “Cleanliness is very good,” and “They do cleaning every day and they come round and inspect your room.” One relative commented, “It is spotless.”

There were effective recruitment and selection processes in place. People’s comments about the staff that worked with them were mainly positive. Relatives’ comments included, “The staff have always been lovely how they interact with my mum – I could hear my mum laughing when I came in,” and, “The staff are absolutely excellent with my mother.”

People were clear about how to make a complaint. One person told us, “I would report any complaint to the manager; I have complained once and the manager sorted it.” Another person said, “If you have a problem, just ask them and they will do it if it is within their power. I would make a complaint to the senior or the manager. I’m aware of the information about how to make a complaint.”

People who used the service told us how much they enjoyed living in the home and how their dignity was respected and upheld. Comments included, “I am quite happy and everything is all right,” and, “I’m quite comfortable here. They help me at night.” One person embarking a minibus to go out for the afternoon told us, “It’s very nice here; they are very good to us. We are going for a pint and a chat.”

We also spoke with relatives who were very positive about the service. A relative of a person who had recently arrived told us, “They provide mental comfort – they really focus on every detail. I always wanted the best for my father but I couldn’t imagine this. The GP comes whenever we need him.” A relative of a person who had been some time in the service said, “We are very happy with the way staff respond and the way mother is treated. I attend a home review once a year. People are generally given more than you would expect. Staff give her all the support she needs. Mother needs help with decisions about clothes. People are fed well and the level of cleanliness remains constant.” A relative commented to us about activities, “There are certain things mother can do. She attends some shows in the home with a visiting entertainer. They have a lot of things to do and they encourage her to participate.”

People we spoke with said they felt the care they received was provided safely and they spoke positively about staff that worked with them. A relative told us, “We are quite pleased with the way the staff treat my mother.”

People we spoke with felt the provider listened to them and acted on their concerns. One person told us, “I respond to surveys and go to the resident and relative meeting. I would go to the manager if I had a complaint.” A relative said, “I attend the resident relative meeting on odd occasions – I have been to one or two – the right things were said. We have responded to most questionnaires; I know how to make a complaint. I think the manager does an excellent job.”

Baytree Court is a purpose built care home registered to provide accommodation and personal care for up to 34 older people in single occupancy rooms with ensuite facilities.

The service had 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.

This inspection was unannounced. The previous inspection of the service took place on 5 July 2013 and was found to be compliant with the regulations inspected.

People who used the service told us they felt safe. Comments included, “I feel perfectly safe here”, “I am very well looked after and don’t doubt that I’m safe”, “They are very careful with my medicines” and “The home is kept so well, we are extremely safe.”

Medicines were stored securely and administered safely. Records showed people received their medicines on time and in accordance with their prescription.

People who used the service received regular positive interaction from members of staff.

The service was kept extremely clean. The building was well maintained and furnished.

People were supported by staff to maintain their privacy, dignity and independence. Everyone looked clean and well-cared for. Staff involved people in choices about their daily living and treated them with compassion, kindness, and respect.

People had access to a wide range of activities. Relatives and friends were able to visit at any time.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and staff followed the Mental Capacity Act 2005 for people who lacked capacity to make decisions for themselves. These safeguards provide a legal framework to ensure people are only deprived of their liberty when there is no other way to care for them or to safely provide treatment.

People’s care plans were written to meet people’s individual needs. The service was responsive to people and used new technologies to support people’s wellbeing.

People who used the service knew how to make a complaint. People felt they were able to express their views at any time and that they were listened to.

Leadership and management of the service was good. There were systems in place to effectively monitor the quality of the service.