Archived: Place Farm House

Place Farm House provides accommodation for up to twenty older people, a majority of whom are living with dementia and who may need support with their personal care needs. On the day of our inspection there were fourteen people living at the home. The home is a large property situated in Patcham, East Sussex. It has a large communal lounge, dining conservatory and gardens.

It is a family run home managed by the provider and a manager. A registered provider is a ‘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 received their medicines on time and according to their preferences, from staff with the necessary training. There were safe systems in place for the storage and disposal of medicines. However, observations raised concerns about the dispensing and administering of some medicines. This is an area of practice in need of improvement.

People were protected from harm and abuse. There were sufficient quantities of appropriately skilled and experienced staff who had undertaken the necessary training to enable them to recognise concerns and respond appropriately. People’s freedom was not unnecessarily restricted and they were able to take risks in accordance with risk assessments that had been devised and implemented. One person told us “You can go where you like, no one tells you what to do”.

People were asked their consent before being supported and staff had a good awareness of legislative requirements in regard to making decisions on behalf of people who lacked capacity. People and their relatives, if appropriate, were fully involved in the planning and delivery of care and were able to make their wishes and preferences known. Care plans documented people’s needs and wishes and these were reviewed and updated regularly to ensure that they were current. Staff worked in accordance with people’s wishes and people were treated with respect and dignity. It was apparent that staff knew people’s needs and preferences well. Positive relationships had developed amongst people living at the home as well as with staff.

People’s health needs were assessed and met and they had access to medicines and healthcare professionals when required. One healthcare professional told us “They have excellent communication skills and will always phone me if there are any urgent concerns. I always find they are eager to help their residents and support them to their optimal well-being. They are extremely dedicated to their residents”. People had a positive dining experience and told us that they were happy with the quantity, quality and choice of food. People were also provided with snacks and drinks, of their choice, throughout the day.

The manager welcomed feedback and used this to drive improvements and change. People were complimentary about the leadership and management of the home. One person told us “You only have to ask once and it gets done”. A relative told us “The provider is a wonderful woman, so kind, she makes sure everything is done properly”. There were quality assurance processes in place to enable the manager to have oversight of the home and to ensure that people were receiving the quality of service they had a right to expect.

Below is a summary of what we found. The summary describes what people using the service, their relatives, visitors and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is it safe?

Care was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw care plans that were sufficiently detailed to allow care workers to deliver safe and responsive care. People told us that they were happy with the care and support that they received. A person who used the service said, "I am very contented here. I don't want for anything. Really, we get thoroughly spoilt.'

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

The provider had appropriate arrangements in place to manage medicines. Medicines were handled appropriately and kept safely.

Is it effective?

The provider had clear procedures to obtain consent that are followed in practice, monitored and reviewed. We were told, "People's consent is considered at every review, or when people's needs change."

Care plans were personalised and included information on the person's life history and identity. This allowed for staff to provide care that was personalised and appropriate to that person.

We saw that there were systems in place to support staff. A member of staff said, 'We are a small, close knit team and while there are the quarterly team meetings what's just as important are all the opportunities every day to speak informally to other carers and a manager about what's going on at the time.'

Is it caring?

Staff spoke with compassion and kindness for the people they supported. People were supported by committed and attentive staff. Observations of care found that people were treated with dignity and respect. A relative told us, 'The care here is absolutely fabulous. It's family run and I like to think that we are part of the family.'

It is responsive?

People told us that they felt happy and confident approaching staff with any concerns. A relative of a person who used the service said,' I have every confidence that [the manager] and staff listen to what [my relative] and I say.'

Is it well-led?

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. Quality and compliance audits were regularly conducted. Where it was required, responses to the audits findings were developed and these were recorded.

There were effective systems in place to reduce the risk and spread of infection. Two visitors and a group of nine people who lived at the home we spoke with commented that the home was always clean. One person told us "The standard of hygiene they maintain here is outstanding. I couldn't do better myself".

The provider has taken steps to provide care in an environment that is suitably designed and adequately maintained. Each of the bedrooms we visited were of a good size, furnished with good quality furniture and with an en-suite toilet and hand wash basin. All had the appropriate fire safety door closures fitted. There was a large communal lounge and dining area as well as three outdoor areas.

People were protected from unsafe or unsuitable equipment because the provider had systems in place to ensure that equipment was regularly well maintained, tested and serviced. We saw records that confirmed service level agreements were in place for the home's equipment.

There were enough qualified, skilled and experienced staff to meet people's needs. A group of nine people who lived in the home that we spoke with told us there had always been enough staff of duty to meet their needs. People told us staff had responded without delay and had been able to provide them with the support they needed. One person said "They came straight away, pretty instantaneous". The staff turnover was low and staff had a good understanding of the needs of the people who lived there.

People's needs had been assessed and care and treatment had been planned and delivered in line with their individual care plan. It was clear from speaking with care workers and management that they had a good understanding of the needs of the people living there and that they knew them well. People who lived in the home, spoke very highly of the care workers and the quality of the support they had provided. They told us they were very happy with the support they had received and that they felt they had been supported safely and consistently. They told us that they were supported in the way they preferred.

One person told us 'The care is wonderful, I'm happy here.'

Another person told us. 'I have no concerns, when I needed to call the staff they came and helped me straight away. I didn't have to wait.'

People had access to health care professionals when needed and had received their medicines as prescribed and intended.

The recruitment practices were safe. Appropriate identity and security checks had been completed as part of the recruitment process. Care workers were experienced and had the skills they needed to do their job well.

The records needed for the management of the home had been maintained and were accurate and complete.