The inspection took place on the 29 October 2014 and was unannounced. We visited again on 30 October 2014 and the provider knew we would re-visit on that date.
Farmborough Court is a large modern, 2-storey purpose built care home, which provides a range of intermediate care services for older people who need convalescence or a rehabilitative stay.
The provider is registered to provide accommodation for persons who require nursing or personal care at Farmborough Court Intermediate Care Centre. The intermediate service is provided in partnership with Sunderland Teaching Primary Care Trust, the Mental Health NHS Trust and the City Hospitals NHS Trust
There is 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.
The home does provide care that is safe. There are procedures in place in relation to protecting vulnerable adults and all staff are trained in what to do if they suspect abuse. The home makes careful assessments of the risks associated with peoples care. Staff work proactively to ensure people’s rights are protected and they are supported to take risks in developing abilities to enable people to live as independently as possible.
The home is careful to protect peoples freedom and applies the Deprivation of Liberty Safeguards well (these are set of requirements to ensure homes do not restrict peoples liberty unless there has been a thorough assessment of the absolute need for that and it is agreed by the local authority.
The home is well staffed. Staff are well trained to their jobs. People spoke well of the care they received and how it helped them with their future plans.
Medicines were well managed with good systems in place to ensure they were administered as they should be. The home was clean and the registered manager had systems in place to ensure that staff know how to reduce the chance of infection and how to ensure the home is kept hygienically clean.
People’s needs were assessed very well with good clear records. The home had effective multi-disciplinary meetings every day where people’s needs and progress was discussed and plans changed accordingly. Records of training showed that staff had the necessary skills to do their work well. The staff felt they were suitably trained for their work.
We noticed that people participated in their plans for care and the goals they wanted to achieve. We saw people’s signatures on relevant documents and were told by people who lived there and their relatives that they felt involved in all of the decisions about their needs and progress.
There were good records that showed what peoples dietary needs were and how the home would support people. There were assessments about people’s ability to swallow safely. Many people told us the food was very good. Meal times were social occasions with the right amount of staff support around. Staff were careful to monitor people’s fluid intakes to ensure they did not become dehydrated.
The home worked very closely and well with other services There was a community nurse based at the home to help with onward planning of peoples care when they left. There were many multi-disciplinary meetings that involved care staff, nurses occupational therapist, speech and language therapists, GPs, social workers, and other relevant professionals needed to ensure a person’s care was right in the home and continued when they left.
Staff were seen to be very caring and people we spoke with said they were. People commented, “The staff are great,” “The staff are wonderful,” “The staff have really helped me.” We saw staff were attentive to people’s needs and polite and courteous whilst friendly. There was a very jovial mood and lots of laughter during meal times. It was clear the staff were skilled at quickly forming friendly caring relationships with people who lived there for a relatively short time whilst being rehabilitated.
During all of the interactions between people and staff we saw staff were careful to seek people’s opinions, or to ask if they needed anything else. For example we saw that when staff were giving out mid-morning drinks they asked if everyone had sufficient or if they had their choice of drink right.
We saw staff treated people with dignity and were respectful to them. One person told us “It’s better than a hotel here.”
We examined eight sets of care records and saw they were personalised to individuals needs and when people’s needs changed plans were altered accordingly. Staff responded on a personal level too. We saw one person wasn’t keen on either of the puddings on offer so at their request a member of staff went to the kitchen and got them an ice cream in their favourite flavour ( the person saying “oo vanilla my favourite”.
We saw evidence in the care plans that people participated in their plans and signed them. We saw that the home had regular meetings with people living there and their relatives to gain their opinions about how the home was run. The registered manager explained that as they were under a new provider they were changing their annual surveys and these would go out in the summer of 2015.
The registered manager kept a record of all of the complaints they received. These recorded what the issues were and how they had all been resolved.
The service was well led by an experienced registered manager who monitored the way care was provided in the home. People and staff we spoke with told us they were approachable. They also commented that they were often seen out talking with staff and people rather than spending all of their time in the office.
Staff told us they received good support and guidance from the registered manager, the deputy and the seniors. We saw records that showed staff had good training to do their roles and that they received regular one to one guidance.
We saw that the registered manager regularly audited care records and other records to ensure there was a consistent high quality in assessments, the plans and that systems within the home were checked as they should be.