- Care home
The Farmhouse
Report from 22 April 2024 assessment
Contents
On this page
- Overview
- Shared direction and culture
- Capable, compassionate and inclusive leaders
- Freedom to speak up
- Workforce equality, diversity and inclusion
- Governance, management and sustainability
- Partnerships and communities
- Learning, improvement and innovation
Well-led
Robust quality assurance systems were not in place to ensure people received safe and personalised support. Systems were in place for staff to raise concerns. The care home worked in partnership with external services to ensure people were in the best of health. Relatives and staff were positive about the management of the home.
This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
The home manager told us they promoted an positive culture within the home. The home manager had a open door culture and therefore support was always available for both staff and people when needed. Staff told us the culture within the home was positive. However due to robust quality assurance and monitoring system not in place, this would be difficult to consistently monitor to ensure there was an open culture.
The services business plan and visions and aims placed people at the heart of the service and staff feel proud working for them. We found people were supported well and staff were positive about working at the home. Service objectives were monitored through audits. However, we found that audit systems were not robust to ensure the visions and aims of the service was adhered to consistently and ensured there was an open and positive culture at the service where both people and staff felt safe and listened too to ensure feedback can be provided. Robust quality monitoring systems were not currently in place such as surveys. The home manager told us that surveys would be sent out soon.
Capable, compassionate and inclusive leaders
Staff and relatives were positive about the home manager. A staff member told us, " [Home manager] is a motivator. They lead by example, a manager that is ready to come and teach us. They don’t just give order. I’ve never suggested anything but I do feel that if I needed to they would listen. A relative told us. “Seems good, obviously we get a snap shot of how things are but it was in a bad place and it does not seem so now.” However, we found little input from providers to ensure the home manager was consistently supported and had robust oversight of the home such as provider led audits. A relative told us, “I think the manager is doing well, but don’t feel the owner deals with issues well.”
The home manager had been in place at the home since November 2023 and not been registered with the Care Quality Commission. Application for registration has been submitted. The home manager knew the home, people and staff well. Staff were positive about the management of the home and people. Relatives told us people enjoyed living at the home. However, although a number of improvements had been made as outlined in the report, some shortfalls still remain with risk assessments, pre-employment checks, safeguarding and good governance, which would require addressing to ensure people always received safe care and support.
Freedom to speak up
Systems were in place for staff to raise concerns internally and externally. The home manager told us, “Everyone knows the whistleblowing processes. There are signs around the house. They can also scan a bar code and make a report easily."
A whistleblowing policy was in place that included how to raise concerns both internally and externally, which allowed staff freedom to speak up. Staff feedback was also sought as part of supervisions and staff meeting. A relative told us, “We are able to give our views and feel like we can talk to the people working in the home.”
Workforce equality, diversity and inclusion
Staff told us they were valued by the management team and enjoyed working at the service.
There was an equality and diversity policy was in place and staff had been trained in this area. Systems were in place for flexible working arrangements as shift plans showed staff were able to work flexibly. Systems were in place to record incidents towards staff and action taken to ensure staff were safe.
Governance, management and sustainability
The home manager told us that they had made a number of improvements to the service and staff were positive about the improvements made at the home. However, further improvements were required in the quality assurance systems to ensure people always received safe high quality care at all times.
During our last inspection we found robust quality assurance systems were not in place to identify shortfalls and take prompt action to ensure people were safe and the service still remains in breach in this area. During this inspection, although we found some improvements had been made, there continued to be shortfalls. Therefore, the home still remains in breach in this area. There was not an effective quality assurance system in place to identify shortfalls and act on them to ensure people were safe. Audits had been carried out on medicine management, infection control systems, care plans and risk assessments. Although, we found improvements had been made with medicine management, infection control and care plans, we continued to find shortfalls with risk assessments, specifically relating to positive behaviour support and safeguarding processes. This was required to ensure safe care was being delivered at all times and there was a culture of continuous improvement. We found shortfalls with risk assessments at our last three inspection, and this still remains. Robust systems were not in place to ensure staff were recruited safely. This meant there was a lack of oversight in ensuring staff were suitable to work with people who used the service, which meant people may not consistently receive high quality care. Records were not always kept up to date. We found some audit such as night welfare checks had missing information, which was required as part of the checks such as on cleaning schedule and staffing. We also found infection control audits had not been scored correctly to determine if action was required. Failure to keep updated records meant there was a risk that people may not receive safe and effective care consistently.
Partnerships and communities
The home manager and staff told us they worked in partnership with health and social professionals to ensure people’s needs were consistently met and they received high quality care.
Feedback from partners were positive about the home. A professional told us, “It's truly remarkable to witness the strides Farmhouse has taken since my involvement began. I've been particularly impressed by their proactive approach in implementing the action plans we discussed.”
Records showed the home working in partnership with social and health professionals to ensure people received safe and effective support. We saw evidence that care reviews taking place with social professionals on peoples care needs.
Learning, improvement and innovation
The home manager told us there was a culture of continuous improvement at the home and part of this was through learning and best practices. The home manager also told us feedback was continuously sought from people, relatives and staff to learn about any potential shortfalls through reviews, supervisions and meetings. Any actions arising from feedback were put onto an action plan and used to make improvements. However, we found some gaps on the action plan, which would require addressing to ensure improvements was taking place. Also not all learning from incidents were being shared with staff to ensure improvements were being made.
Robust systems were not in place for learning and improvement. A number of improvements had been made since our last inspection. Records showed learning had taken place in some areas following our last inspection to ensure improvements had been made and an action plan was in place. However, robust audit arrangements were not in place to ensure shortfalls were identified and improvements and learning were sustained. We also found learning was not consistently taking place following incidents to ensure people received safe care.