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Inspection Summary


Overall summary & rating

Good

Updated 25 January 2017

Holme Farm is registered to provide accommodation and personal care for 30 older people, some of whom may be living with dementia. The home is a purpose built, single storey service which is situated in the village of Elsham and has access to all local facilities. On the day of the inspection there were 23 people using the service.

We undertook this unannounced inspection on 8 and 12 December 2016. At the last inspection on 2 and 7 October 2015, we asked the provider to take action to make improvements to risk assessing, care planning and the analysing of accidents and incidents. We received an action plan from the registered provider detailing how improvements would be made including a timescale; this action has been completed.

The service had a registered manager in post who was also the registered provider. A registered manager is a person who has registered with the CQC 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.

We found improvements had been made in the way the service assessed and monitored risks to people's safety. We saw risks assessments were in place and these contained steps for staff to follow to help minimise the risks specific to people using the service. An analysis of accidents and incidents was undertaken regularly to identify any trends or patterns. This meant people’s needs could be reassessed if and when required. People who used the service received care in a person centred way with care plans describing their preferences for care. We found people’s plans of care were regularly reviewed, detailed and organised and had been updated following any changes in their needs.

At the last inspection we made a recommendation for the registered provider to find out more in relation to providing activities and meaningful occupation for people living with dementia. During this inspection we saw people were encouraged to take part in various activities if they wished to do so.

People told us they enjoyed the meals. People received a well-balanced diet and their specialist dietary needs had been assessed and provided for. One main meal was provided at lunchtime and alternatives were available on request. The meals provided to people were varied.

Staff contacted community health care professionals when required. Dieticians were contacted for advice and treatment when people lost weight or there were concerns about their food and fluid intake.

People we spoke with told us they felt safe living at Holme Farm. We found staff were recruited safely and there was sufficient staff to support people. Staff received training in how to safeguard people from the risk of harm and abuse and they knew what to do if they had concerns. Staff provided people with information and spoke with them in a patient way. People's privacy and dignity was respected and their confidential information was held securely.

Staff received supervision, albeit not regularly, and we saw staff had access to training relevant to their roles which supported them to feel skilled and confident when providing care to people.

We found staff supported people to make their own decisions. When people lacked capacity for this, staff acted within the principles of the Mental Capacity Act 2005 and ensured important decisions were made within best interest meetings with relevant people present.

Plans were in place for emergencies like a fire or a flood and staff knew what to do in the event of an emergency. Safety equipment, electrical appliances and gas safety were all checked regularly.

The service had a quality monitoring system in place which ensured that checks were made and people were able to express their views. People told us the registered provider/manager was approachable and people who used the service felt they were listened to and their v

Inspection areas

Safe

Good

Updated 25 January 2017

The service was safe.

People had been assessed to ensure any potential risks were managed safely. Regular checks were completed of the environment to ensure that people were protected from potential harm.

People who used the service were protected from the risk of abuse. Staff spoken with knew what to do if they had any concerns. People received their medicines as prescribed.

There were sufficient numbers of staff, available at all times to meet the needs of the people who used the service. Safe recruitment processes were followed.

Effective

Good

Updated 25 January 2017

The service was effective.

People were provided with a variety of meals and their nutritional needs were monitored to ensure they were not placed at risk of malnutrition and dehydration. People told us they liked the meals provided.

The health and wellbeing of people was monitored closely by staff who worked well with community medical staff to ensure their health needs were effectively met.

Staff understood the principles of the Mental Capacity Act 2005, which meant they promoted people's rights and followed least restrictive practice. The legal requirements relating to the Deprivation of Liberty Safeguards were being met. When people living with dementia were unable to make decisions about their care, we found capacity assessments and best interest meetings had been completed as required.

People were supported by staff that had received training relevant to their roles. Staff received supervision and support.

Caring

Good

Updated 25 January 2017

The service was caring.

We observed staff had developed both positive and caring relationships with the people who used the service. People's wishes for privacy were respected and their personal dignity was maintained by staff who demonstrated care and compassion for meeting their needs.

People were supported by staff that had a good understanding of their individual needs and preferences for how their care and support was delivered.

Responsive

Good

Updated 25 January 2017

The service was responsive.

People received person centred care. People had assessments of their needs and care plans had been developed to guide staff in how to support them in line with their preferences and wishes.

There had been some improvements with the activities for people. We found activities were provided on a daily basis. People were encouraged to participate in exercise classes and visiting entertainment in the service.

People were encouraged to say if anything was not right about the service, and there were systems in place for them or their relative to make a formal complaint. People told us they had no concerns and knew how to raise a complaint.

Well-led

Good

Updated 25 January 2017

The service was well led.

The culture of the service was open, which meant people felt confident to express their views. We saw there was a quality monitoring system, which consisted of audits to check systems and questionnaires to obtain people's views.

The registered provider/manager and assistant manager were visible and there was an open and transparent culture. There were clear lines of communication within the staff team and staff felt comfortable discussing any concerns with the registered provider/manager.