Archived: Dalwood FarmHouse

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run. The registered manager was on leave at the time of the inspection and the service was being run by the deputy manager.

Following the last inspection in September 2015, the registered manager had not taken action to improve the way risks were managed. Plans to assess and manage the risks people faced did not always contain up to date information or provide guidance to staff on the support that people needed. The plans did not include information on how to safely evacuate people from the building in the event of a fire or other emergency.

The service did not always act in line with the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves.

The registered manager did not have effective systems to assess, monitor and improve the service being provided. The action plan submitted following the last inspection had not been followed and the improvements the registered manager had said they would make had not been completed.

Medicines were safely managed and people who use the service were positive about the care they received. Comments from people included, “I am generally happy here, I have everything I need” and “I am happy living here”.

There were systems in place to protect people from abuse and harm and staff knew how to use them. Staff understood the needs of the people they were supporting.

Staff received training suitable to their role and an induction when they started working for the service. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Overall, we found that the provider had taken sufficient action to improve the home's training and appraisal systems for staff, so that people using the service were looked after safely.

The personal support plans were clear and detailed. Staff we spoke with said they found them very easy to follow. There was a section for each element of support the person required such as physical health, mental health, behaviour, social interaction and personal care. We saw information to help staff recognise early signs of any change in a person's health and wellbeing.

Although the house is over three hundred years old, it provides an environment which has been adapted as much as possible, to meet the needs of the people living there.

We looked at the providers training matrix and supporting files of these staff. We could see there was no set annual training programme covering such topics as moving and handling, food hygiene or first aid. We saw staff had received training in these and other subjects two years ago. Although this meant they had some knowledge of the subjects, staff were not able to support people living in the home using the most recent information available.

The information about making a complaint was available in an easy read format in the main hallway. We saw that the information was clear and guided people through the procedure should they wish to make a complaint. There were contact details for a local advocacy group who act on behalf of anyone living in the home, should they wish to complain.

We saw and heard people being supported with kindness and patience. People had one to one staffing through the day time. They took part in activities of their choice, in the home and out in the community. Two people liked helping tend the animals kept at the farm, or maintaining the grounds.

The home had a close working relationship with a GP and other health professionals. People had the support they needed with long term health conditions and when they were unwell.

If people wanted private space, there were two sitting rooms, or they could go out into the grounds or to their personal rooms whenever they chose. People kept in touch with their families.

One person told us 'the staff all know me very well, I don't have any problem talking with any of them'. Another person told us 'I trust all the staff'. We found the staff worked together well as a team. The registered manager worked some shifts as a support worker, so they were well known to the people living in the home and the staff.