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Dalwood FarmHouse Requires improvement

Reports


Inspection carried out on 15 March 2017

During a routine inspection

Dalwood Farmhouse is a care home which provides accommodation and personal care for up to three people with learning disabilities. At the time of our inspection three people were living at the home. This inspection took place on 15 March 2017 and was unannounced. We returned the following day to meet with the deputy manager and complete the inspection.

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.

Inspection carried out on 22 September 2015

During a routine inspection

Dalwood Farmhouse is a care home which provides accommodation and personal care for up to three people with learning disabilities. At the time of our inspection three people were living at the home. This inspection took place on 15 March 2017 and was unannounced. We returned the following day to meet with the deputy manager and complete the inspection.

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.

During a check to make sure that the improvements required had been made

The purpose of this desk based review was to assess the improvements made in relation to shortfalls we identified during our previous inspection on 5 September 2013 . We did not request information directly from people using the service on this occasion.

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.

Inspection carried out on 5 September 2013

During a routine inspection

We observed people being offered choices about their support such as which activity they wished to undertake. We saw staff asked people’s permission before entering their room or undertaking any care.

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.

Inspection carried out on 22 October 2012

During a routine inspection

We met and talked with the three people who were living at the home. We talked with three members of staff and the registered manager.

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.

Inspection carried out on 30 November 2010

During a routine inspection

People told us that they liked living at Dalwood farmhouse. They said that staff treated them nicely. They told us they knew the things they liked and disliked. People told us they made decisions about their life and were involved in their review meetings.

People told us about the things they enjoy doing such as food shopping, playing dominoes and helping with the animals. They told us that they enjoy going out with members of staff.

People said that they talk to members of staff and the manager regularly. People told us who they would go to if they had any worries or concerns.

People told us about their medicines and how staff supported them with this. One person told us how they help staff by making the drinks for people to take their medicines with.

People told us that they could choose what food they ate.

Reports under our old system of regulation (including those from before CQC was created)