Archived: Cottage Farm

The service had a registered manager. 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 provider had systems in place to respond and manage safeguarding matters and make sure safeguarding concerns were raised with other agencies.

There were appropriate arrangements in place for supporting people to manage their finances. Daily checks of people’s monies were carried out to reduce the risk of financial abuse.

Relatives and health care professionals told us people were cared for safely at the home and if they had any concerns they were confident these would be quickly addressed by the staff or registered manager.

Assessments were in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and were able to tell of the strategies’ in place to keep people safe.

People were supported to maintain their independence in areas such as personal care and activities of daily living such as shopping, cooking, cleaning and laundry.

There were sufficient numbers of qualified, skilled and experienced staff deployed at all times to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe and effective recruitment procedures.

Staff were supported in their role and had been through the provider’s own induction programme and received supervision and appraisals providing them with appropriate support to carry out their roles

Medicines were ordered, stored, administered and disposed of safely.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection five people living at the home were subject to a DoLS and the provider was complying with the conditions applied to the authorisation. The manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

People were involved in their care planning. Staff supported people with health care appointments and visits from health care professionals. Care plans were updated accordingly to show any changes. Care plans were routinely reviewed to check they were up to date.

People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed.

Staff said they enjoyed working at the service and received good support from the registered manager.

Relatives and health care professionals had confidence in the registered manager and staff to deliver good care.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

At the time of this inspection, the home was providing accommodation, care and support to five people with learning disability, physical disability or sensory impairment. We used a number of different methods to help us understand the experiences of people using the service. Some of the people using the service had complex needs which meant they were not all able to tell us their experiences. We observed the care and support being given and how staff interacted with people. On the day of our inspection the registered manager was on annual leave. We spoke with the area manager and five staff and looked at care and support records.

This is a summary of what we found '

Is the service safe?

The service was safe because care plans were based on people's assessments of needs and set out the actions staff had to take to provide the support people required and wanted. For example help with washing, transferring and mobilising, toileting or assistance to eat, accessing the community and participating in social or leisure activities.

All staff we spoke with were knowledgeable about people's financial support needs and were able to describe and explain the information in the providers safeguarding policy.

The home had an experienced and stable team of staff who were supportive to each other and were clearly committed to providing a good standard of care to people living in the home.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one. The area manager was aware of recent changes to the legislation and was awaiting further guidance from the provider organisation.

Is the service effective?

The service was effective because staff had regular monthly meetings with people living at Cottage Farm [My Monthly Meeting] where people's goals and objectives were discussed and plans put in place to help people achieve them. One person who used the service said: 'I like talking to the staff to tell them how I feel and what I need. If I didn't do that they wouldn't know how to care for me'.

All staff had supervisions approximately every six to eight weeks. We saw copies of the most recent supervisions completed between January and May 2014. Staff we spoke with confirmed they had regular supervisions. One member of staff we spoke with told us they were useful. They said they discussed training and development requirements.

Is the service caring?

The service was caring because care plans were updated promptly when people's needs changed. Daily records were in place in relation to the delivery of care and treatment.

Staff told us they received a handover at the start of their shift so they were aware of any changes in people's needs This meant that care and treatment was planned and delivered in a way that met people's needs.

Is the service responsive?

The service was responsive because people's needs were reviewed at least twice a year as a minimum. However people's needs would be reviewed at any time if their circumstances or needs necessitated this.

Is the service well led?

The service was well led because staff meetings took place each month and minutes of these meetings were kept. Staff we spoke with confirmed this and said the staff meetings enabled them to discuss issues openly with the registered manager or area manager and the rest of the staff team.

Staff recorded all activity and support provided during their shift and these were signed and dated. Any incidents or events were also reported to the registered manager or team leader.

There was evidence that learning from incidents/investigations took place and appropriate changes were implemented. We found that all behavioural incidents had been reviewed for each individual and summarised. This meant that any changes in behaviours or incidents for people could be quickly identified and plans reviewed if necessary.

During this visit we inspected the storage arrangements for medicines held in the home. We saw that since our previous visit the provider had installed a bespoke medicine cabinet. The cabinet was located in the manager's office and secured to an internal wall.

Since our previous visit seven care workers had completed an e-learning module provided by a local pharmacy in the care and safe use of the administration of medicines. The area manager told us that once the training had been completed then the care workers would be observed by her-self and competency assessed, before being authorised to administer medication.

People were not protected against all the risks associated with medicines because the provider did not have secure or safe storage arrangements in place for medication.

People who lived at Cottage Farm had varied and individual daytime activities. The Area Manager told us that all the people living at Cottage Farm needed support from care workers to access community facilities. When we visited, four care workers were on duty. One care worker we spoke with said: 'I feel I have the skills and knowledge required to meet the needs of people who lived at Cottage Farm'. One care worker we spoke with said: 'Generally there are always enough staff on duty to meets peoples' needs and to look after people safely'. One person who used the service said: "They look after me when I go out. I like to go out and have fun".

Care workers were able, from time to time, to obtain further relevant qualifications. During the visit we spoke with two care workers, who told us they received good training, which helped them understand and meet peoples' needs. One care worker we spoke with said: 'I receive regular one to one supervision sessions with the Area Manager. I find these sessions useful and it gives me the opportunity to raise concerns or issues I may need to talk about'.

Assessments of people's needs had been completed by the registered manager who had recorded the needs and support that people required. There was evidence that people had contributed to their care plans.

We spoke with two care workers and the registered manager who all demonstrated a good knowledge of safeguarding vulnerable adults. We looked at the training records for all the staff and saw that training in safeguarding vulnerable adults had taken place in the last 12 months.

Staff spent time with and interacted with people in a positive manner attending to their needs but at the same time promoting independence where appropriate.

We saw that all care plans and monitoring records were held in the office which is secured when not in use. Staff records were well maintained and also held securely in the office