Archived: Spring Bank Farm

The service did not have a registered manager in place at the time of the inspection. Although the present manager was in the process of applying to become 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.

When we last inspected the service on 5 and 6 October 2016 we found people who used the service were not always provided with safe care and treatment, the provider did not always follow safe practices when employing staff and had not undertaken quality audits which would assist them maintain safe standards of care for people who lived at the service The provider sent us an action plan telling us they would make these improvements by November 2016. We found at this inspection that this had been completed and the provider had made improvements in line with the action plan.

The risks to people’s safety were reduced as the staff had good knowledge of the different types of abuse people may be exposed to. They had received training to assist them to recognise safeguarding concerns and they were aware of the process for reporting concerns. Risk assessments had been completed in areas that had been highlighted as potential risks to people’s safety. The service had enough suitable trained staff to provide care and their recruitment processes were safe.

People’s medicines were managed safely and staff received ongoing appropriate training for their roles. People were supported to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles within the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.

People were encouraged to follow a healthy balanced diet and any specialist diets were catered for. Staff were supported to manage the different health needs of the people who lived at the service.

People were supported by staff who had an excellent knowledge of their needs and treated them with dignity and respect. Relatives were encouraged to contribute to their family member’s support plans which were person centred and fully reflected their needs. Where required people had access to advocacy services.

People were supported to undertaken a range of social activities of their choice tailored to meet their individual needs.

The management team responded to complaints positively and relatives felt they could report any concerns to them and they would be taken seriously.

The management team undertook quality monitoring processes to monitor and improve the quality of the service provided.

The service did not have a registered manager in post. 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 pervious registered manager had left their post in January 2016 and the provider had recently appointed a new manager to the service who had not yet applied to become the registered manager.

Safeguarding incidents were managed appropriately. Risks to people’s safety were assessed but on occasion when people’s needs changed the risk assessment did not reflect the change in a timely way.

Staff levels did not always meet the needs of people and agency staff were used to support people. There was a high turnover of staff and new staff were not always supported in their role. The recruitment processes in place lacked complete records of pre-employment checks for new staff employed. Medicines were not always managed in a safe way as errors and near misses were not recorded or monitored.

Staff received training for their roles but there was a lack of update training for staff and there was a lack of regular supervision and appraisals for staff.

People were encouraged to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles within the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.

People’s health needs were not always managed in a timely way. However people were protected from the risks of inadequate nutrition and specialist diets were provided for those people who required them.

People who used the service, and their representatives, were encouraged to contribute to the planning of their care and people were treated in a caring and respectful manner

People who used the service, or their representatives, were not encouraged to be involved in decisions about the service and people did not always feel their concerns or complaints were taken seriously. There was a lack of quality monitoring audits systems in essential areas such as medicines, care plans and the environment.

The accommodation was appropriately designed and suitable to meet the needs of the people living there and risks within the home had been assessed. The home was clean and was personalised to the people who lived there.

We saw that support plans and risk assessments were informative and up to date. Staff were aware of their contents, which enabled them to deliver appropriate and safe care. The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. Staff recruitment, induction and training systems were robust.

We observed the number of staff working with people was sufficient to enable them to be safe and well supported. We saw that staff were attentive to people's needs. Staff interacted with people in a friendly, respectful and professional manner.

The records showed that staff supported people to follow their favourite pastimes, to be part of the local community and to go on holiday if they wanted to. We saw that people's bedrooms were comfortable and that they had their own belongings around them.

We also saw that there were Mental Capacity Act (2005) (MCA) assessments in place regarding people's capacity to make day-to-day decisions.

There were appropriate measures taken to ensure that the people who lived in the home were protected against the spread of health care associated infections.

People who used the service and their families were supported to make complaints. Staff on duty told us that they tried to ensure that complaints were dealt with informally and in line with the provider's complaints procedure.