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Inspection carried out on 17 October 2017

During a routine inspection

The Farthings Nursing Home is registered to accommodate 60 people for nursing and personal care. It is a large purpose built building that provides passenger lift access to both floors. There are a number of lounge areas on each floor and dining rooms located on the ground and first floor. There are 58 single bedrooms and one double, the majority of which have en-suite facilities. There is a large parking area at the front of the property. At the time of our inspection visit there were 57 people who lived at the home.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and treated people with dignity and respect.

People who lived at the home and their visitors told us they were happy living at the home and felt safe in the care of staff supporting them. One person said, “ I feel perfectly safe, the staff look after me.”

People visiting the home told us staff were attentive, kind and caring towards their relatives. They said their relatives were getting the best care possible and staff went above and beyond their expectations with the care provided.

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs.

The service had sufficient staffing levels in place to provide support people required. People told us staff were responsive and available when they needed them.

Medication procedures observed protected people from unsafe management of their medicines. Regular audits and medication risk assessments had been completed to ensure procedures were safe. Medicines were safely kept with appropriate arrangements for storing in place.

We saw there was an emphasis on promoting dignity, respect and independence for people who lived at the home. People told us staff treated them as individuals and delivered person centred care. Care plans seen confirmed the service promoted people’s independence and involved them in decision making about their care.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

The design of the building and facilities provided were appropriate for the care and support provided.

The service had safe infection control procedures in place and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff knew people they supported and provided a personalised service in a caring and professional manner. Care plans were organised and had identified care and support people required. We found they were informative about care people had received.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

We saw people who lived at the home had access to healthcare professionals and their healthcare needs had been met. Three visiting healthcare professionals spoke highly about the care provided by the registe

Inspection carried out on 06 October 2015

During a routine inspection

This inspection visit took place on 06 October 2015 and was unannounced.

At the last inspection on 23 July 2014 the service was meeting the requirements of the regulations that were inspected at that time.

The Farthings Nursing Home is registered to accommodate 60 people for nursing and personal care. It is a large purpose built building that provides passenger lift access to both floors. There are a number of lounge areas on each floor and dining rooms located on the ground and first floor. There are 58 single bedrooms and one double, the majority of which have en-suite facilities. There is a large parking area at the front of the property. At the time of our inspection visit there were 51 people who lived there.

There was a registered manager in place. 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 registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices. People we spoke with told us they felt safe and their rights and dignity were respected.

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with and records seen confirmed a structured induction training and development programme was in place.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

We looked at how the service was staffed. We found sufficient nursing and care staff levels were in place to provide the support people required. We saw the deployment of staff throughout the day was organised. We saw staff were available to support people when needed and call bells were answered quickly. One person we spoke with said, “The staff do not leave me waiting when I request help. I know they will be with me in no time when I use my call bell.”

Care plans we looked at confirmed the registered manager had completed an assessment of people’s support needs before they moved into the home. We saw people or a family member had been involved in the assessment and had consented to the support being provided. People we spoke with said they were happy with their care and they liked living at the home.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care being provided.

Visiting healthcare professionals told us they were happy with the care being provided. They told us staff were always receptive to advice given and worked closely with them.

People were happy with the variety and choice of meals available to them. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met. People who had been identified as being at risk from poor nutrition had a care worker allocated to assist them to eat their meals.

The environment was well maintained, clean and hygienic when we visited. No offensive odours were observed by any members of the inspection team. People who lived at the home said they were happy with the standard of hygiene in place.

Equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

People told us they were happy with the activities arranged to keep them entertained. The service employed a full time activities co-ordinator and a structured activities programme was in place. One person said, “The girls who organise the activities do a wonderful job. There is always something going on and we have lots of trips out. We are going around the illuminations soon which I am very excited about because I have never seen them.”

We found medication procedures in place were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept and appropriate arrangements for storing were in place. People told us they received their medicines at the times they needed them.

The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required. When we undertook this inspection two applications had needed to be submitted. Appropriate procedures had been followed and (CQC) had been informed about the applications as required by law.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were comfortable with complaining to staff or management when necessary.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included questionnaires which were issued to people to encourage feedback about the service they had received. The people we spoke with during our inspection visit told us they were satisfied with the service they were receiving.

Inspection carried out on 23 July 2014

During a routine inspection

What people told us and what we found

Our inspection team was made up of an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. During the inspection the team gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. We also spoke with Blackpool council�s contracts monitoring team and Healthwatch Blackpool who are an independent consumer champion for health and social care.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard people they supported. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk. People living at the home told us they were happy and well looked after. We found recruitment practices were safe and thorough. This ensured people working for the home were fit to work with vulnerable people. Systems were in place to make sure the manager and her staff learnt from events such as accidents and incidents, complaints and concerns raised about the service.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support. People�s health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found the care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person. People spoken with said their care plans were up to date and reflected their current needs.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. The people we spoke with were very happy with the care being provided. One person said, �I haven�t been here very long but I have settled very quickly. The staff have been very kind and helpful. I have no concerns about anything.� Two people visiting their relative told us they were very happy with the home and had no concerns about the care provided. They said, �We are really glad we found this home after some bad experiences in two previous homes. It is obvious to us how much better off he is here.� Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

Records showed admissions to the home were well planned. Information about people�s care and dietary needs had been recorded. We also saw potential risks to people�s health and welfare had been identified. Guidance had been provided for staff to ensure they provided safe and appropriate care. We found people completed a range of activities in and outside the service regularly. On the day of our inspection people were entertained by a singer in the afternoon. People we spoke with said they enjoyed the activities organised by the home. We found people had access to healthcare professionals. People received regular health checks with their General Practitioner and the outcome of these visits were recorded on their care records.

Is the service well-led?

The service had quality assurance systems in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.

Inspection carried out on 17 September 2013

During a routine inspection

During our inspection we looked at care, staff training records and staff supervision arrangements. We checked maintenance records and undertook a tour of the building. We also spoke with a number of people living at the home and staff throughout the inspection. We observed the quality of care and support provided by staff during the inspection. We did this to confirm people were having their care needs met. We also wanted to identify that staff had been well trained and appropriate support arrangements were in place for them.

We found people were being supported by staff who had been well trained and appropriate support arrangements were in place for them. The home had been well maintained and was clean and hygienic when we visited. Good care practices were observed and people were having their nutritional needs met.

We observed the staff team providing sensitive and flexible personal care support. The staff were kind and patient and showed a good understanding of the needs of the person in their care.

The people we spoke with said they were happy and enjoyed living at the home. One person said, �The staff are looking after me really well. They are very kind and approachable. I have a good laugh with them. Just enjoyed a very good breakfast and looking forward to my lunch�.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

Inspection carried out on 14 December 2012

During a routine inspection

During our inspection we looked at care records and the homes duty rota. We did this to confirm people were well supported and staffing levels were sufficient to meet people�s needs. We also spoke with people staying at the home, a visiting relative, several staff members and the manager. The people we spoke with said they were receiving safe and appropriate care which was meeting their needs. They told us the staff were polite, caring and professional when undertaking their work. Comments received included:

�The care provided here is absolutely brilliant. I am convinced my mum wouldn�t still be with us if she hadn�t moved into the home. I have no worries about her care. I am always updated about her welfare whenever I visit�.

�Always plenty of staff around, you never have to go looking for them. I find them all very friendly and caring people�.

�This is a very good home. When I moved in I asked them to help me and they have. I can�t find fault with anything. The care is excellent, the food is good and we have regular entertainment�.

Inspection carried out on 21 June 2011

During a routine inspection

We spoke to people about their experiences living in the home and were told the staff team provided sensitive and flexible personal care support and they felt well cared for.

�The staff are all very kind and do their best for you�.

�Very good nursing and you get all the attention you need. I was worried about coming into care but had no need. I feel I have chosen one of the better homes and wouldn�t hesitate to tell people how good it is�.

�My mum looks really well and is very contented. There is a good atmosphere in the home. The staff are all friendly and welcoming when you visit. I cannot praise them high enough�.

�I have been very impressed with my parents care and have no concerns about the home. They are both settled and happy. All the staff are kind and friendly�.

�I looked around a number of homes and liked this one the best. The staff who showed me around were so helpful. We discussed the care my mum would need and I felt so reassured she would be well looked after�.

�I was really poorly when I moved into the home but have been so well looked after I feel really well�.

�The food is excellent, plenty of variety and choices available�.

�I am well fed the food is lovely�.

� Mum has put weight on since she came into the home and is thriving�.

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