Park Farm House

We found the following examples of good practice.

Staff greeted visitors at the entrance to the home and took their temperature and ensured they were wearing the correct Personal Protective Equipment (PPE). Arrangements for visiting were displayed clearly so health and social care professionals, friends and family knew what was expected of them to keep people safe.

Visitors had to leave their contact details as part of a track and trace and complete a health declaration and show a negative lateral flow test. Vaccination status was checked for all contractors and health and social care professionals in line with legislation that had come into effect in November 2021. A contractor was on site and confirmed that they had completed the above process.

The environment had been adapted by moving furniture to enable social distancing and the home had been decluttered to help with keeping communal areas clean. The provider had replaced the furniture with items that were washable to minimise risks of cross infection. Regular cleaning was taking place including high touch points such as door handles, handrails and television remotes.

Staff said that the provider last year had also employed a housekeeper to help with the day to day cleaning as previously this was completed by the care staff. Staffing had been increased since the last inspection so there were now three care staff at peak times to help with mealtimes and to support people with one to one and group activities. There was also a senior manager on shift that also could support when needed.

Staff were positive and the atmosphere was calm, with staff engaging with people. Staff spoke positively on how the team had pulled together during the pandemic to ensure people were safe and received the care and support they needed. They were proud that they had not needed agency and staffing had been maintained throughout. A person told us the staff were kind and they were happy living in Park Farm House. People were seen having healthy banter with staff.

People were supported to see friends and family in accordance with government guidance. People and their relatives had been asked who their named visitors would be. Essential Care Givers (named relative) were supported to visit during the recent outbreak and where people were end of life relatives were also supported to spend time with their loved one.

Relatives we contacted were satisfied on how the staff and management had managed the pandemic and kept their loved ones safe. A person living in the home told us could they speak with their daughter regularly on the phone and they had visited.

The provider/registered manager and the senior management had ensured that staff had up to date information to keep people and staff safe. Staff demonstrated a good understanding of the guidance to minimise risks in respect of the pandemic. Risk assessments were in place that were in the process of being updated to reflect changes in government guidance. Audits were completed in respect of health and safety which covered infection control and waste management.

All staff had received additional infection prevention and control training, and this had been updated annually. Further training was planned for all staff.

Park Farm House is registered to provide accommodation for up to 10 people who require help with personal care. The service specialises in the care of older people living with dementia but does not provide nursing care. At the time of our visit there were seven people living at the service.

There was 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 of the Health and Social Care Act 2008.

People were protected from abuse because staff understood how to keep them safe, including understanding the processes they should follow if an allegation of abuse was made. All staff informed us concerns would be followed up if they were raised.

Staff knew how to minimise risks and provide people with safe care and treatment. Procedures and processes guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments, which identified how risks to people were minimised.

There were processes in place to ensure the premises and equipment were regularly checked and to manage the prevention and control of infection. The registered manager reviewed accidents and falls to ensure people had the right support to keep them safe.

Appropriate arrangements were in place to ensure people's medicines were obtained, stored and administered safely.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people's needs.

Staff had effective support, supervision and training to develop the skills needed to care for people effectively. People told us they enjoyed the meals and we saw staff offered people hot and cold drinks throughout the day.

People's care was provided in line with the Mental Capacity Act and staff understood the importance of seeking appropriate consent for care and treatment.

People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.

People received care that was personalised to them and met their individual needs and wishes. Staff respected people's privacy and dignity and interacted with people in a caring, compassionate and professional manner. They were knowledgeable about people's choices, views and preferences and acted on what they said. The atmosphere in the service was friendly and welcoming.

People were supported to maintain relationships with relatives and friends. Visitors were made to feel welcome. People were supported as individuals taking into consideration their culture and religious needs.

People had personalised care plans, which detailed how they wanted staff to meet their individual needs. A range of activities were provided by staff for people to participate in. People had access the provider's complaints procedure.

The registered manager had made improvements to the quality assurance processes with regular audits of the service undertaken.

There was an open culture at the service and the views of people, relatives and staff were gathered.

The registered manager for Park Farm House is the registered provider. 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.

Park Farm House is a family run business. The providers live in an annex attached to the main farmhouse. Staff spoke positively about the team and the provider. The home is set in a rural area on the outskirts of Bristol. There are no direct public transport links to this home. The nearest village is a mile away.

Some improvements were required to ensure the service was well led. This included formalising the checks on quality with records of those checks being maintained. The provider did not submit the Provider Information return on time which has meant the rating for well led will automatically be requires improvement under our process. The provider needs to document quality checks that were being completed in respect of maintaining and improving the quality of the service provided to people.

People were receiving care that was responsive and effective and tailored to their needs. Care plans were in place that clearly described how each person would like to be supported. People had been consulted about their care and support. The care plans provided staff with information to support the person effectively. Other health and social professionals were involved in the care of the people. Safe systems were in place to ensure that people received their medicines as prescribed. The philosophy of the service was ‘Park Farm House was the person’s home and they came first’. The provider told us it was really important that people felt safe and regarded Park Farm House as their home.

People’s rights were upheld, consent was always sought before any support was given. Where people lacked the mental capacity, family and health and social care professionals were involved. Improvements could be made to the recording in this area.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management and safe recruitment processes.

Staff were caring and supportive and demonstrated a good understanding of their roles in supporting people. Systems were in place to ensure open communication including team meetings, daily handovers between shift changes and one to one meetings. Staff had received training to enable them to meet people’s needs. Further training had been organised during the inspection to increase staff’s knowledge on the Mental Capacity Act and Deprivation of Liberty Safeguards.

We saw that staff were kind, gentle and respectful and always acknowledged people by name. Staff always asked people before providing support. We saw in people's care records that where appropriate best interests decisions had been made with professionals and people's families.

It was evident that staff knew people well and that people were relaxed and comfortable with them. Staff were able to tell us in detail about people's personalities and care needs. Throughout our inspection we observed that people appeared comfortable and at home in their environment. We observed that staff reassured and supported people appropriately. Medicines were stored and administered safely.

Park Farm House provided a homely environment and people had free access to communal areas. Everybody had their own room with en-suite. The provider made sure all equipment was serviced and in good working order.

Staff felt well supported and received regular training and supervision. They told us they could always approach management for advice.

The provider had a system in place to monitor the quality of the service. The manager told us that they carried out daily checks on cleanliness and on the mood of people living at the home to ensure they were happy.

The home had clear criteria for accepting new people and an important consideration was how people would fit in. Staff had a good understanding of the needs of people with dementia. They knew the people living at the home well and understood that people did not always communicate their preferences verbally.

Staff understood the importance of safeguarding and the Deprivation of Libery Safeguards were used appropriately.

People who received regular visitors had the opportunity to go out but opportunities to access the community for other people were limited. The provider may wish to note that there could be more things in place to support people without regular visitors to access the community regularly .