Farmhouse Residential Rest Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Regular audits of accidents and incidents took place to look for themes and trends, to make desired improvements and prevent further occurrences.

Following a complaint from a relative about their loved one’s care, the provider responded promptly and appropriately by undertaking a full and thorough investigation to establish the facts and understand the circumstances surrounding the incident. This process was carried out transparently and with due regard for those affected, ensuring the concern was taken seriously. An apology was offered to acknowledge the failings. Learning from the outcome of the investigation was shared with the staff team, and a dedicated training session was delivered to all staff to reinforce expected standards, reflect on practice, and help prevent a similar incident from occurring in the future.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

As part of this approach, people had a completed Herbert Protocol (the Herbert Protocol is a national safeguarding scheme used by police and emergency services to help quickly find vulnerable people who go missing) included within their care files, which was kept up to date and ensured key personal, medical, and risk information was readily available. This supported a prompt, informed response should anyone be reported missing, helping to reduce risk and safeguard people’s wellbeing

People’s needs were fully assessed before being admitted into the service, involving people, their relatives and other agencies when applicable. This was to ensure all the relevant information was gathered to facilitate a smooth transition into the service and the person’s needs could be safely met.

Where people were identified as having needs that could not be fully met by the service, the provider worked proactively with other agencies and professionals to arrange appropriate support, referrals, and coordinated care, ensuring people’s individual needs were met safely and effectively.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

Staff had all received training in safeguarding procedures. Staff we spoke with knew who to report to if they had any safeguarding concerns. One member of staff said, “I would report it to the manager, they would definitely deal with it, but if not, I would go to the safeguarding team or CQC.” When safeguarding incidents occurred, the provider took appropriate action to report the incident to the local safeguarding authority.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Some people were subject to Deprivations of Liberty Safeguards, (DoLS). The provider had appropriate systems in place to ensure applications for DoLS were made in a timely way and any conditions imposed for DoLS agreements were kept under review.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Clear guidance in people’s care plans was in place to support safe practice, and staff demonstrated confidence in following agreed risk management strategies. This included specific assessments such as fire risk assessments and Personal Emergency Evacuation Plans (PEEPs), which outlined how people would be supported safely in the event of an emergency.

Staff were knowledgeable about the risks identified for each person and understood the actions required to reduce or manage those risks effectively.

Following a fall, the management team carried out an appropriate assessment and put measures in place to reduce the risk of further incidents. This included closer monitoring and the use of sensor mats. Sensor mats are placed by the bed or chair and are triggered when pressure is applied or removed, alerting staff if the person attempts to stand without support. This enabled staff to respond quickly, helping to reduce the risk of further falls and maintain the individual’s safety.

We saw one person who was on respite at the time of the inspection had an incident whilst eating their lunch. A new risk assessment was drawn up immediately and the staff member told us this would be handed over to all staff at their handovers to ensure the person was safe from this occurring again.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider undertook regular health and safety checks to maintain a safe environment and to ensure compliance with relevant regulations, including checks related to fire safety and hot water temperatures. These routine checks helped to reduce the risk of accidents or harm and ensured the premises remained safe, well maintained, and suitable for people living there.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and staff, we spoke with mostly told us they felt there were enough staff at all times. One staff member said, “Yes, there are enough of us, to the number of residents here at the moment, no one has to wait long.” Another member of staff told us, “There is always a member of staff in the lounge, and we take it in turn to have breaks, there is a good mix of staff.” However, another member of staff told us they felt that more staff should be available in the evenings when some people experienced ‘sundowning’. Sundowning refers toincreased confusion, agitation, or restlessness in people living with dementia, typically beginning in the late afternoon or early evening. They told us that sometimes staff had to miss their breaks to support people.

The provider used a staffing dependency tool and audited the call bell alarms to ensure people were responded to in a timely manner. At times, staffing numbers were increased to meet the needs of the home, for example during an infection outbreak, the domestic support was increased for a period of time.

Safe recruitment processes were in place, and all necessary checks were completed before staff began working at the service to ensure they were safe to work with people who used the service. There was ongoing programme of training available to all staff which ensured staff remained competent in their roles and understood the needs of the people they supported.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had robust infection prevention and control arrangements in place, led by a designated infection control champion who completed monthly audits and escalated any actions to the management. The environment was maintained to reduce infection risk through ongoing refurbishment using wipeable surfaces and furnishings. In addition, each person had an individual, person‑centred infection control risk assessment to guide staff in managing risks safely, including plans for situations where isolation may not be possible.

The kitchen had recently achieved a five-star hygiene rating from the food standards agency following an unannounced visit.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

There was not enough information included within PRN (when required) medication protocols, which meant staff did not always have clear guidance on when these medicines should be administered. In addition, records did not always clearly evidence when certain PRN medicines had been given or the rationale for their use, which limited assurance that medicines were being administered appropriately and in line with best practice. Following the inspection the nominated individual sent us an action plan telling us how they planned to make improvements in this area.

Medicines were stored securely and administered by appropriately trained staff. Fridge and room temperatures were monitored regularly, and an electronic system was in place to alert staff when medicines were due. Routine stock checks were completed, and a review of 2 medicines confirmed that physical stock levels matched records.