Farmhouse Residential Rest Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 71 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The registered manager was absent from the service at the time of the inspection, and the home was being managed day to day by the nominated individual.

The nominated individual and registered manager promoted an open and inclusive culture focused on person‑centred care. Equality, diversity and human rights were well understood and supported through reasonable adjustments. Staff spoke positively about values such as dignity, respect, safety and compassion, which were reflected in everyday practice.

The management worked with people, relatives and staff to develop the service and used feedback to support improvement. Staff said they felt listened to and valued. Risks to achieving service goals were monitored and addressed, helping to maintain a positive and improving culture.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The nominated individual had stepped in to manage the service whilst the registered manager was absent. Although they did not know all aspects of the running of Farmhouse Residential Rest Home, they were knowledgeable and demonstrated the skills to be able to manage the home safely and effectively.

Staff told us both the nominated individual and the registered manager were supportive and proactive in ensuring that care was delivered safely by staff who felt supported and competent in their roles.

The nominated individual recognised staff meetings and one to one supervision had not taken place regularly since they had been covering due to the prioritisation of work. Following the inspection, they sent us an action plan detailing how they planned to put these forums back in place.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People and staff were encouraged to raise concerns and share their views through regular engagement about how the service was run.

Staff told us that they were able to raise concerns with management and they would be listened to. One member of staff told us, “I know there will never be an issue if I raise concerns.” When concerns had been raised, the appropriate action was taken.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us they felt supported working at Farmhouse Residential Rest Home. The provider made adaptions to staff work patterns and implemented risk assessments dependent on staffs’ individual circumstances.

The provider did not always have effective accountability systems, which impacted upon the overall governance of the service.

Governance systems were not consistently effective in providing full oversight and supporting improvement. The provider’s systems had not fully identified the issues found during this inspection. For example, some PRN medication protocols did not always contain enough detail to fully support safe administration, and medication records were not always sufficiently clear to demonstrate safe practice. There was also limited accessible standardised information to support people to communicate effectively. In addition, one person’s care needs had not been reviewed promptly to ensure their support remained appropriate and responsive to change. However, no harm had come to anyone because of these omissions.

While audits were in place, these were not always effective in identifying areas for improvement or ensuring actions were taken and reviewed. Where issues had been identified, follow‑up arrangements were not always robust enough to confirm sustained improvement. As a result, governance arrangements did not always provide sufficient assurance that risks were consistently identified, addressed and used to drive learning and improvement in the quality and safety of care.

Following the inspection the nominated individual sent us an action plan advising us how they were going to address the above issues and said, ‘Revise audit processes to ensure that findings and actionable items are systematically reported to the manager’.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The management and staff worked effectively with external partners, ensuring notifications were made to the CQC as required in line with regulatory requirements. The management were fully aware of ‘Duty of Candour’ and kept relevant people informed at all times in an open and transparent manner.

Management and staff liaised appropriately with external health and social care professionals, including community nurses, GPs and specialist teams, to support safe and coordinated care. Staff sought advice promptly when people’s needs changed and shared relevant information to support continuity of care.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

There was a strong culture of learning and continuous improvement within the service. Lessons learned were clearly identified and shared with the staff team to support ongoing improvement.

The nominated individual was responsive to our feedback, putting together an action plan, detailing how they planned to address the concerns we raised with them during the inspection. This demonstrated a willingness to learn and make improvements to the quality of life for people.