Telford Hall

Updated 2 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 4 inspectors; one of which was a medicines inspector.

Service and service type

The Farmstead is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Farmstead is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 17 weeks and had submitted an application to register. We are currently assessing this application.

Notice of inspection

The first day of the inspection was unannounced. The second day was announced.

Inspection activity started on 9 May 2023 and ended on 10 May 2023. We visited the service on both dates.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who lived at the home, 5 relatives and a visiting professional. We spoke with 11 members of staff which included the nominated individual, manager and deputy manager, registered nurses, care staff, domestic and maintenance staff, the administrator and activity staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at 3 care plans and multiple medication administration records. We looked at staff recruitment and training records and records relating to health and safety and the management of the home.

Updated 2 June 2023

About the service

The Farmstead is a care home providing nursing and personal care to up to a maximum of 66 people. The service provides support to older people, younger adults, people with dementia, physical disabilities and sensory impairments. At the time of our inspection there were 31 people using the service. The Farmstead is a purpose-built care home. Each of its 3 floors has its own communal dining and lounge areas with a kitchenette. A passenger lift gives people access to all floors.

People’s experience of using this service and what we found

People told us they felt safe living at the home and with the staff who supported them. Staff had been trained to recognise and report signs of abuse. There were sufficient staff to meet people’s needs and help keep them safe. The provider’s staff recruitment procedures helped to protect people from harm. Risks to people were assessed and there were plans in place to mitigate risks. People received their medicines when they needed them from staff who were trained and competent, however further improvements were needed in relation to the safe management and administration of medicines. The provider followed best practice in relation to infection control and prevention and management of risks relating to COVID-19.

People were provided with enough food and drink to meet their needs. People were positive about the quality and quantity of the food they received. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the provider's policies and procedures supported this practice. People lived in a home which was well-maintained and adapted to meet their needs. People saw healthcare professionals when they needed. People were supported by staff who were trained and competent to carry out their role.

People told us they were supported by kind and attentive staff who respected their wishes and treated them with respect. People were supported to live their lives as they chose and were regularly consulted about the care they received. People’s privacy was respected, and they could spend time alone in their bedroom when they wanted. People were supported to be as independent as they could be.

People told us staff knew them well and what was important to them. People were supported to maintain contact with those who were important to them and were provided with opportunities for social stimulation. People’s communication needs were assessed and responded to. People did not raise any concerns about the care they received but felt confident action would be taken to address any concerns they may have. There were systems in place to ensure people’s needs and preferences would be understood and met during their final days.

Systems to monitor and improve the quality of the service provided had improved. Staff morale was good and staff told us they felt well supported. Staff received the supervision and support needed to carry out their role effectively. The views of people were sought and valued. The provider worked in partnership with other professionals to ensure good outcomes for people. The provider was aware of their legal requirement and of their responsibility to be open an honest when things go wrong.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 7 February 2023) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 7 February 2023. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Farmstead on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.