The Farmhouse

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 Requires Improvement. At this assessment, the rating has improved to Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Systems were in place to learn from lessons following accidents and incidents. Records showed that accidents and incidents were recorded and reviewed with lessons learnt to minimise the risk of occurrence. Lessons learnt were shared with staff in staff meetings.

There had been no new admissions to the home following our last assessment.

People had access to healthcare services when needed. Records showed that people had access to a number of healthcare services such as GP, Dentist and Hospitals. Hospital passports were in place that included people’s background, health issues and how to support people should they access healthcare services.

During our last assessment, we found robust processes were not in place to safeguard people from abuse. During this assessment, we found improvements had been made.

Systems were in place to safeguard people from abuse and harm. A safeguarding policy that included types of abuse and who to report too was in place. Records showed that safeguarding concerns were reviewed with appropriate actions taken where required.

During our assessment, we observed staff protecting people from potential risks of harm. We saw staff were supporting people to prepare their meals in the kitchen. Another person was being supported to use the community. We saw that staff communicated with people, in a calm and respectful manner, and people responded to staff in a positive way.

Relatives told us people were protected from abuse and felt safe. A relative told us, “I am thrilled with the place. I would never leave [person] where I didn’t think [person] was safe. Another relative said, “[Staff] are able to keep everyone safe. I can walk in any time, talk to the manager, the deputy or any of the staff and I can see [person] is safe”. Another relative told us, “Definitely safe at the home.”

The registered manager was able to show us the systems they had to help ensure staff understood safeguarding procedures and understood their responsibility when there was a safeguarding concern. The registered manager told us, “I held a safeguarding workshop recently. We looked at the form used for [safeguarding], where to print the form, how to complete it and who it needs to go to.”

Staff had received training in safeguarding and staff we spoke to were aware on safeguarding processes. A member of staff said, “I would report to my manager immediately of any safeguarding concerns. If I felt the concern had not been addressed as needed to be, I would report to the local authority or CQC.”

During our last assessment, we found people’s risks were not properly assessed to ensure they were supported in a safe manner particularly when they were anxious. During this assessment, we found improvements had been made.

Risk assessments were in place to ensure people received safe care. Improvements had been made with risk assessments when people were anxious. Risk assessment included how to support people safely when they were anxious. Risk assessments had also been completed for skin integrity, nutrition, falls and health conditions.

We observed staff were engaging with people appropriately and had a good understanding of people’s likes and dislikes. Staff were clear on how to avoid known risks to people and identified through body language if a person was becoming anxious about something, which helped keep people safe from avoidable harm. We saw people engaged in various activities, for example, we saw a person was being supported to use public transport to the leisure centre. Another person had become more confident in using the community on a frequent basis, as previously the person did not like going out, which showed positive risk taking.

Relatives told us that they felt staff looked after people well. A relative told us, “The staff know how to work with my [person]. I go in and talk to the staff, ask them questions and by their responses, it is clear they know them well.” Another relative told us, “If anything happens, we get a call. The current manager is very hands on in the service, he knows what he is doing. They are able to motivate staff to do what they need to do.”

We saw evidence staff received appropriate risk management training, which helped them develop their skills on managing risks to people. Staff were able to tell us how they supported people with their identified risks. A staff member said, “Risk assessments are accessible online, where we can read any changes or updates to the risk assessment that the manager has completed. There are different risk assessments that are in place for staff to follow for example, we have risk assessments for people who may become anxious and there could be a risk that staff could be injured.”

The registered manager showed us evidence that risk assessment was reviewed on a regular basis. The registered manager told us, “I review risk assessment monthly; we discuss them in staff meeting and staff supervisions. I review risk assessments after any incident or concerns that have been identified.”

The premises and environment were adapted to meet people’s individual needs who used the service. Checks were being made on the premises to ensure it was safe to live in such as fire safety checks. Checks on equipment were made to ensure it was safe to use such as on wheelchairs.

The registered manager told us about the systems that they had in place to check the environment was safe for everyone who used the service. This included daily, weekly and monthly checks completed by management and staff. When repairs were identified, they were reported to their maintenance team. The registered manager also told us that they had recently carried out a review on the time it was taking to fix repairs, which had now been addressed, and things were being repaired much quicker.

We observed the environment was safe. The home was clean and tidy, which ensured people were able to move around the home safely. Fire safety equipment was in place such as fire alarms and fire extinguishers. We saw evidence that there was an improvement plan in place to identify work to help improve the home to help ensure that equipment was updated and replaced if required.

During our last assessment, we found robust systems were not in place to recruit staff safely. During this assessment, we found improvements had been made.

Systems were in place to ensure pre-employment checks were carried out and staff were recruited safely. At the last assessment, we saw gaps in recruitment files, such as not all staff had completed interview notes, gaps in employment and references had not always been received and detailed induction records had not been kept. At this assessment, we found this had been addressed. Checks had also been made on staff background such as identification and criminal record checks with references being sought to check if staff were of good character.

Staff were deployed effectively to ensure people received safe care. We observed there was enough staff to support people safely and staff rota confirmed this, which included 1:1 support.

Relatives we spoke to had no concerns with staff. A relative told us, “We see a lot of the manager whenever we are there. The deputy manager is very good too and they help us with a lot of the appointments [person] has.” Another relative said, “The manager and deputy manager are amazing. I do worry about my [person], however the staff are able to care for my [person], which stops me worrying so much.”

Following from our last assessment, records showed that staff continued to receive effective training to perform their roles effectively, such as with learning disabilities and autism along with key training in first aid and moving and handling. Staff also received regular support through supervisions and appraisals.

An infection control policy was in place. Infection audits were being carried out to ensure the risks of infection was minimised. Staff had been trained in infection control.

We observed the home was cleaned regularly with a cleaning rota in place. Handwash facilities and personal protective equipment was available to minimise the risk of infections. We saw that there was good food and hygiene procedures in place that was being followed by all staff. We saw a person being supported by staff to help clean their bedroom and do their laundry.

Staff were very positive about the service and how they work as part of a team to ensure infection was minimised. A staff member told us, “We all support each other and work as a team to help keep the home clean and tidy. Another staff member said, “We let our manager know when we need to order more cleaning products and handwash, aprons and gloves.”

The management of the service told us how they work with external partners and organisations to help ensure infection control systems and hygiene were robust. This included, collaborating with the local authority’s environmental health as well as external contractors.

Medicines were being managed safely. A medicines policy was in place. Staff were trained in medicines and assessed to ensure they were competent to manage medicines.

Medicine administration charts were completed to evidence people were given medicines as prescribed. There were protocols available to guide staff on how to manage ‘when required’ medicines. We also reviewed medicine audits, which were completed and gave a clear record of what medicine was in stock and when it needed to be re-ordered by the pharmacy. This assisted the service to have robust systems, which helped to ensure that people received their medicines safely and on time.

Staff told us they felt confident in managing people’s medicines and that the training they received supported them to have a good understanding of their roles and responsibilities regarding administering people’s medicines safely.