The Farmhouse

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Peoples needs were assessed regularly to ensure they received personalised care. People had access to healthcare services and were supported to live healthier lives. 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 policies and systems in the service supported this practice. The care home worked in partnership with health and social professionals to ensure people were in the best of health.

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 home manager and staff told us that people’s needs were assessed regularly to ensure they continued to receive personalised care.

During our last inspection we found pre admissions system were not robust to determine if people could be supported safely. During this inspection, we found improvements had been made. There has not been new admission since our last inspection. However, pre-admission form had been revised to include if people could be supported effectively such as the support needed, routines and preferences. The home manager told us that they would also ensure information was captured from the previous care home and placing authority where possible to ensure people receive person centred care. They would also involve the person and their representatives in the assessment process. Reviews were carried out with people regularly to ensure they received support in accordance with their current circumstances. The reviews discussed people’s preferences and allowed them to make choices on their daily routines where possible. This meant that people’s needs, and choices were being assessed and reviewed to achieve effective outcomes for their care.

People received evidence based care and support. Relatives were positive about the care provided. A relative told us, “Yes, they [staff] seem supportive.”

The home manager and staff told us people's care was based around what was important to them and according to their preferences. A staff member told us, "I read their (people) care plans and learn from them during my induction. Everything is in the care plan.”

Care plans included the support people required with care needs Records showed that people had been supported to access a number of health services to ensure they were in the best of health. Feedback was sought from people, relatives and staff through meetings and reviews to ensure people received safe and effective support at all times.

Staff told us they worked well with each other and external services and were supported by management. A staff member told us, "Everyone gets on well with each other. We work well together. There are no concerns." A relative told us, “They seem a good team and work well together. I have always seen positive support to everyone well. The new manager is doing well and made lots of positive changes. In the past the staff were always on their phones but that has now stopped.”

Feedback from professionals were positive and we were informed the service worked well with health and social care professionals.

The service worked in partnership with other agencies such as health and social professionals if people were not well, to ensure people were in the best of health. Staff handovers were completed during shift change, which included tasks completed and wellbeing of people. This helped staff to keep up to date with any changes in people's needs.

People were supported to live healthier lives. A relative told us, “Yes, I recently accompanied them to a dentist appointment. There was a particular staff member there who has left, it is a shame that happens, but things seem to be settling.” Another relative commented, “[Person] has been having a lot of support, regarding health.”

The home manager and staff told us that people were always supported to live healthier lives. This included encouraging a balanced diet, participating in activities and promoting independence. A staff member told us, "Almost every day they go out. We communicate with them and do arts and crafts, watch action film, play with games, some of them like music. I like seeing people happy and making others happy.”

People were supported to live healthier lives. We saw that people were encouraged to drink and eat a balanced diet and were encouraged to take part in activities. Care records included the contact details of people’s GP, so staff could contact them if they had concerns about a person’s health. Annual reviews of their health were carried out. A health action plan and hospital plan were in place that recorded how people should be supported with upcoming health appointments. People also had access to dental services. We observed that people had access to dental care products to ensure they were in the best of oral health. People were supported with activities. People’s preferences with activities were recorded and activities were planned weekly. Records showed that people participated in a number of activities, which included accessing the community and indoor activities such as baking, dancing and playing games. People were able to maintain relationships with family and friends.

People's care needs were monitored consistently to improve outcomes. Relatives had no concerns about the care people received.

The home manager and staff told us people’s outcomes were always monitored through daily observations and reviews such as key worker meetings. During reviews, care needs were discussed to improve outcomes. The home manager told us that regular audits and feedback were carried out also to monitor and improve outcomes.

Systems were in place to monitor and improve outcomes. Care plans were personalised to ensure outcomes can be met. Reviews were carried out regularly to ensure people’s support and outcomes were monitored. Audits were being carried out and action plan was in place to ensure people received personalised care according to their needs. We saw a range of audits carried out in relation to aspects of the safe running of the home. However, in some cases these were not carried out consistently and actions had not always been followed up. The home manager told us this would be addressed.

Consent was sought from people where possible. A relative told us, “I have seen staff ask for consent before they support [person].”

The home manager and staff were aware of the principles of the Mental Capacity Act (MCA) and the need to ask for consent. Staff told us that they would always request people’s consent where possible before doing any tasks.

During our last inspection we found Mental Capacity Act (MCA) principles were not being followed. During this inspection, we found improvements had been made. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. Systems were in place to obtain consent from people to provide care and support. MCA policy was in place and staff had been trained on the MCA. People were able to make day to day decisions about their lives. For example, they were able to choose how they wanted to be supported. Where people did not have capacity to consent to care and treatment, then MCA assessments had been carried out and best interest decision process was followed. Records had been completed in full to include who attended the meeting and date of meeting. DoLS applications had been made in a timely manner to deprive peoples of their liberty lawfully for their own safety. However, we found on the care plans the provider shared with us that people’s consent for care plans to be made accessible for others to view was signed and dated by the manager. We saw no mental capacity assessment or best interest meeting giving consent for these to be viewed. This was discussed with the home manager who said they would address this.