Church Farm Care Home

We found the following examples of good practice.

There was clear communication with visitors, arrangements for visiting were by appointment only, and allowed for social distancing whist meeting individual's needs. A room was set aside for visits with an external door which meant visitors did not need to walk through the home. Visitors took a lateral flow test and had a temperature check before the visit to test for coronavirus.

People told us they were well supported during the recent outbreak of Covid-19.

The layout of the service had allowed for isolation when needed to prevent the risk of spread of infection..

Staff spent time with people in meaningful activities.

The service was clean with personal protective equipment stations at regular intervals. A robust cleaning schedule was maintained. Equipment was cleaned and tagged as clean between uses.

The layout of the service had been adjusted to give space between people when using communal areas.

Staff were knowledgeable about their responsibilities with infection prevention and control.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Church Farm is a care home which offers care and support for up to 60 predominantly older people. At the time of the inspection there were 44 people living at the service. Some of these people were living with dementia. The service occupies a building over two floors with passenger lift for people to access the upper floors. There was an on-going safeguarding investigation being carried out at the time of the inspection by the local authority. This incident is subject to a separate process and as a result this inspection did not examine the circumstances of that specific concern. However, the information shared with CQC about the incident indicated potential concerns about the management of risk in relation to the availability of equipment. This inspection examined those risks. We found that when people’s health indicated they needed additional equipment action was taken to acquire it.

The records in care plans, relating to the powers of attorney held by some people living at the service, were misleading and inaccurate. Some care plans stated relatives held power of attorney for care decisions when they did not. This meant people who did not hold the appropriate legal powers could be involved in care plan decisions and reviews and were asked to sign consent forms which they were not legally able to do. We have made a recommendation about this in the Effective section of this report.

There were systems in place for the management and administration of medicines. Regular medicines audits were being carried out on specific areas of medicines administration and these were effectively identifying if any issues occurred such as the dating of prescribed creams when opened. We identified an issue with the length of time taken to complete the morning medicine round leaving only a short period of time before the afternoon round began. This could have implications for people on time specific medicines and pain relief. We also observed frequent interruptions of the staff member carrying out the medicine round. We have made a recommendation about this in the Safe section of this report.

The premises were well maintained. The service was not registered for dementia care. However, there were some people, who were living at the service with some early dementia. There was no pictorial signage for people who may require additional support with recognising their surroundings. The deputy manager told us this was constantly under review depending on people’s needs.

The premises were regularly checked and maintained by the provider. Equipment and services used at Church Farm were regularly checked by competent people to ensure they were safe to use.

We walked around the service which was comfortable and appeared clean with no odours. People’s bedrooms were personalised to reflect their individual tastes. People were treated with kindness, compassion and respect.

Risks in relation to people’s daily lives were identified, assessed and planned to minimise the risk of harm whilst helping people to be as independent as possible.

Staff were supported by a system of induction training, supervision and appraisals. Regular staff meetings took place to support each team of staff. Daily heads of service meetings took place to help ensure communication was good across the service. The registered manager was supported by the deputy manager and the provider with regular visits from regional manager, and a team of motivated staff at the service.

Risks in relation to people’s daily life were assessed and planned for to minimise the risk of harm. People were supported by staff who knew how to recognise abuse and how to respond to concerns. The service held appropriate policies to support staff with current guidance. Mandatory training was provided to all staff with regular updates provided. The manager had a record which provided them with an overview of staff training needs. The provider monitored the service training provision against set objectives.

The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. The service had some staff vacancies at the time of this inspection. These vacancies were being covered by existing staff and no agency staff were used.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.

Care plans were well organised. Care planning was reviewed regularly and people’s changing needs were recorded. Daily notes were completed by staff.

People had access to activities. An activity co-ordinator was in post who provided a varied programme of activities for people.

We spoke with four members of staff, the manager and deputy manager. Staff told us that they enjoyed working in the home. One said, 'The residents really make the place'. Another told us, 'I love it here, it's a lovely place to work'.

We found that people were supported appropriately. The home had a new manager in place. She was active in seeking the views of people, their relatives and visitors in order to develop the service. At the time of our inspection, the previous manager had not deregistered with CQC and therefore their name remains on any reports until such time as this information is received.