Archived: Falcons Rest & Poachers Cottage

People using the service and their families told us that improvements had been made and the registered manager was running the home effectively.

We found that people were having their care needs met. The arrangements for each person were being actively reviewed and changes were proving beneficial for several people.

The health and therapy professionals involved in the service told us the staff were following guidance more consistently and this was benefiting people living at the home.

People's care plans had been reviewed and records were more accurate and useful.

There was a full staff team that were being deployed effectively. The staff were better trained and supported to carry out their role and responsibilities.

There were effective leadership arrangements in place to manage the care service and monitor quality, and health and safety risks.

We found that since the last inspection the service had reverted back to a care home that did not provide nursing care. As a consequence the care staff had taken over the responsibility of managing the medicines for the people using the service.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

We found that the service had improved the recording, storing, administration and monitoring of medicines. We therefore found that the service had systems in place to ensure the safe management of medicines and ensure that people using the service were safeguarded against the risks associated with medicines.

We found that people and their relatives were generally satisfied with care provided but were concerned about the nursing and management arrangements. They were cautiously pleased about the provider's recent decision to stop providing nursing care. The nursing care would then be provided by community district nurses.

People's health and care needs were being assessed and planned for but some improvements were still needed. People were taking part in more personalised and therapeutic activities.

There were still shortfalls in how people's medicines were being managed that continued to put people at risk of not having their medicines correctly.

Care staffing levels were appropriate and more carer staff were being recruited. Training for care staff was taking place but more was needed. All of the nursing shifts were being covered by nurses from agencies and clinical arrangements had not always been effective and to a good standard.

A new manager had been in post a few weeks and the service had been better led. There were still risks to people using the service and improvements were still needed in the same four areas. These will be followed up and we will report on any action when it is complete.

We found that a new care planning system was being put in place. This work had not been completed and we could not yet see that an effective system was in place for updating the plans as people's needs changed. Many people's support had been reassessed in consultation with professionals and positive changes had been made as a result of these reassessments. People were taking part in more activities based on their specific needs and preferences. There was evidence that learning had taken place from incidents where people had not received the correct health care.

Changes had been made but there were still shortfalls the management of medicines.

Staffing levels were appropriate more often and senior carers were now leading the care team. Many of the nursing shifts were still being covered by nurses from an agency. There were still vacancies in the nursing team and competency checks were not taking place. The manager's post was to be re-advertised.

The service had been led more proactively but the management and quality assurance systems were not yet fully effective. Improvement were needed in the four areas we assessed. These will be followed up and we will report on any action when it is complete.

The process of changing to nursing care had led to a restructure of the staff team and there had been staff shortages. Staffing levels had improved but there were still vacancies for both care workers and nurses so agency staff were regularly used. Staff training needs and competencies across the team had started to be addressed.

We found that medicine management systems did not fully protect people. People's health needs were not always assessed and planned for in a timely manner. Some activities and therapies were provided but development was needed to fully meet people's complex physical and communication needs. The acting manager was regularly working shifts to help with staffing shortages. This was taking her time away from improving and monitoring the systems in the home.