Farriess Court

About the service

Farriess Court is registered for 26 beds and is a residential care home, providing personal care and accommodation for adults in one adapted building. Some people were living with dementia or a physical disability. At the time of the inspection there was 19 people using the service.

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

The potential risk identified at the last inspection, regarding some radiators not being covered had been addressed. This ensured people were no longer at risk of scalds from exposed radiators. Since our last inspection the local authority had identified improvements that were needed to the maintenance of some areas of the building, such as windows in some bedrooms and communal areas, that did not open. We saw the provider had commenced this work and had an action plan in place to address all areas. We identified other areas that required repair, such as the flooring and walls in the laundry room. The manager added this work to the action plan in place.

We have made a recommendation for the provider to review good practices measures regarding the smoke room; to prevent smoke from cigarettes drifting into smoke free areas.

We saw that risk assessments were in place and identified how risks were to be minimised to keep people safe and overall these were followed by staff. However, we saw that one person’s risk assessment was not always followed regarding the supervision they required when smoking cigarettes. We followed this up with the manager, who told us they would address this with the staff team, to ensure the risks to this person were minimised.

People accessed healthcare services and were supported to keep well. However, we identified that developments in the assessment of people’s oral health care and training for staff in this area may enhance people’s wellbeing. The manager confirmed that she would address this. Staff were provided with training in other areas to develop their skills and knowledge and meet people's needs.

People received the support they needed to take their prescribed medicines on time and in their preferred way. Sufficient staff were available to support people as needed. Recruitment checks were completed before staff commenced employment to ensure they were suitable. People were safeguarded from harm, as staff were trained and understood their role in reporting any concerns to protect people. Control measures were in place to minimise the risk of infections.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s capacity was assessed when they were unable to make decisions independently. This was to ensure that decisions were made in their best interests and that they were supported in the least restrictive way. People told us they enjoyed the food and we saw their dietary needs and preferences were met.

People were support by staff who knew them well and understood their preferences and interests. Information was available in an accessible format to aid people’s understanding. People’s care plans were reviewed regularly and included their preferences on how their care should be delivered. People knew how to raise concerns about the service and these were addressed following the provider’s procedure.

People and their visitors knew who the manager was and were confident that the home was managed well. Quality monitoring systems were in place to drive improvement and the provider’s action plan demonstrated that improvements were ongoing. However, the provider’s quality assurance systems had not been effective in identifying all areas that required improvement.

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 requires improvement (published 31 January 2019) and there was one breach 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.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvement. Please see the safe, effective and well led key question sections of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Farriess Court was previously inspected by the Care Quality Commission on 6 July 2017. We found two breaches of the regulations. We asked the provider to complete an action plan to show what they would do and by when to improve the premises to promote people’s safety and to ensure effective governance of the service. The overall rating for the service was requires improvement. We found some improvements had been made, however further improvements are required.

This is the second time the service has been rated Requires Improvement.

People were exposed to potential risk as some radiators and other heating devices used to heat some rooms within the service were not covered to protect people from coming into contact with hot temperature surfaces.

People told us they felt safe at Farriess Court. Individual risk assessments identified potential risks to people. Staff were knowledgeable about keeping people safe, which included their awareness of safeguarding and the implementation of the personalised risk assessments. People were supported by staff that had been recruited and had checks undertaken to ensure they were suitable for their role. People’s medicine was managed safely.

We found improvements could be made for the benefit of people living with dementia, memory loss or confusion by considering how the décor and signage within the service could be developed, to improve people's well-being consistent with good practice guidance. We have recommended that all staff undertake training in dementia awareness to enable them to better understand and support those living with dementia.

People’s needs were assessed to ensure staff could provide the support required. People’s needs were met by staff that had the skills to provide safe care and who were regularly supervised and had their competency assessed.

People’s health care needs were monitored, and people worked in partnership with staff to monitor their health. People were supported to have maximum choice and control of their lives and staff supported them in the least restrict way possible; the policies and systems in the service supported this practice. People’s dietary needs were met and people spoke positively about the food.

People spoke positively about the care and approach of staff towards them. Staff’s knowledge and awareness of people meant they had developed positive relationships. We observed positive interactions with people, with staff providing opportunities for people to take part in activities and by spending time engaging in conversation.

People’s records were electronically stored and were used by staff to update people’s records throughout the day, providing a clear audit trail of the care provided and staff’s observations as to people’s wellbeing. People’s preferences about their care had been sought and recorded to ensure staff supported people consistent with their wishes and expectations.

People were confident in raising concerns, we found concerns and complaints had been investigated and any necessary actions taken. However, information about complaints and other key information such as advocacy services and safeguarding were not displayed where they could be easily accessed and clearly visible.

The provider had not addressed all the areas identified within the previous inspection report for improvement. A range of audits had been introduced to monitor the quality of the service, however these had not identified the potential risk to people of hot surface temperatures of radiators. The provider’s oversight of the registered manager through formal supervision was not robust.

People’s views about the service were regularly sought and their comments in the main positive. However, the results once analysed were not shared with people to provide them with information about the service and the provider’s plans in response to their views. The provider displayed the rating awarded by the CQC following its previous inspection on the notice board at Farriess Court and on its website.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Farriess Court is a care home that provides residential care for up to 26 people. The home specialises in caring for older people. At the time of our inspection there were 22 people in residence.

Farriess Court had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider did not have effective systems in place to assess, monitor and improve the quality of care. There was no system by the provider to supervise or oversee the registered manager and how they ensured people were safe in the home.

Health and safety checks were not always completed to ensure risks to people’s safety were minimised. We identified some health and safety issues with regards to the premises to the registered manager and the provider on the day of our inspection visit where we had immediate concerns to people’s safety.

Risks to people’s health and welfare were identified but not effectively managed and where people were at risk of harm, actions had not been taken to keep people safe. Staff were aware of the reporting procedure for faults and repairs.

Staff were subject to a recruitment procedure that ensured staff were qualified and suitable to work at the home. Most staff received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse. There were sufficient staff available to meet people’s personal care needs and we saw staff worked well in meeting people's needs.

People felt staff were kind and caring, and their privacy and dignity was respected in the delivery of care and their choice of lifestyle. Care plans and risk assessments were in place and people were involved in the review of their care plan, and when appropriate were happy for their relatives to be involved. We observed staff offered people everyday choices and respected their decisions. Staff had access to people’s care plans and received regular updates about people’s care needs.

People were provided with a choice of meals that met their dietary needs. The catering staff were provided with up to date information about people’s dietary needs, and staff sought the opinions of people to tailor their individual meal choices. Medicines were ordered, stored and administered safely and staff were trained to provide the medicines people required. Care plans included the changes to peoples care and treatment, and people attended routine health checks.

Staff provided a variety of personalised activities for people. Staff had a good understanding of people’s care needs. People were able to maintain contact with family and friends as visitors were welcome without undue restrictions. Staff sought medical advice and support from health care professionals.

Staff told us they had access to information about people’s care and support needs and what was important to people. Staff knew they could make comments or raise concerns with the management team about the way the service was run.

The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, however there was no formal process for people’s relatives or health and social care professionals. We received positive feedback from a visiting health professional with regard to the care offered to people and professionalism of care staff.