We considered our inspection findings to answer questions we always ask;Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
This is a summary of what we found.
At the time of our inspection there were 17 people living at Kent Farm Care Home including three people living in The Old Dairy. The Old Dairy is a five bedroom annexe in the grounds of the main house a short distance away which provides accommodation specifically for people living with dementia.
The inspection took place over one day with two inspectors. During our inspection, we spoke with 11 people who lived at the home, six staff, the visiting masseuse, a community nurse, the cook and the housekeeper and the registered manager. Some people living with dementia were unable to comment directly on their care but we spent time in the communal areas observing their experiences and how staff interacted with them.
Is the service safe?
The service was safe because people were supported by staff who had received appropriate training in the skills required to perform their roles.
There was a stable staff team and enough staff on duty with the appropriate qualifications, skills and experience required at all times. Named staff were allocated to meet people's needs in The Old Dairy and numbers changed depending on need.
The home had suitable arrangements in place to reduce the risks of people receiving inadequate nutrition or becoming dehydrated.
The service was safe because staff told us and we saw there was sufficient equipment to meet people's mobility needs. We saw maintenance schedules for equipment at the home which included the lifts, hoists and general d'cor such as floor coverings and furniture and these ensured maintenance was timely.
Arrangements were in place to manage emergencies, such as power failures, where necessary. We saw a list of emergency contact telephone numbers for staff to ring which included the lifts, hoists, sluices and fire equipment.
The registered manager and staff had undergone training to understand their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. We saw that there had recently been confusion about the practical application of DoLS safeguards, as staff had not had to apply them in the past. However, we saw that the home had learnt from this experience and refresher training had been booked for all staff, which was confirmed by the registered manager, and a meeting had been held to discuss how the health professionals and the home could work together more effectively.
Is the service effective?
We know the service is effective because staff we spoke with knew people very well and understood people's care and support needs. We saw very comprehensive care plans which had identified people's needs and how those needs should be met in a very person centred way involving family/advocates as possible.
The service had undertaken regular audits and produced action plans which were then acted upon so that people could be sure their needs were met.
Is the service caring?
The service was caring because people were treated with respect and their dignity was maintained by staff. Throughout our visit, we saw that people were treated in a caring and compassionate manner and with dignity and respect. We saw staff were engaged in cheerful conversations with people and treated them as individuals, also involving them when undertaking tasks in line with people's wishes.
People told us they were happy with the care they received. Comments included, 'I love it here, people are very nice and we have lovely parties', 'I am certainly looked after very well', and 'everything's good here'. Several people had previously lived in the local area and maintained family contacts and friendships with people in the village.
Is the service responsive?
The service was responsive to people's social needs. There was a regular programme of activities in place and we also saw staff sitting chatting with people in the communal areas and in their rooms.
The home had appropriate systems in place for gathering, recording and evaluating information about the quality and safety of the overall service. Systems were in place to make sure the registered manager and provider learnt from events such as accidents and incidents. This reduced the risks to people and helped the service to continually improve.
The service was responsive because people's needs were risk assessed and their care plans regularly reviewed and based on person centred care.
Is the service well led?
We found the service was well led. The registered manager has been in post for a number of years and is currently registered with CQC. We were told by staff and people who used the service and their visitors they had confidence in the registered manager and were able to approach her if they had any concerns. During our visit we saw the manager teaching a newer staff member about how individual people liked to receive their care. When the manager asked a staff member to show us what they did when they arrived on shift, the staff member was clear about their role and how to be sure they were aware of any care need changes.
The provider lived on site and the registered manager said they were well supported. One staff member said the provider 'is fantastic. Staff told us the provider worked with the registered manager and the staff to ensure the standards people expected at the home were maintained.
The registered manager undertook an annual survey to find out the views of people living at the service and their relatives and staff. This was due to be repeated for 2014. These focussed on topics such as an admissions survey which asked people about whether they felt involved in the assessment of their needs. The manager said they had not received any formal complaints in the past year but dealt with verbal concerns as they arose. These were currently not recorded which the manager said they would do from now on to show they were acted upon in a timely way. People we spoke to all told us they would not hesitate to voice any worries with the manager, staff or the provider who was regularly in the home.