This was a comprehensive inspection and took place on 15 November 2017. It was unannounced.

Far End Residential Home is a ‘care home’. 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.

Far End Residential Home is a care home without nursing for up to three people requiring support and personal care by reason of age. At the time of the inspection three people lived at the service. The service is separated into two well defined areas. People are accommodated on the upper floor of the house in large individual bedrooms .There is a shared bathroom, toilet and kitchen with a garden room providing communal living space on the ground floor. The remainder of the lower floor is occupied by the registered manager and general manager who live on the premises. Outside there is a large garden for people to enjoy.

At the last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

The home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection a registered manager was in post and assisted with the inspection.

People continued to receive safe care from the service. Risk assessments were completed and measures taken to reduce identified risks without restricting people’s freedom. Recruitment procedures were followed to ensure as far as possible only suitable staff were employed. Staff were trained to safeguard and protect people. They reported concerns promptly when necessary. People received their medicines safely when they required them.

People continued to receive effective care from staff who were trained and had shown they had the necessary skills to fulfil their role. However, refresher training in topics considered mandatory by the provider was not all completed at the frequency recommended as current best practice. We have made a recommendation that the provider refer to the current best practice guidance on ongoing training for social care staff.

Staff were supported through one to one meetings, appraisals and daily conversations with the managers. Staff were encouraged to seek advice, discuss and review their work and develop their skills and knowledge. People were supported with nutrition and hydration and had sufficient to eat and drink to maintain their health and well-being. People’s healthcare needs were monitored and advice was sought from healthcare professionals whenever necessary. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

The service remained caring and people reported staff were kind, caring, compassionate and patient. People’s privacy and dignity were protected and staff treated them with respect. People and when appropriate their relatives, were involved in making decisions about their care.

The service remained responsive to people’s individual needs. Staff knew people well and individual care plans were person-centred. They focused on and respected the diverse needs and preferences of each person and their desired outcomes. People knew how to complain and felt they were listened to if they ever raised an issue. The service was working to the accessible information standard. People were supported to engage in meaningful activities of their choice.

The service continued to be well-led. There was an open, friendly and person centred culture. The managers had clear values which

The inspection took place on 5 November and was unannounced.

Far End Residential Home is a care home without nursing for up to three people requiring support and personal care by reason of age. Some may also be living with dementia. At the time of the inspection three people lived at Far End Residential Home.

The home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection the providers were both registered managers.

People using the service were happy; they were seen to be relaxed during the inspection and told us they were happy and felt safe. People were treated with kindness and respect and their dignity was maintained. Support was individualised and designed to meet the specific needs and preferences of people living at the service.

Risks to people were assessed and managed without restricting people’s freedom. Staff were aware of how to keep people safe by reporting concerns promptly through procedures they understood well. Robust recruitment procedures were in place to ensure only staff of suitable character were employed.

People’s rights were protected and staff understood their responsibilities with regard to gaining people’s consent and the relevance of the Mental Capacity Act 2005. The Mental Capacity Act 2005 provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. The providers liaised with the local authority with regard to people’s mental capacity and made Deprivation of Liberty Safeguards (DoLS) referrals when appropriate.

Staff were trained appropriately to meet people’s needs. New staff received induction, training and support from experienced members of staff and the providers. Staff felt well supported by the provider and said they were always listened to. People’s medicines were managed safely. Staff had received appropriate training in the safety of medicines and their knowledge and skill was assessed regularly.

People and their relatives were involved in planning and reviewing the support they required. People’s health was monitored and they saw healthcare professionals promptly when necessary. People were encouraged to be as independent as possible and they were able to take part in activities of their choice. The quality of the service was monitored regularly by the providers.

Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. A complaints procedure was available but no complaints had been received.

The care and support for the three people who use this service is mostly provided by the two registered providers, with part time assistance from one care worker and occasionally a volunteer.

We observed people’s care plans contained ‘consent to care’ forms signed by people who use the service. One person told us “staff don’t make me do things.”

We looked at three care plans. They were person centred, reviewed regularly, and included personal risk assessments. One person told us “It’s not like a residential home, it’s my home.”

One care worker said “We provide flexible care. There’s a very good staff ratio, so people get a personal service. It’s unique and different here. People get to use the grounds, and are very content and happy.”

We saw the home was clean, and staff were aware of actions to take in order to reduce the risk of infection. They had received appropriate training and guidance to maintain suitable infection control.

Staff told us they felt supported by the managers, and received appropriate training to deliver their roles safely. We saw records confirmed training was current. We noted all staff, including the volunteer, received regular supervisions and annual appraisals, and were encouraged to attain further qualifications.

We looked at an annual questionnaire carried out by the providers. This noted people who use the service were satisfied with the care they received, and provided an opportunity to identify any improvements required.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

On the day of our inspection there were 3 people living at Far End Residential Home. People who lived at Far End Residential Home told us they were happy living at the home and that they were able make their own choices about their daily lives. We were told about how staff at the home supported people to maintain as much independence as possible. One person living at the home told us “have a bath three times a week. The carer sees me into the bath; I am allowed to bathe independently and then a carer helps me out of the bath.” We were also told “I’ve got no problems, they are really good. They are really respective of us".

People told us that they enjoyed the meals provided by Far End Residential Home. They were all able to make choices about the food they ate and staff at the home respected their choices.

People knew who to address any concerns or complaints to. We were told that if they had any concerns they would speak to the “owners or one of the carers”. All the people who lived at the home expressed that they had nothing to complain about, but if they did they had confidence that the complaint would be dealt with promptly and effectively.