About the service:

Farnham Common House is a purpose-built residential care home. It was providing personal care to 44 older people and people with dementia at the time of the inspection.

People’s experience of using this service:

• People were cared for by kind and caring staff who understood the support they required.

• People’s diverse needs were met.

• 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 environment was designed to meet the needs of people with a range of disabilities. It had appropriate equipment in place to support daily living.

• Checks and servicing took place to ensure the premises were safe.

• People received appropriate support with their medicines and any healthcare support they required.

• There was effective monitoring of the service to ensure people’s needs were met.

• Staff received the training and support they needed to meet care needs and to develop as professional workers.

• The provider had clear visions and values about how it expected the service to be run. The staff team achieved these.

• There were some areas where care could be improved. We have made recommendations about

recording people’s healthcare needs and about palliative and end of life care needs, to ensure these are documented and provide guidance for staff.

Rating at last inspection:

The service was rated ‘Good’ at the last inspection on 13 and 14 June 2016. We published our report on 27 June 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Inspections will be carried out to enable us to have an overview of the service. We will use information we receive to inform future inspections.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 13 and 14 June 2016. It was an unannounced visit to the service.

We previously inspected the service on 7 November 2013. The service was meeting the requirements of the regulations at that time.

Farnham Common House provides care for up to 50 older people and people with dementia. Forty nine people were living there at the time of our inspection.

The service 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.

We received positive feedback about the service. Comments included “I’m quite happy here,” “People here care a great deal,” “It’s all very good. We have a lovely room and a nice outlook. What more could we ask?,” “I like living here a lot because of the care I get. I like being here with people” and “I’m really pleased with the care. Mum’s very independent and difficult, they’ve been really patient with her. They persevere with her. They’ve been really good, I can’t fault them.” Health and social care professionals also spoke positively about people’s care. For example, one said the home was “One of the best ones in the area.”

We found there were enough staff to meet people’s needs. The home used robust procedures when recruiting workers, to make sure people were supported by staff with the right skills and attributes. Staff were supported through a structured induction, regular supervision and an annual appraisal of their performance. There was an on-going training programme to provide and update staff on safe ways of working.

People’s needs were recorded in care plans. These were kept up to date to reflect changes in

people’s circumstances. Risk assessments had been written to identify the likelihood of people sustaining injury or harm whilst they received care. For example, through falls or where they were assisted with moving.

People were supported to keep healthy and well. They had access to healthcare professionals and received their medicines safely.

There were safeguarding procedures and training on abuse to provide staff with the skills and knowledge to recognise and respond to safeguarding concerns.

People were protected from the risks associated with unsafe premises. The building was well maintained. Equipment was serviced to make sure it was in safe working order. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

The service was managed well. The provider regularly checked the quality of care at the service through visits and audits. These showed the service was performing well. There were clear visions and values for how the service should operate and staff promoted these. Records were maintained to a good standard and staff had access to policies and procedures to guide their practice.

We spoke with the manager and a range of staff as part of this inspection visit. We had conversations with 18 people who lived at the service, to gain their views about their care. Everyone we spoke said they felt safe and well looked after. One person told us “The carers are very attentive.” Another said “I have been living here for about eight years and am very well looked after as the staff are lovely.” People commented that staff were kind. They told us call bells were answered quickly when they rang for assistance. People said they would speak with the manager if they had any concerns.

A relative told us their family member had settled in well in a very short time. They said they were happy with the care their family member received.

A visiting healthcare professional said they were made to feel welcome. They told us staff followed up on any recommendations they made about people’s care.

We looked at how people were protected from the risk of abuse. We found there were safeguarding procedures in place and staff had undertaken training on protecting vulnerable adults from abuse. Staff recognised indicators of abuse and knew how to report these if they came across them.

We checked infection control practice. There were effective systems in place at the service to reduce the risk and spread of infection. Staff were provided with guidance on infection control measures. Personal protective items were available, such as disposable gloves and aprons. Staff attended training on infection control to equip them with the skills and knowledge to prevent the spread of infection.

We found people’s medicines were managed safely. Staff who handled medication had undertaken training on the safe management of medicines. Medicines were stored securely and accurate records were maintained.

The premises were appropriately maintained. Bedrooms were single occupancy and personalised, to make them homely. The building was kept warm and well lit. A range of checks was carried out to make sure people were protected from potential hazards, such as the risk of fire.

The people we spoke with during our visit said they were happy living at Farnham Common House. One person said, “I like living here, I haven’t got any complaints”. Another person said, “I cannot fault this home. It is wonderful. The staff are excellent and more like friends to us”.

Care plans showed that people were involved in making decisions regarding their care and support. We observed the care staff obtaining people’s consent before giving any care and did this through appropriate communication techniques. The care given by staff generally reflected what was documented in people’s care plans, and care plans were regularly audited.

People using the service told us that they felt safe and had no concerns. We noted that the premises and environment promoted people’s safety and security.

We saw that there were enough suitably trained and experienced staff to meet the needs of people using the service. Staff felt well supported and could access various education programmes in relation to meeting people’s needs.

The service had various methods that were used to ensure the quality of the care was assessed and monitored. Meetings, reviews and audits were in place and records were available.

Comments from people using the service included 'carers are very good indeed, I give them full marks', 'staff are very good and understanding', 'staff are a grand lot – we have lots of fun,' 'I have no concerns about my care', 'I like it here' and 'I'm happy here, no complaints.' One person told us that she is enabled to be as independent as possible and that staff help with the tasks she cannot manage.

We observed people being given choices of drinks during the morning and at lunchtime. People had made choices about their lunchtime meal and we saw staff referring to a list of options when serving food. We saw that tablecloths were used at lunchtime and clothes protectors were offered to people to help prevent soiling their clothes. Two people told us their were good choices at mealtimes.