This inspection took place on 27 and 30 April 2018 and was unannounced. The previous inspection was carried out on 14 March 2017 and there had been one breach of legal requirements at that time. We rated the service requires improvement overall. The registered manager had submitted an action plan to the Care Quality Commission so that we could monitor the improvements made. We found at this inspection significant improvements had been made.

Park Farm House is registered to provide accommodation for up to 10 people who require help with personal care. The service specialises in the care of older people living with dementia but does not provide nursing care. At the time of our visit there were seven people living at the service.

There was 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 of the Health and Social Care Act 2008.

People were protected from abuse because staff understood how to keep them safe, including understanding the processes they should follow if an allegation of abuse was made. All staff informed us concerns would be followed up if they were raised.

Staff knew how to minimise risks and provide people with safe care and treatment. Procedures and processes guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments, which identified how risks to people were minimised.

There were processes in place to ensure the premises and equipment were regularly checked and to manage the prevention and control of infection. The registered manager reviewed accidents and falls to ensure people had the right support to keep them safe.

Appropriate arrangements were in place to ensure people's medicines were obtained, stored and administered safely.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people's needs.

Staff had effective support, supervision and training to develop the skills needed to care for people effectively. People told us they enjoyed the meals and we saw staff offered people hot and cold drinks throughout the day.

People's care was provided in line with the Mental Capacity Act and staff understood the importance of seeking appropriate consent for care and treatment.

People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.

People received care that was personalised to them and met their individual needs and wishes. Staff respected people's privacy and dignity and interacted with people in a caring, compassionate and professional manner. They were knowledgeable about people's choices, views and preferences and acted on what they said. The atmosphere in the service was friendly and welcoming.

People were supported to maintain relationships with relatives and friends. Visitors were made to feel welcome. People were supported as individuals taking into consideration their culture and religious needs.

People had personalised care plans, which detailed how they wanted staff to meet their individual needs. A range of activities were provided by staff for people to participate in. People had access the provider's complaints procedure.

The registered manager had made improvements to the quality assurance processes with regular audits of the service undertaken.

There was an open culture at the service and the views of people, relatives and staff were gathered.

This inspection took place on the 14 March 2017. Park Farm House is a residential care home for older people. It is registered to provide accommodation for up to 10 people who require help with personal care. The home specialises in the care of older people living with dementia but does not provide nursing care.

The registered manager for Park Farm House is the registered provider. 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 and associated Regulations about how the service is run.

Park Farm House is a family run business. The providers live in an annex attached to the main farmhouse. Staff spoke positively about the team and the provider. The home is set in a rural area on the outskirts of Bristol. There are no direct public transport links to this home. The nearest village is a mile away.

Some improvements were required to ensure the service was well led. This included formalising the checks on quality with records of those checks being maintained. The provider did not submit the Provider Information return on time which has meant the rating for well led will automatically be requires improvement under our process. The provider needs to document quality checks that were being completed in respect of maintaining and improving the quality of the service provided to people.

People were receiving care that was responsive and effective and tailored to their needs. Care plans were in place that clearly described how each person would like to be supported. People had been consulted about their care and support. The care plans provided staff with information to support the person effectively. Other health and social professionals were involved in the care of the people. Safe systems were in place to ensure that people received their medicines as prescribed. The philosophy of the service was ‘Park Farm House was the person’s home and they came first’. The provider told us it was really important that people felt safe and regarded Park Farm House as their home.

People’s rights were upheld, consent was always sought before any support was given. Where people lacked the mental capacity, family and health and social care professionals were involved. Improvements could be made to the recording in this area.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management and safe recruitment processes.

Staff were caring and supportive and demonstrated a good understanding of their roles in supporting people. Systems were in place to ensure open communication including team meetings, daily handovers between shift changes and one to one meetings. Staff had received training to enable them to meet people’s needs. Further training had been organised during the inspection to increase staff’s knowledge on the Mental Capacity Act and Deprivation of Liberty Safeguards.

We carried out an unannounced comprehensive inspection of this service on 11 and 16 December 2014. At which there were three breaches of legal requirements found. People were at risk in the event of a fire, as checks had not been completed on the fire equipment. The second breach was staff had not received fire training or participated in a fire drill. The third breach in legal requirement was staff recruitment was not robust to show how the registered provider had come to the decision to employ a member of staff.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on the 30 March 2015 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Park Farm House’ on our website at www.cqc.org.uk.

Park Farm House is a residential care home for older people. It is registered to provide accommodation for up to eight people who require help with personal care. The home specialises in the care of older people living with dementia but does not provide nursing care. There were eight people living in the home at the time of this inspection.

Park Farm House is a family run business. The providers live in an annex attached to the main farm building. Staff spoke positively about the team and the provider.

One of the provider owners is the registered manager. 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 and associated Regulations about how the service is run.

The home is set in a rural area on the outskirts of Bristol. There are no direct public transport links to this home. The nearest village is a mile from the Farm.

At our focused inspection on the 30 March 2015, we found that the provider had followed their plan which they had told us would be completed by the 13 February 2015 and legal requirements had been met.

People were safer because the provider regularly checked the fire equipment and ensured staff had received appropriate training and guidance including participating in a fire drill.

Safe recruitment processes were now in place to ensure people were supported by suitable staff.

Due to their dementia most of the people living at the home were unable to tell us about their experiences of the care they received. We spent time in communal areas in order to gain some understanding of their experiences.

We saw that staff were kind, gentle and respectful and always acknowledged people by name. Staff always asked people before providing support. We saw in people's care records that where appropriate best interests decisions had been made with professionals and people's families.

It was evident that staff knew people well and that people were relaxed and comfortable with them. Staff were able to tell us in detail about people's personalities and care needs. Throughout our inspection we observed that people appeared comfortable and at home in their environment. We observed that staff reassured and supported people appropriately. Medicines were stored and administered safely.

Park Farm House provided a homely environment and people had free access to communal areas. Everybody had their own room with en-suite. The provider made sure all equipment was serviced and in good working order.

Staff felt well supported and received regular training and supervision. They told us they could always approach management for advice.

The provider had a system in place to monitor the quality of the service. The manager told us that they carried out daily checks on cleanliness and on the mood of people living at the home to ensure they were happy.

Park Farm House had a homely and relaxed atmosphere. The seven people living there had a diagnosis of dementia. We observed that everybody appeared to be settled and comfortable. There was a lot of contact between staff and people living at the home. Staff told us they felt it was very important to have time for people and was one of the things they liked best about the home.

The home had clear criteria for accepting new people and an important consideration was how people would fit in. Staff had a good understanding of the needs of people with dementia. They knew the people living at the home well and understood that people did not always communicate their preferences verbally.

Staff understood the importance of safeguarding and the Deprivation of Libery Safeguards were used appropriately.

People who received regular visitors had the opportunity to go out but opportunities to access the community for other people were limited. The provider may wish to note that there could be more things in place to support people without regular visitors to access the community regularly .

This inspection took place over two days on the 11 and 16 December 2014. Park Farm House is a residential care home for older people. It is registered to provide accommodation for up to 8 people who require help with personal care. The home specialises in the care of older people living with dementia but does not provide nursing care.

The registered manager for Park Farm House is the registered provider. 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 and associated Regulations about how the service is run.

Park Farm House is a family run business. The providers live in an annex attached to the main farm building. Staff spoke positively about the team and the provider.

The home is set in a rural area on the outskirts of Bristol. There are no direct public transport links to this home. The nearest village is a mile from the Farm.

People were at risk in the event of a fire. This was because suitable checks were not being completed on the fire equipment and not all staff had taken part in a fire evacuation (drill).

People were not fully protected against unsuitable staff working with them. This was because there was a lack of recruitment information to demonstrate how the provider had come to the conclusion to employ the staff.

People were receiving care that was effective and responsive in meeting their support needs. Staff were knowledgeable about the people they were supporting and they were caring in their approach. The philosophy of the service was ‘Park Farm House was the person’s home and they came first’. The provider told us it was really important that people felt safe and regarded Park Farm House as their home.

People were involved in day to day decisions. Other health and social care professionals were involved in their care. There was a warm and relaxed atmosphere on both days that we inspected the home. Staff were engaged with people spending time sitting with them and chatting.

There was sufficient staff supporting the people, with additional staff available at night in the event of an emergency. Everyone living at Park Farm House had a diagnosis of dementia. Staff had received appropriate training to support people including dementia awareness. Staff told us it was important that they gave people time. Staff said they never felt they had to rush personal care or the support they gave to people.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.