Woodlands Farmhouse is a 'care home'. People in care homes receive accommodation and personal care as single package under one contractual agreement. There was also a small domiciliary care service being run from the same site but separate to the care home. However staff from the domiciliary service do help out in the home to ensure care is provided when needed by people.

The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. Woodlands Farmhouse accommodates 12 people with an additional respite bed in one adapted building. There were 10 people living in the service at the time of our inspection visit.

There was a registered manager in post but the day to day running of the service was with a care manager. A registered manager is a person who has registered with the CQC 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 and associated regulations.

There were systems and practices in place to protect people from situations in which they may experience abuse. Risks to people's safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. In addition, the necessary provision had been made to ensure that medicines were managed safely.

Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service to support people to stay safe and meet their needs. Background checks had been completed before care staff had been appointed.

People were protected by the prevention and control of infection and lessons had been learnt when things had gone wrong. The service recently had an outbreak of a serious infection brought into the home by a visitor, which affected everyone. So the staff were very aware of the actions they need to take to keep the chance of infection spreading to a minimum.

Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

Care staff had been supported to deliver care in line with good practice guidance. People enjoyed their meals and were supported to eat and drink enough to maintain a balanced diet.

People had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. Furthermore, people had benefited from the accommodation being adapted, designed and decorated in a way that met their needs and expectations. The home was going through a refurbishment programme to improve the fabric of the building.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They were also supported to express their views and be actively involved in making decisions about their care as far as possible. Confidential information was kept private.

People received personalised care that was responsive to their needs. Care staff had promoted positive outcomes for people who lived with dementia including occasions on which they became distressed. People's concerns and complaints were listened and responded to in order to improve the quality of care. In addition, suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a positive culture in the service that was open, inclusive and focused upon achieving good experiences for people. People benefited from there being a management framework to ensure that staff understood their responsibilities so that risks and regulatory requirements were met. The views of people who lived in the service, relatives and staff had been gathered and acted on to shape any improvements that were made.

Quality checks had been completed to ensure people benefited from the service being able to quickly put problems right

This inspection was unannounced and took place on 09 November 2015. This was the first inspection since the established service was re-registered as a Limited Company.

There is 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.

People living at Woodlands Farmhouse told us they were happy with the care and support provided. They said the manager and staff were open and approachable and cared about their personal preferences and kept them involved in decision making around their care. One person said, “I visited plenty of homes in the area and decided on this one, it was my choice and I was involved with everything to do with my care plan and moving in.” Another person said, “I have been here for respite care and now I come back daily so I am involved and it my decision.”

Everybody told us they felt safe living in the home, one person said, “I feel very safe living here.” Whilst another person said they felt very safe when being cared for by the staff. Everybody was relaxed with staff and there was a friendly, cheerful atmosphere in the home.

People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed staff took time to talk with people during the day. One person said, “They do listen to you and take time to sit down for a chat.” Another person said, “They are never too busy to have a laugh and a joke.” A staff member said they felt they had plenty of time to do their tasks and chat with people through the day. The manager confirmed staffing levels could be flexible to meet the care needs of people and to support other staff with activities.

People told us they received care from care workers who were knowledgeable about their needs and were appropriately trained to meet them. Care workers had access to training specific to their roles and the needs of people for example they had received training in stoma care and diabetes care. They understood people’s needs and were able to explain to us how they would care for each person on a daily basis. One staff member said, “There is always enough information in the care plans to tell us about people. But because we are a small home we know everybody personally.”

People’s care needs were recorded and reviewed regularly with senior staff and the person receiving the care or a relevant representative. All care plans included the person’s written consent to care. Staff had comprehensive information and guidance in care plans to deliver consistent care the way people preferred.

The registered manager had a clear vision for the service. Their statement of purpose said, they aimed to provide a “service that is driven by the needs and aspirations of our individual clients through listening to them.” Staff said they knew how the manager felt about the way they provided care for people. One staff member who worked in both the agency and the care home said, “The manager speaks with us daily and the daily emphasis is on listening to people and providing the care they want as well as the care they need.” Another staff member said, “The most important thing to do is take time to listen, especially when some people find it difficult to say what they are thinking.”

The provider had a robust recruitment procedure which minimised the risks of abuse to people. Staff said they knew how to report any concerns and people who lived at the home said they would be comfortable to discuss any worries or concerns with the manager.

People saw healthcare professionals such as the GP, district nurse, chiropodist and dentist. Staff supported people to attend appointments with specialist healthcare professionals in hospitals and clinics. Staff made sure when there were changes to people’s physical wellbeing, such as changes in weight or mobility, effective measures were put in place to address any issues.

The service had a complaints policy and procedure which was available for people and visitors to view on the noticeboard. People said they were aware of the procedure and knew who they could talk with. People and staff said they felt confident they could raise concerns with the registered manager and they would be dealt with appropriately.

There were systems in place to monitor the care provided and people’s views and opinions were sought on a daily basis. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.