CQC report explained · a residential care home
What the CQC found at Dixons Farm
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, staffing, fire safety and infection control were managed safely. A new fire alarm system had been installed since the previous inspection.
- Effective?
- Good
- People's needs and choices were assessed, and staff had suitable training and supervision. Mental capacity and best-interest records, healthcare support and meal arrangements were in place.
- Caring?
- Good
- Staff were observed treating people with kindness, dignity and respect. People were supported to make choices and to be as independent as possible.
- Responsive?
- Good
- Care plans included people's needs, preferences and goals. People were supported with communication, activities, relationships and access to the local community.
- Well-led?
- Good
- Inspectors found visible management, regular meetings and ongoing audits. Staff and relatives gave positive feedback about the management and changes since the previous inspection.
What inspectors found, March 2020
Rated Good; inspectors found safe, kind care and clear improvements since the previous inspection, but noted two record-keeping issues.
The inspection was unannounced and took place on 25 February 2020. One inspector reviewed records, medicines, staff files, training, audits and meetings. They spoke with one person, one relative, eight staff and two visiting professionals.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were safe, supported by trained staff, treated with dignity and helped to make choices and build independence.
The previous inspection, published in March 2019, rated the home Requires Improvement and found two breaches of regulation. This inspection found enough improvement for the breaches to be cleared. Inspectors did note that one care record needed updating and that some daily records had been left in a public area. Both issues were dealt with during the inspection.
Safe systems
Risks, medicines, incidents and fire safety were monitored. The home recorded lessons learned and had completed relevant safety checks.
“Risks were assessed and managed. Lessons were learned.” from the report
Choice and independence
People were supported to make decisions, develop skills and become more independent. Staff used communication methods suited to individual people.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Kind care
Inspectors saw staff supporting people with kindness and respect. People's likes, dislikes, needs and choices were recorded.
“We observed staff supporting people's needs, with kindness, respecting their individual choices and diverse needs.” from the report
Activities and community life
People had individual activity programmes based on their interests. Activities took place both at home and in the local community, and people could choose not to take part.
“Individual activity programmes had been developed for all people according to their interests and choice.” from the report
Improved management
Management systems had improved since the previous inspection. Audits, team meetings and monitoring were taking place.
“A range of audits had been completed, including senior audits by the senior team and quality team.” from the report
One care record needed updating
needs fixingOne person's record did not fully reflect the support needed with meals. The manager acted immediately to update it.
“One person's record required updating in relation to the support they required with meals. The registered manager took immediate action to ensure these reflected the person's current need.” from the report
- 01How do you check that each person's care records, including meal support, always reflect their current needs?
- 02How do you make sure daily records and other personal information are kept private?
- 03What refurbishment work is still planned, including the sensory and activities rooms in the garden?
- 04How will you involve my relative and our family in care decisions, activities and future goals?
- 05How do you support people who use sign language, visual cards or other communication methods?
This was an unannounced planned inspection covering all five CQC questions; the previous Requires Improvement ratings and breaches were reviewed and inspectors found they had been improved. This explanation was written from the published report of 13 March 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2019
Dixons Farm was rated Requires Improvement; inspectors found kind care and good personalised records, but safety, consent, dignity and leadership needed improvement.
This was an unannounced scheduled inspection on 22 January 2019. One inspector and one specialist nurse advisor reviewed records, observed the home, and spoke with relatives and staff. They could not speak directly with residents because of their limited ability to communicate.
The home was rated Requires Improvement overall. Safe, Effective, Caring and Well-led were all rated Requires Improvement. Responsive was rated Good. Inspectors found risks linked to fire safety, incident reviews, medicines, consent and staffing. They also found some people were not always supported to express their wishes or maintain their privacy and dignity.
There were positive findings. Staff were often kind, care records contained useful information, people had access to health professionals and food choices, and activities were taking place. The new manager and senior team had started action to address the problems, but audits had only recently restarted and improvements were not yet fully established.
The previous inspection in June 2016 rated the home Good in all five areas and Good overall. This inspection found that the service had declined since then. The provider was required to send CQC an action plan, and CQC said it would check that action was taken.
Personalised care records
Care records contained clear information about people's individual needs, risks and how staff should support them.
“Care records had good information about people's individual needs and how to ensure people received effective care.” from the report
Health and professional support
The home involved relevant health and social care professionals in reviews and care planning.
“There was good evidence of multidisciplinary working across health and social care professionals, including liaison with professionals in other areas of the UK.” from the report
Food and daily involvement
People had menu choices, food supplies were available and people were supported to take part in shopping and household tasks.
“We saw people undertaking the food shopping trip during our inspection with the support of staff.” from the report
Kind interactions
Inspectors saw some positive relationships between staff and residents, and relatives gave positive feedback about the care.
“We observed some kind and positive interactions between people and staff.” from the report
Fire safety actions
seriousUrgent actions from the fire risk assessment had been identified, but the home could not show that they had been completed. This created a risk linked to the premises.
“There was no record to confirm that these actions had been completed.” from the report
Consent and restrictions
seriousCapacity assessments did not always explain which decisions they covered. Some applications relating to restrictions on liberty were also submitted late.
“Capacity assessment had been completed however they did not specify clearly what decisions the assessment related to.” from the report
Incident learning
needs fixingA large number of incidents had occurred over a short period, but they were not analysed promptly enough to reduce future risks.
“The analysis of these did not occur in a timely manner.” from the report
Medicines left unattended
needs fixingA staff member left medicines unattended in a public area while administering them. CQC recommended using recognised guidance to improve medicines management.
“We observed the staff member responsible for administering people's medicines left them unattended in a public area of the service.” from the report
Privacy and choice
needs fixingA person's wish to access a communal area was not supported, and personal care was discussed in a public area. The manager said action would be taken.
“However, we saw one occasion where staff discussed a personal care intervention in a public area of the service.” from the report
Staffing consistency
needs fixingStaff said staffing levels and the use of agency workers were concerns. Recruitment was continuing to create a more consistent staff team.
“Not really enough staff. They are relying alot on agency [staff] and try to get the same staff, they are recruiting” from the report
- 01Have all urgent actions from the fire risk assessment now been completed, and can you show us the evidence?
- 02How are capacity assessments and Deprivation of Liberty applications now checked to make sure they are complete and submitted on time?
- 03How do you make sure medicines are never left unattended in public areas?
- 04What has changed to reduce reliance on agency staff and ensure all staff have the skills needed for the people living here?
- 05How do staff record and respond to non-verbal wishes, privacy needs and requests for meaningful activities?
This was an unannounced inspection of all five CQC questions, including the premises and care provided; inspectors could not speak directly with residents because of their limited ability to communicate. This explanation was written from the published report of 1 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Dixons Farm
3 rated inspections over 4 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.