Archived: Holt Farm Care Limited

We found that following our last inspection all staff had attended medicines training. We found improvements had been made and people were protected from the risks associated with medicines because the arrangements that were now in place for the management, storage and recording of medicines were being followed.

Holt Farm provides care for up to six people with learning disabilities and / or mental health needs. The home is situated in Steeple Aston near Bicester and is operated by Holt Farm Care Ltd.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and care workers told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found;

Is the service safe?

People were not always cared for safely because they were not protected against the risks associated with medicines. The arrangements in place in relation to the management, storage and recording of medicines was not always followed.

Risk assessments were in place and regularly reviewed. People's needs were assessed and reflected in the care plans.

Systems were in place for the safekeeping of people's money. Some people kept and handled their own money and decisions and risk assessments relating to this were documented in their care records.

There were arrangements in place to deal with foreseeable emergencies. There were plans for managing people's needs in the event of a power failure and adverse weather conditions. Each person had an emergency evacuation plan for use in the event of a fire.

Systems were in place to make sure that the manager and care workers learnt from events such as accidents, incidents and complaints. This reduced the risks to people and helped the service to continually improve.

The provider understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager was aware of the recent Supreme Court judgement in relation to the Deprivation of Liberty Safeguards and was taking appropriate action. There were no people subject to a DoLS at the time of our inspection.

Is the service effective?

The service was effective. People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with care workers that they understood people's care and support needs and they knew them well. One person told us. 'I've never had a better staff team. They are here to do a good job and they support everybody'. We saw that care workers received appropriate training to support them to undertake their duties.

Is the service caring?

The home was caring. People told us they felt respected. One person said, 'they [care workers] talk to me nicely, they are friendly'. We spoke with three care workers. They had detailed knowledge about the people they supported, and they talked about them with respect. We saw that people were given choices and supported to make decisions about their care. Throughout our inspection the atmosphere was pleasant and we observed many interactions between care workers and people that were caring, relaxed and friendly.

Is the service responsive?

The home was responsive. People's needs had been assessed before they moved into the home, were regularly reviewed and reflected in the care plans. We saw evidence that care workers recognised when a person's condition changed or their health had deteriorated and sought the help and advice of other professionals. Care workers had a learning and development plan which was regularly reviewed and altered to meet the changing needs of people who used the service.

Is the service well-led?

The service was well led. There was a registered manager in post who was visible and available for people and staff to raise any concerns. We saw that the provider took account of complaints to improve the service. During our inspection we looked at the quality assurance systems that were in place. The information reviewed demonstrated that the home had an effective system to regularly assess and monitor the quality of service that people received.

We spoke with two of the five people who used the service and three relatives of people who received a service. Everyone we spoke with was complimentary of the service they received. One relative told us, 'The home seems good; it suits (my relative) and makes them happy'.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Appropriate checks were undertaken before staff began work. The proprietor had conducted comprehensive interviews to ensure support workers had appropriate knowledge and were physically and mentally fit for work.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

The complaints system was bought to the attention of people using this service, and their relatives. An easy read copy of the complaints procedure was on display in the home's entrance hallway, the kitchen and lounge. The provider had also updated their complaints procedure. A copy of this procedure was provided a to people's relatives.

There were four people living in the home at the time of our inspection. We spoke to the two people living in the home who could best communicate with us and because their responses were often "yes" or "no", we have not been able to use their quotes effectively in this report. However we have described what we asked them and how they responded. Both people told us they felt cared for, were happy living in the home and liked their rooms. One said, "I love the view from my room". They told us they had not been involved in planning their care and the files supported this.

We spoke with the relatives of three people living in the home. All said they were not appropriately involved in issues of consent, even when their relatives did not have the mental capacity to consent for themselves. Care records supported these views. Two relatives told us that they did not feel their complaints had been resolved and that they had found record keeping to be a problem, "I've asked to look at body maps on several occasions but mostly they've not been completed." Another said, "I don't think the communication book gets used."

The lack of effective recruitment procedures and safeguarding policies, procedures and training also meant that people were not protected from harm.