Falcons Rest and Poachers Cottage

About the service

Falcons Rest and Poachers Cottage is a residential care home providing personal care for up to 14 people. The site consists of 2 purpose-built houses, named Falcons Rest and Poachers Cottage respectively. The service provides support to younger adults with a learning disability who may also have physical disabilities and/or sensory impairments. At the time of our inspection, 14 people were living at the home.

People’s experience of using this service and what we found

Right Support

People received personalised care and support built around their needs and wishes. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People’s needs were assessed, and care plans were developed with them, and their relatives where required. People’s safety risks were considered, and clear guidance was in place to support staff. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff enabled people to access specialist health and social care support in the community. Staff supported people to maintain relationships that were important to them and engage in activities they enjoyed.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff promoted equality and diversity in their support for people. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People’s care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life.

Right Culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments, or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. People and those important to them, including advocates, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

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

Rating at last inspection

The last rating for this service was good (published 7 June 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staff practices. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective, caring, responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Falcons Rest and Poachers Cottage on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Falcons Rest and Poachers Cottage is a care home that provides personal care for up to 14 people with a learning disability who may also have physical disabilities and/or sensory impairments. The site consists of two purpose-built houses, named Falcons Rest and Poachers Cottage respectively. At the time of our inspection visit, there were 14 people living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People's experience of using this service:

• We were not assured the provider and management team always engaged effectively with people’s relatives and the community professionals involved in people’s care.

• Staff expressed concerns over the service’s ongoing staff recruitment and retention issues. The provider had a recruitment and retention strategy in place designed to address these issues.

• Staff understood how to recognise and report abuse.

• Risks associated with the premises, equipment used and people’s individual care needs had been assessed, kept under review and plans put in place to manage these.

• Staffing levels at the service enabled people’s needs to be met safely.

• People’s medicines were handled and administered by trained staff who underwent annual competency checks.

• The provider had put measures in place to protect people, staff and visitors from the risk of infections.

• People’s care needs were assessed and reviewed to achieve effective outcomes.

• Staff received ongoing training and supervision to enable them to succeed in their roles.

• People were supported to make choices about what they ate and drink, and the risks associated with their nutrition or hydration were managed with specialist input.

• People were supported to access community healthcare services to ensure their health needs were monitored and addressed.

• The purpose-built environment in which people lived enabled staff to meet their individual needs effectively.

• People were treated with kindness, dignity and respect by staff and management.

• Staff and management understood their role in promoting equality and diversity within the service.

• People’s individual communication needs were assessed to promote effective communication.

• People’s care plans were individual to them and covered key aspects of their care and support needs.

• People had support to participate in a range of social and recreational activities.

• People's relatives understood how to raise any concerns or complaints regarding the service.

• Steps were taken to establish people’s wishes for their future care.

• The provider had quality assurance systems and processes in place to enable them monitor the safety and quality of people’s care.

• Staff felt well-supported and valued by an approachable management team.

We found the service met the requirements for 'Good' in four areas, and 'Requires improvement' in one other area. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: At the last comprehensive inspection, the service was rated as 'Requires improvement' (inspection report published on 20 April 2018). At this inspection, the overall rating of the service has improved to ‘Good’.

Why we inspected: This was a planned inspection based on the service's previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any information of concern is received, we may inspect sooner.

Falcons Rest and Poachers Cottage is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Falcons Rest and Poachers Cottage provides accommodation and personal care for up to 14 people with a learning disability who may also have physical disabilities and/or sensory impairments. The site consists of two purpose-built houses, named Falcons Rest and Poachers Cottage respectively. At the time of our inspection visit, there were 12 people living at the home.

A registered manager was in post at the time of our inspection. 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.

At our last comprehensive inspection of the service on 10 July 2017, we found breaches of Regulations 12 and 17 of the Health and Social Care 2008 Act (Regulated Activities) Regulations 2014. We gave the service an overall rating of Requires Improvement. These breaches related to the provider's failure to review staff training and competency in relation to the management of people’s medicines, and the effectiveness of the provider’s quality assurance. The provider sent us an action plan setting out the improvements they intended to make.

At this inspection, we found that, although the provider had made some improvements to the service, they remained in breach of Regulations 12 and 17. We were not assured staff consistently followed the provider’s procedures for the handling and administration of people’s medicines, or that the provider’s quality assurance was as effective as it needed to be.

Staff did not always make appropriate use of personal protective equipment to protect people from the risk of infection. The risks associated with people’s care and support needs had not always been fully assessed and recorded. Mental capacity assessments and best-interests decisions had not always been carried out in line with the requirements of the Mental Capacity Act. People’s care plans were individual to them, but had not always been kept under regular review. People had enough to eat and drink, but the information recorded in relation to associated risks was not always accurate. People’s relatives contributed to decision-making that affected their family members living at the home, but care review meetings had not been organised on a consistent basis.

Staff had been trained in, and understood, their individual responsibilities to protect people from abuse and discrimination. Staffing levels ensured people’s needs could be met safely. Staff received a structured induction and ongoing training, designed to help them work safely and effectively.

Staff and management worked effectively with external health and social care professionals to ensure people received coordinated care, and ensure people’s health needs were met. The overall design and adaptation of the service reflected people’s individual care needs.

Staff adopted a kind and caring approach to their work, and helped people express their views. They recognised, and worked to promote, people’s rights to privacy and dignity. People’s individual communication needs had been assessed, and staff adjusted their communication with people accordingly. People had support to participate in in-house and community-based activities. People and their relatives understood how to raise concerns with the provider.

The management team had improved their working relationships, and communication, with people, their relatives, staff and community professionals. Staff felt well supported, were clear what was expected of them and benefited from a stronger sense of teamwork.

You can see what action we told the provider to take at the back of the full version of the report.

Falcons Rest and Poachers Cottage provides accommodation and personal care for up to 14 people with a learning disability who may also have physical disabilities and/or sensory impairments in two purpose-built houses. At the time of our inspection, there were 11 people living at the home.

A registered manager was in post at the time of our inspection. 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.

The registered manager was unavailable during our inspection. The provider's national service improvement manager, operations manager and temporary service manager were present.

The provider had not kept the training and competency of staff that administered medicines to people under review. There had also been a high rate of staff turnover at the service, which had resulted in fewer trained staff available to support people with social and therapeutic activities.

Staff understood the implications of the Mental Capacity Act 2005 for their work with people. However, people's right to make their own decisions about their own care and treatment was not always fully supported by the staff and management team.

People’s care plans included details about what was important to them, and how to best support them. However, these plans had not always been reviewed to ensure the information and guidance provided was accurate and up to date.

A lack of consistent leadership and management meant staff were not always fully supported to fulfil their duties and responsibilities. The provider’s quality assurance activities were not as effective as they needed to be.

Staff had received training in, and understood, how to recognise and report abuse. The risks to individuals had been assessed and plans put in place to manage these. The management team assessed and monitored people's staffing requirements, and followed safe recruitment practices.

People received individualised support to eat and drink, and any associated risks had been assessed with support from dietary and nutritional specialists. Staff supported people to access healthcare services and took prompt action when people were unwell.

Staff treated people with kindness and compassion and promoted their rights to privacy and dignity.

People’s relatives knew how to raise complaints or concerns about the service. The provider had developed formal complaints procedures to ensure these were investigated and responded to appropriately.

You can see what action we told the provider to take at the back of the full version of the report.

Falcons Rest and Poachers Cottage provides accommodation and personal care for up to 14 people with a learning disability who may also have physical disabilities and/or sensory impairments. There were 11 people living at the home when we visited.

A registered manager was in post at the time of our inspection. 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 were protected from avoidable harm and abuse because staff understood the potential signs of abuse and knew who to report any concerns about people’s safety or wellbeing to. The provider had clear procedures in place for responding to concerns raised by staff or others.

The risks associated with individual’s care and support needs had been assessed and plans developed to manage these. Incidents or accidents involving people living at the home were closely monitored by the management team and the provider to ensure lessons were learned.

There were enough staff on duty to meet the needs of the people living at the home and the use of agency staff was closely managed by the management team to promote continuity of care. The registered manager followed safe recruitment practices and all staff employed were subject to appropriate pre-employment checks.

People’s medicines were stored, administered and disposed of safely by competent staff.

Staff had the right skills and knowledge to support people effectively and understood people’s communication needs and preferences. Staff had been given an effective induction when starting work at the home and spoke positively about the range of ongoing training provided. This training reflected the individual needs of the people living at the home. The management team identified, recorded and reviewed staff training needs.

Staff were well-supported by the management team and received regular one to one sessions.

The service was working in accordance with the requirements of the Mental Capacity Act 2005 (MCA). Staff had a good understanding of the MCA and how to apply this in their day to day work. The provider had made DoLS applications for all of the people currently using the service, two of which had been fully processed and granted.

Staff had been trained in the safe and appropriate use of restraint and understood the circumstances in which restraint might appropriately and lawfully be used.

The people living at the home were offered a choice of food and drink and received appropriate support with eating and drinking. Any risks associated with people eating and drinking had been assessed, recorded and managed with the involvement of specialist external advice as required.

Staff understood people’s health needs and supported them to attend routine appointments and check-ups. A wide range of external healthcare professionals were involved in monitoring the health of the people living at the service.

Staff spoke to people in a warm, friendly and polite manner, listening to them and responding appropriately to their requests. People were relaxed and at ease in the home’s environment. Staff knew people well and treated them with dignity and respect.

There were no unnecessary restrictions upon the visiting arrangements at the service.

People were supported to make choices about their day to day care and support and the care and support provided was tailored to people’s needs. People’s relatives were involved in the planning of the care delivered to their family members.

People’s care plans set out their individual needs, interests and preferences and placed an emphasis upon supporting people’s decision-making. Staff were given the time needed to read these plans.

People were supporting to spend time doing things they enjoyed and found interesting, although current staff vacancies had impacted upon people’s activities.

Staff helped people keep in touch with those they valued.

People’s relatives understood how to raise concerns or complaints about the service and felt confident these would be listened to. Formal procedures were in place for handling and responding to complaints.

The atmosphere within the home was warm and welcoming. Staff spoke with enthusiasm about their work and understood what was required of them.

The registered manager promoted an open dialogue with the people living at the home, their representatives and the home’s staff team. Staff viewed the management of the service positively and felt their opinions mattered. The registered manager understood the responsibilities associated with their role, was well-supported and provided effective management and leadership to the service. They kept up to date with current best practice and carried out regular quality assurance checks in order to test out and improve the quality and safety of the service provided.