Strawberry Field

We found the following examples of good practice.

The home was visibly clean throughout, with regular cleaning of high-risk areas such as touch points and shared facilities. People were involved in the cleaning of their home environment, with a rota in place to maximise their independence.

During the recent outbreak, measures were put in place to support people to maintain their safety, as well as social contact with the other members of the home and staff, to prevent social isolation.

People chose to mainly spend time with visitors off site, with risk assessments in place. Plans were also in place to safely support face to face visiting at the home where required.

Strawberry Field is a residential care home providing personal care to four people at the time of the inspection. The service can support up to four people with learning disabilities and/or autism.

The service was a house with one self-contained flat upstairs. There was a sleep-in room for staff which was also the office.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People felt safe and staff understood their responsibilities in relation to safeguarding. Risks relating to people’s individual needs and within the environment had been identified and plans were in place to mitigate known risks. There were consistently enough staff to meet people’s needs and there were safe recruitment practices in place.

People’s medicines were managed and administered in a safe way. The service was clean, and staff took steps to minimise the risk of infection. There were processes in place to learn from accidents and incidents.

Assessments of people’s needs took place prior to them moving to the service. Staff received training relevant to their role and attended regular supervisions.

People were supported to maintain a healthy nutritional intake and risks relating to this were managed. Staff worked with other healthcare professionals to ensure people received consistent care. People were able to contribute to the decoration and design of the service.

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 treated people in a caring way which respected their privacy and dignity. People felt listened to and were supported when they were upset. People were involved in the planning of their care and were supported to be as independent as possible.

People’s care was planned and delivered in a person-centred way. Staff understood people’s individual communication needs and spoke with people according to their individual needs. People felt able to raise a concern or make suggestions. People’s end of life wishes had been discussed with people and documented.

There was a clear vision of the service which staff embedded into their practice. There were processes in place to involve people, their relatives and staff in providing feedback about how the service was run. Quality monitoring audits had been improved since the last inspection. These were undertaken by the registered manager and a senior member of staff to assess and monitor the quality of service being delivered.

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 12 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Strawberry Field provides care for up to 4 people. The home supported people who had a range of learning disabilities. One person lived in a self-contained flat within the service. The home was an extended bungalow in rural Norfolk.

There was a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. During this report we will refer to the registered manager as the manager. The day to day running of the service was carried out by one senior member of staff.

People benefitted from being supported by staff who were safely recruited, trained and who felt supported in their work by their colleagues and by the manager. There was consistently enough staff to safely meet people’s individual needs.

Staff understood how to protect people from the risk of abuse and knew the procedure for reporting any concerns. Medicines were administered safely and adherence to best practice was applied. People received their medicines on time, safely and in the manner the prescriber intended. The service regularly audited the administration of medicines, although we found a delay in responding to an issue with one person’s medicines. The manager was aware staff needed further training with administering people’s medicines. Medicines were stored securely.

Staff knew and understood the needs of people living at Strawberry Field. Staff also knew what was important to each person and how to help them achieve this.

Staff received yearly appraisals. Staff also had regular supervisions. However the supervisions and testing of staff knowledge was not robust. The manager told us they were aware of this and were looking into ways to improve this. The manager observed practice and was involved in the daily running of the service.

Staff told us they enjoyed working at Strawberry Field. We saw that staff assisted people with kindness and compassion. People’s dignity and privacy was maintained and respected. People were treated as individuals.

The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was depriving some people of their liberty in order to provide necessary care and to keep them safe. The service had made applications for authorisation to the local authority DoLS team. The service was working within the principles of the MCA.

People’s care plans contained important, relevant and detailed information to assist staff in meeting people’s individual needs. People had been involved in making decisions around the care they received. People’s needs had been reviewed on a regular basis. People’s care was person centred.

People were supported to maintain good health and wellbeing. The service was proactive in dealing with changes to people’s physical and mental health.

The service had links with the local community and the manager planned to continue developing these. The service encouraged people to maintain relationships with people who were important to them. There were planned activities on a daily basis to support people to maintain their interests and fulfil their goals. There was a positive, open culture and a homely atmosphere at Strawberry Field.

There were some systems in place to monitor the quality of the service. However, these were not always robust. We found some short falls in the monitoring of the safety of the premises. We also found that although issues had been identified in some of the audits the management team had completed, there was no plan of action in place to address these. We made a recommendation that the service improved its quality monitoring of the service.

We considered our inspection findings to answer the five questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found based on our observations during the inspection.

If you want to see the evidence supporting our summary, please read the full report.

Is the service caring?

We spoke with three people who used the service. One person said to us, "I like living here." Another person said, "It's good here. I've got my own flat and I like doing my own cooking. I'm really good at making stews and stir fry meals." Another person told us they liked living with the other people. All of people we spoke with spoke highly of the staff members who supported them.

People's privacy and dignity was respected, and people were encouraged and supported to maximise their independence.

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Where people did not have the capacity to give consent, we found the provider acted in accordance with legal requirements. Care plans and risk assessments were informative, up to date and regularly reviewed.

Staff told us that the manager and other senior staff were approachable and they would have no difficulty speaking to them if they had any concerns about the service. The manager responded in an open, thorough and timely manner to complaints. Therefore people could be assured that complaints were investigated and action was taken as necessary.

Is the service safe?

The accommodation was adapted to meet the needs of the people living there, was suited to caring for people with limited mobility and was properly maintained. The service was warm, clean and was personalised to the people who lived there.

People were protected by effective staff recruitment systems. There were proper process in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

People we spoke with were satisfied with the care and support they received. No one raised any concerns with us. This was consistent with positive feedback from people reported in the provider's own annual quality assurance survey. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care records.

Is the service well led?

Staff said that they felt well supported by the manager, there was a good team ethic and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

We saw that people had a care plan that met their needs and encouraged them to be as independent as possible. We saw people preparing their own meals and drinks during our inspection.

People had their health needs met and were supported to manage their own hobbies, household tasks and lifestyle activities. We saw one person mowing the lawn and another person preparing to go to their keep fit class during our visit.

The majority of people attended day care or worked at the farm within the company grounds, although go out to social activities, visited family, arranged their own holidays and are supported with shopping trips by the staff to ensure people have a balanced and varied choice.

People were supported by skilled and experienced staff and the service was regularly checked for people's comfort and safety needs.

Both people told us they were happy living at Strawberry Field and that all the staff were kind and supported them very well. One person showed us their paintings they had done telling us they had displayed their paintings in a local gallery.