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Archived: Roughcote Hall Farm Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 6 October 2016

During an inspection looking at part of the service

This inspection took place on 6 October 2016 and was unannounced. We inspected to look for improvements following our previous inspection in March 2016 where we had found several breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to people not receiving care that was safe, effective, caring, responsive or well led. We had issued three warning notices and told the provider to make improvements. At this inspection we found that the provider had made some improvements and they were no longer in breach of any Regulations, however further improvements were required. This report only covers our findings in relation to the areas of concern. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Roughcote Hall Farm on our website at www.cqc.org.uk.

Roughcote Hall Farm provides accommodation and personal care for up to eight people with a learning disability. There were seven people using the service at the time of the inspection.

The service was not required to have a registered manager and was being managed by the provider. 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 still not always given the opportunities to engage in activities that met their individual needs and preferences due to the restrictions on times of any planned community activities and the amount of people attending the activity at the same time. The provider needed to seek advice and support to ensure people were receiving the financial benefits available to them.

People were safeguarded from abuse and potential abuse as the provider and staff knew what to do if they suspected abuse had taken place.

Staffing levels had been increased and there were sufficient staff to keep people safe and meet people's assessed needs.

People's medicines were being stored and administered safely. The provider had purchased new locked facilities to ensure medicines were stored safely and implemented a new medication audit to ensure that people received their medicines at the prescribed times.

Risks of harm to people were assessed and precautions put in place to minimise the risks to people.

The provider was following the principles of the MCA 2005 by ensuring that people who lacked the capacity to consent to their care were supported to make decisions that affected their care and welfare.

People were cared for by staff that were supported and trained to fulfil their roles.

People had access to health care when they became unwell or their health needs changed.

People's nutritional needs were met and people were supported to eat food of their choice.

People were treated with dignity and respect and they felt able to talk to staff or the provider if they had any concerns about their care.

The provider had made improvements to the systems they had in place to monitor the service and had been responsive to our previous inspection findings.

Inspection carried out on 21 March 2016

During a routine inspection

This inspection took place on 21 March 2016 and was unannounced. At our previous inspection in 2013 we found no concerns in the areas we looked at. At this inspection we had concerns that people were not receiving care that was safe, insufficient staff numbers and ineffective governance systems. We found several breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Roughcote Hall Farm provided accommodation and personal care for up to eight people with a learning disability. Eight people were using the service at the time of the inspection.

The service was not required to have a registered manager and was managed by the registered provider. For the purpose of this report we will refer to them as the manager. 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 not safeguarded from abuse as the management did not report incidents of alleged abuse to the local safeguarding authority for further investigation.

Risks to people were not always minimised through the effective use of risk assessments and there were insufficient staff to keep people safe.

People's medicines were not stored and administered safely.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The principles of the MCA were not followed to ensure that people were consenting or being supported to consent to their care and support. People were at risk of unlawful deprivation as referrals for a DoLS assessment had not been made for people who lacked capacity to consent to their care within the service.

Care was not always personalised and did not meet people's individual needs. Advice was not always sought from other professionals to ensure care being delivered was appropriate.

The systems the provider had in place to monitor the quality of the service were ineffective. Some staff training was out of date.

People had access to a range of hobbies and interests, however these were restricted to the day time hours due to lack of available staff.

Staff were kind and caring, however people were not encouraged to be as independent as they were able to be due to rules and routines.

People received health care when they were unwell and had sufficient to eat and drink to remain healthy.

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Inspection carried out on 14 October 2013

During a routine inspection

People received care and support that met their individual needs. People had care records which had been written in a style that people understood, and people told us they had decided how they wanted to be supported.

We saw that people received their care in a positive and caring manner and the staff were friendly and professional in their approach. One person told us, �The staff are lovely here. They always listen to us and we get to have fun together too.�

People were supported to go out and do the things they enjoyed in their home and the local community including; going to college, arts and crafts classes, shopping and eating out. People were supported to maintain relationships with family members and friends. One person told us, �We�re out all the time, some weeks we�re never in. We�re always busy doing things we want to do.�

The staff told us they enjoyed working at the home. We saw that all the checks were made to ensure they were fit to do their job.

We saw that the provider had an effective system in place to assess and monitor the service, which focussed on improvement.

Medication systems were in place and monitored to ensure people received their medicines as prescribed.

Inspection carried out on 5 July 2012

During a routine inspection

We carried out this visit to check on the care and welfare of people using this service. The visit was unannounced which meant the provider and the staff did not know we were coming. We carried out this visit as part of our schedule of planned inspections.

There were seven people living at the home on the day of our visit. We spoke with four people using the service and the four staff on duty. Part of our visit included accompanying people on a visit in the local community.

People who lived at the home were supported to take part in activities that were interesting and stimulating so that they had a meaningful lifestyle. People were encouraged to maintain links with the local community and their family. We saw that choices were offered and that people's views were sought and acted upon. People we spoke with confirmed this, one person said, "Staff ask us where we want to go or what we want to do. They arrange everything so we get to do what we want.� This meant that people could continue to lead a lifestyle of their choice.

People's privacy and dignity were respected. We observed how staff supported people and spoke with them during our visit. We saw that people were relaxed with staff. We saw staff spoke positively with people, were encouraging and asked people what they wanted to do and how to be supported. People told us, �The staff are fantastic here, and if you want anything they�re always there.� And �They are lovely and I couldn�t be in a better place.�

Staff spoken with were able to tell us about people's needs which meant they received care in a way that they preferred. People told us they were happy with the support provided.

People told us they were asked for their views about the home. People using the service knew how to complain if they were unhappy, but said they had not needed to do this. One person told us, �I can always speak to the staff, they listen to what we say.�

Reports under our old system of regulation (including those from before CQC was created)