Archived: West Farm

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found:

Is the service safe?

We spoke with two relatives, three social workers, a local authority contracts monitoring officer and a safeguarding officer to ascertain their views.

The service had been placed into organisational safeguarding following our last inspection on 19 March 2014 and subsequent warning notices in respect of assessing and monitoring the quality of the service and record keeping. This process meant that the local authority safeguarding team were monitoring West Farm and checking that people were safe. Regular safeguarding meetings were held. A representative from the local authority's safeguarding team chaired these meetings and senior staff from West Farm, together with health and social care professionals and others involved in the service also attended. These included North Tyneside Clinical Commissioning Group's safeguarding lead; a senior social worker; a local authority contracts monitoring officer; representatives from North Tyneside Metropolitan Borough Council and senior staff from the new provider. We attended three of these meetings and found that the provider was promptly addressing all the concerns we had raised.

The short break service was closing shortly and was being taken over by another provider. To facilitate this process; staff from the other provider were working alongside staff from West Farm.

At this inspection, we saw that all areas of the home had been painted and decorated and there were no damaged areas of plaster. Records of maintenance and servicing of the premises were available which demonstrated that checks on the electrical, fire, gas and water systems had been carried out to make sure these were safe.

Records were now accurate and up to date and could be located promptly.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The interim manager informed us that no one was currently subject to Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. These safeguards aim to ensure that people are looked after in a way that does not inappropriately restrict their freedom. The interim manager told us that she was aware of the recent Supreme Court judgement regarding what constituted a deprivation of liberty. She explained that she was in the process of considering what implications this ruling had on people who accessed West Farm.

Is the service effective?

There were four people staying at the service at the time of the inspection. Three were out accessing activities within the local community during the day; one remained at the service throughout the day so staff could monitor his medical condition.

This person had epilepsy and wore an epilepsy monitor on his wrist which alerted staff if he had a seizure. He also wore a helmet to protect his head in case he fell. Staff were knowledgeable about his needs and could describe these to us.

People's specific healthcare needs were provided by staff from an external specialist healthcare provider. We spoke with the clinical lead from this company. She told us she had no concerns about people's care and welfare with whom they had been involved. There was no one with healthcare needs accessing the service on the day of our inspection.

Staff told us that there was 'plenty' of training available. The interim manager provided us with information about training which showed that staff had completed training in safe working practices and also to meet the specialist needs of people who accessed the service such as epilepsy training.

Is the service caring?

We saw positive interactions between staff and the person who remained at the service during the day. Staff were kind and attentive and anticipated his needs. They spent time talking with him and discretely monitored his condition.

We asked him whether he enjoyed staying at West Farm. He nodded his head in agreement. We also asked him whether the staff were nice and looked after him well, he nodded his head again to indicate that they were.

Is the service responsive?

There was an emphasis on meeting social needs and that people's hobbies and interests were promoted by the service. Trips into the local community were organised including visits to the cinema, theatre and pub.

We noticed that the service had a complaints procedure. Pictures had been added to make the information easier to understand. Leaflets and information about how to make a complaint were now available in the entrance of the building. The interim manager explained that no complaints had been received.

Is the service well-led?

At this inspection, the registered manager who is named in the beginning of this report was not in charge and not managing the regulated activities. His name appears because he was still on our register at the time of our visit.

The provider had asked the previous registered manager who used to manage the service to come back to oversee the management of the service. Staff were extremely complimentary about her. One member of staff said, 'Since she's come back, she's got it all sorted.'

We found that a range of audits were now in place to monitor the quality of the service provided. A new infection control audit had been devised and new cleaning schedules were in place and being adhered to. Questionnaires were completed following people's stay to find out their views and opinions of West Farm. One person had stated, 'I liked everything.'

The interim manager had a clear overview of staff training and when staff supervisions and appraisals were due. These systems helped her ensure that staff were appropriately trained and supported.

We considered that an effective system was now in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

There was one person using the service who was out accessing the local community at the time of the inspection. Therefore, we consulted the staff and looked at records to ascertain whether improvements had been made.

We found that improvements had been made with medication management. We considered that people were now protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them safely.

Staff informed us that they felt supported. They told us that supervision meetings were held regularly and a yearly appraisal was carried out. However, we concluded that staff did not always receive appropriate training for their professional development.

We considered that an effective system was not fully in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

People were not fully protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained.

West Farm provides short break care and support for people with a learning disability. The manager informed us that the service was closing in the next couple of months and the short break service was being taken over by another provider.

We spoke with one person who informed us that she had 'enjoyed' her time at West Farm. We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Appropriate arrangements were not fully in place in relation to medication management.

The provider had not always taken steps to provide care in an environment that was suitably designed and adequately maintained.

It was not clear that all staff had received appropriate training for their professional development.

An effective system was not fully in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

Records relevant to the management of the service, people and staff were not always accurate or fit for purpose. Certain records could not be located promptly when needed.

We were unable to speak to all of the people using the service because of the nature of their condition. We spoke with staff and observed their practices in order to determine how this care and support was carried out.

We saw how people were treated by staff and their involvement in making choices about their care and support. We saw people could receive medical and specialist attention if they needed it and were helped to fulfil their social needs within the service and community during their stay.

Staff told us they enjoyed working at West Farm. One member of staff said, "We have a great team approach" and "We make time to get to know people and make sure we provide consistent support." We saw how people were treated by staff and their involvement in making choices about their care.

We saw the service was clean, comfortable and warm. There were suitable adaptations and equipment to support people during their stay. People and their families or advocates were given the opportunity to comment on the service, change routine or raise complaints.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received.