Archived: Care Management Group - Farmhouse

Farmhouse is a residential care service providing personal care and accommodation for up to seven people living with a learning disability and autism. At the time of our inspection seven people were using the service.

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

Systems had been established to safeguard people from the risk of abuse. Individual risks had been assessed, and people were protected from the risk of harm associated with the maintenance of the service and the spread of infection. Medicines were being managed in a safe manner. There were enough staff working at the service and pre-employment checks were carried out on prospective staff. The service learnt from accidents and incidents to provide safe care and support.

Assessments were undertaken to determine people’s needs before they moved into the service. Staff received training to support them in their roles. Staff were provided with ongoing support through supervisions and appraisals and received a thorough induction, to enable them to provide effective care and support. People’s nutritional needs were met, and people were supported to access relevant healthcare professionals. The service took into consideration individual preferences and likes when adapting then home. 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.

People were treated in a caring manner by staff. Staff understood how to support people in a way that respected their dignity, privacy and promoted their independence.

It was not always clear that people were involved in the planning and reviewing of their care. We recommended the provider review best practice guidance and ensure evidence people are involved in making decisions about their care.

People received individualised care that met their needs. The care plans were person centred and discussed people’s protected characteristics. People were supported to engage in their local community and participate in activities of their choice. Information was provided to people in an accessible format. People told us they felt able to make a complaint and were confident that complaints would be listened to and acted on. People’s end of life wishes had been explored.

People, and staff spoke positively about the service and said it was managed well. There were processes in place to manage and monitor the quality of the service provided. The management team had regular contact with people using the service and their staff. The registered manager kept up to date with best practice to ensure a high-quality service was being delivered.

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.

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

Rating at last inspection (and update)

The last rating for this service was good (published 28 February 2017). The service continues to be rated good.

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.

The Farmhouse provides care, accommodation and support with personal care for seven people with a learning disability.

There was a registered manager in post. 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 and associated Regulations about how the service is run.

At the last inspection in August 2014, we found one breach of regulations. The registered provider had not notified us of incidents or allegations of abuse. At this inspection we found that action had been taken and we had received the necessary notifications of incidents at the service.

Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Staff were aware of their responsibilities to ensure people were safe and what to do if they had any concerns. They were confident that the registered manager would address any concerns.

People were protected by the provider’s recruitment process which ensured that staff were suitable to work with people who need support.

People were encouraged to make choices and to have as much control as possible over what they did. Systems were in place to ensure that their human rights were protected.

People had complex needs and their care was planned in partnership with their relatives. Relative felt any issues or concerns they raised would be dealt with by the registered manager. Their views were sought and valued.

The staff team worked closely with other professionals to ensure people were supported to receive the healthcare they needed. People received their prescribed medicines safely.

Staff received the support and training they needed to give them the necessary skills and knowledge to meet people’s assessed needs, preferences and choices and to provide an effective and responsive service. Staffing levels were sufficient to meet people’s assessed needs.

People received a personalised service and were supported to be as independent as possible and to have an active social life.

People were treated with respect and their privacy and dignity was maintained. They were supported by a consistent staff team who knew them well.

People’s cultural and religious needs were respected and celebrated and their nutritional needs were met

The registered manager and the provider monitored the quality of service provided to ensure that people received a safe and effective service that met their needs.

Staff and relatives felt that the service had improved under the leadership of the registered manager.

We saw that people were supported to have a nutritious diet that met their needs and preferences. There were systems in place to ensure that they received their prescribed medication appropriately. We found that staff received the training and support that they needed to carry out their duties and support people who used the service. One member of staff said 'I have had lots of training and definitely get the right training and support.' A relative told us 'the manager is training staff and making them more confident.'

People had confidence that if they were not happy about anything the manager would address this. One relative said 'I am absolutely happy to raise anything. He does something about it and reports back to you.' Another said 'when I have raised things with the manager he has dealt with them straightaway.' People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.

The relatives we spoke to made positive comments about the service and said that it was a "lovely environment". People also told us that they felt they were kept informed and involved with the service and that their relative was "happy and settled".

You can see our judgements on the front page of this report.