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Inspection carried out on 5 June 2018

During a routine inspection

We inspected the service on 5 and 6 June 2018. The inspection was unannounced. Farm House provides accommodation and personal care for up to five people with a learning disability. The service is a detached old farm house set in a rural area on the outskirts of Woodchurch village on Highlands Farm, which is a tourist attraction and where the provider has other registered services located. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Each person has a single room and there is a communal bathroom, separate shower room, toilet, kitchen/diner, laundry and lounge. There is an enclosed garden and paved seating area.

At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People told us they felt safe living at Farm House and staff helped them when they needed support. A relative told us "This place is fantastic for [my loved one]. They love it here”

The service had 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 2008 and associated Regulations about how the service is run.

The provider took appropriate action to manage accidents and safeguarding incidents. Staff members were prepared to report any suspected abuse and knew about the procedure for this. Staff were recruited safely and medicines were stored and administered in a timely manner.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's needs were assessed before moving to the service and staff had the right skills and training to support people. People were encouraged to eat healthy and balanced diets.

People received a service which was caring. People were treated with dignity and respect by staff who were compassionate and caring. Staff treated people's private information confidentially. People were able to make decisions about how their care was provided, and were involved in reviews along with family members.

People received care that was personalised to their individual preferences. Staff knew people's needs and personalities well. When people or their families had complaints or concerns they were encouraged to raise them. Management saw complaints to be an opportunity to improve the service.

The registered provider, Canterbury Oast Trust had a set of core values and the registered manager aligned those values with this service. The registered manager made sure these values were embedded into the culture of the service.

Further information is in the detailed findings below

Inspection carried out on 6 February 2017

During an inspection looking at part of the service

Care service description

Farm House provides accommodation and personal care for up to five people with a learning disability. At the time of the inspection there were five people living at the service and no vacancies. The service is provided in a detached old farm house and is not suitable for people with poor mobility. It is set in a rural area on the outskirts of Woodchurch village on Highlands Farm, which is a tourist attraction and where the provider has other registered services located. Each person has a single room and there is a communal bathroom, separate shower room, toilet, kitchen/diner, laundry, snug and lounge. There is an enclosed garden and paved seating area.

Rating at last inspection

At the last inspection, the service was rated Good and Requires Improvement in the 'Safe' domain.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 19 November 2015. A breach of legal requirements was found in relation to medicine management. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12 of the Health and Social Care Act Regulated Activities Regulations 2014, Safe care and treatment. We undertook this focused inspection to check that they had followed their plan and to confirm that they have now met legal the requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Farm House on our website at www.cqc.org.uk

At this inspection we found the service remained Good overall and is now rated Good in the Safe domain.

Why the service is rated Good.

People told us they felt safe living at Farm House and staff helped them when they needed support. A relative told us “This place is good”.

People received their medicines safely and when they should. There were systems in place to ensure medicines were stored correctly and safely.

Risks were assessed and staff took steps to keep people safe whilst enabling their independence.

Staff knew how to recognise and respond to abuse. They had received training on how to keep people safe.

People lived in a homely environment, which was well-maintained. Regular checks were made on the premises and equipment to ensure it was safe.

Accidents and incidents were recorded and appropriate action taken to reduce the risk of further occurrences.

People were protected by safe recruitment procedures. People had their needs met by sufficient numbers of staff and staff rotas were based on people’s needs and activities.

Inspection carried out on 24 November 2015

During a routine inspection

This inspection took place on 19 November 2015, and was unannounced. The previous inspection on 29 January 2014 was a follow up inspection to check on breaches found during an inspection on 10 September 2013. The inspection found no breaches in the legal requirements.

Farm House provides accommodation and personal care for up to five people with a learning disability. At the time of the inspection there were five people living at the service and no vacancies. The service is provided in a detached old farm house and is not suitable for people with poor mobility. It is set in a rural area on the outskirts of Woodchurch village on Highlands Farm, which is a tourist attraction and where the provider has other registered services located. Each person has a single room and there is a communal bathroom, separate shower room, toilet, kitchen/diner, laundry, snug and lounge. There is an enclosed garden and paved seating area.

The service is run by a registered 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 received their medicines safely and when they should. However we found one shortfall relating to medicine storage.

People were involved in the planning of their care and support. Care plans contained information about people’s wishes and preferences. They detailed people’s skills in relation to tasks and what support they required from staff, in order that their independence was developed. People had regular reviews of their care and support where they were able to discuss any concerns or aspirations. Risks were assessed and staff took steps to keep people safe whilst enabling their independence.

People told us their consent was gained through discussions with staff about their support. People were supported to make their own decisions and choices and these were respected by staff. Staff had received training in the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood this process.

People were protected by safe recruitment procedures. New staff underwent an induction programme, which included shadowing experienced staff, until staff were competent to work on their own. Staff received training relevant to their role. Staff had opportunities for one to one meetings, staff meetings and appraisals, to enable them to carry out their duties effectively. Some staff had gained qualifications in health and social care. People had their needs met by sufficient numbers of staff. Staff rotas were based on people’s needs, health appointments and activities.

People were relaxed in staff’s company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. Staff were kind and patient in their approach. Some staff had worked at the service for some considerable time and had built relationships with people and were familiar with their life stories and preferences.

People had a varied diet and were in control of budgeting, planning, shopping, preparation and cooking their meals. Staff encouraged people to eat a varied and healthy diet. People had a varied programme of work based and leisure activities that they had chosen; they regularly accessed the community and staff worked with people to develop their independence in a number of areas.

People were supported to maintain good health and attend appointments and check-ups. Appropriate referrals were made to health professionals if and when required. People did not have any concerns, but felt comfortable in raising issues. Their feedback was gained both informally and formally. The registered manager worked alongside staff and took action to address any concerns or issues straightaway to help ensure the service ran smoothly.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.

Inspection carried out on 29 January 2014

During an inspection looking at part of the service

On 10 September 2013 we inspected Farm House and found non-compliance in the area relating to management of medicines. This was a follow up inspection to check compliance against that area.

During this inspection we spoke with two people who were using the service, the manager and one staff member.

People told us they continued to be satisfied with the service provided and they got their medication when they should.

Inspection carried out on 10 September 2013

During a routine inspection

We spoke with two people who used the service and one member of staff.

People told us their privacy and dignity was respected and that the staff �are all nice� and �kind�. People said their independence was encouraged. People felt they were able to express their views and were involved in decisions about their care and support.

People told us they had been involved in developing their care plans to ensure the care and support was delivered in the way they chose. People were entirely happy with the care and support they received. One person said, �I like living here, I�ve got lots of friends�. Another person said, �I like it here, I like everybody�. People said they had review meetings where they discussed their aspirations and any concerns.

People told us they did not have a lot of medication, but they got their medication when they should. However we found shortfalls in the medication systems.

People thought highly of the staff and thought they had the necessary skills and experience. People told us that staff were available and supported them when they needed help.

People had been able to express their views and give feedback about the service during residents� meetings, at their review meeting and through completing questionnaires. The service carried out audits and checks to ensure the service ran effectively.

Inspection carried out on 10 January 2013

During a routine inspection

People were able to make their own decisions in relation to their care and support. People said they were happy living at Farm House and satisfied with the care and support they received. One person said, �I like to take my time, I can do that here, I don�t get rushed�.

People told us they knew about their care plans, or that staff had discussed their care and support with them.

People said they like their rooms; the home was well maintained and always clean and tidy.

People told us they liked the staff team who were always on hand to support them when needed. People knew who to speak with if they had any concerns, which they didn�t, but were confident any concerns would be �sorted out�.

Inspection carried out on 14 October 2011

During a routine inspection

People told us they were treated with kindness and respect, and their independence was encouraged. They were happy with the care and support received and felt safe living at Farm House. People told us staff were nice and caring. People felt confident any concerns would be sorted out and they had a say in what happened in the home.