We carried out a review of the data available to us about Yewdale Farm on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Yewdale Farm, you can give feedback on this service.
Yewdale Farm is a residential care home providing accommodation and personal care for up to nine people as well as supported living accommodation and personal. At the time of the inspection there were four people using the service. Each person had their own room and shared a kitchen and other communal areas. The service can also support people with personal care in their own home and one other person was suing this service.
People's experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Based on our review of is the service safe, responsive and well-led questions, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support
The service gave people care and support in a safe environment that was clean and suitably equipped to meet people's physical and emotional needs. Staff complied with measures designed to reduce the risk of COVID-19 spreading within the service. Staff focused on people's strengths and promoted what they could do, enabling the opportunity for people to lead fulfilling and meaningful lives.
Staff supported people to pursue their interests inside and outside the home, and to achieve their aspirations and goals. The service worked with people to plan for when they experienced periods of distress; to minimise any restrictions and to ensure people had as much freedom, choice and control over their lives as possible.
Staff received training in the use of restraint and were confident in their ability to deploy this training. At the time of our inspection no person required restraint. Any restraint would be in an emergency situation as a last resort and for the shortest time possible.
Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. Staff enabled people to access the community and pursue their interests in their local area. People were administered their medicines in a way that respected their independence and achieved positive health outcomes.
Right Care
Staff promoted people's equality and diversity, supporting and responding to their individual needs. People's care plans were an accurate reflection of the support they needed and what people could do independently.
Staff had training on how to recognise and report abuse, and had the skills protect people from poor care and abuse, or the risk of this happening. The service worked with other agencies to do so. The service had enough appropriately skilled staff to meet people's needs and keep them safe.
Staff had a thorough understanding of people's individual ways of communicating and this enabled people to be listened to. People received care that supported their needs and aspirations, was focused on their
quality of life, and followed best practice.
Right Culture
People were supported by staff who understood best practice in relation people's strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff knew people well and responded to their needs and wishes. This helped people achieve their aspirations and live a meaningful life.
Staff put people's wishes, needs and rights at the heart of everything they did. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
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 requires improvement (published 13 December 2019).
Why we inspected
We received concerns in relation to people's safety and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Yewdale Farm on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good infection prevention and control (IPC) practice.
Visiting was suspended at the time of the inspection, except in exceptional circumstances based on people’s individual wellbeing. Visiting is to commence from the 8 March 2021. There was an effective process and systems in place for visitors entering the service, in line with the government guidance.
There was enough personal protective equipment (PPE) available and staff used this effectively.
Contact with family, friends and healthcare professionals was done via virtual meetings. This helped promote wellbeing and mitigated the risk of cross contamination or introducing infections.
Individual risk assessments were in place for any person or staff member at an increased risk of infection which included being able to isolate.
Good cleaning regimes were in place. The service was clean, odour and clutter free.
Yewdale Farm is a residential care home providing personal care to people who have a learning disability or autistic spectrum disorder. The service is also registered to provide the regulated activity of personal care. This regulated activity was not being provided at the time of this inspection.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Six people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
Support plans did not always give staff enough guidance to ensure that they knew how people wanted their needs met. Areas of the service required redecoration or refurbishment, but there were no agreements or timescales in place. The registered manager did not know when this action would be taken.
People were safe. Safeguarding procedures had been followed. There were enough staff deployed to support people, so people were not at risk of harm. Risk assessments were in place. There was a system in place to learn lessons from incidents or accidents.
Leadership of the service was good. Quality assurance systems were in place, but these had not identified and rectify shortfalls in the quality of people’s care plans in a timely way. The provider had not acted properly to ensure people lived in a pleasant home. The management team always worked collaboratively with external health and social care professionals. People, relatives and others were asked for their views about the service. Staff felt their views were listened to.
Staff received a suitable induction, training or support to ensure they were able to effectively meet people's needs.
People told us that staff were caring, kind and tried to do their best for the people they were supporting. We saw that people were comfortable with the staff and enjoyed their company.
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.
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
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
Rating at last inspection
The last rating for this service was good (published 22 April 2017).
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.
This inspection was undertaken by one inspector. At the last inspection on 5 February 2015 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.
A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Systems were in place to manage risks to people using the service and to keep them safe. This included assisting people safely with their mobility and whilst out in the community.
There was sufficient numbers of staff on duty to safely assist and support people. The recruitment and selection procedure ensured that only suitable staff were recruited to work with people using the service.
The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have choice and control over their lives as much as possible. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s needs were assessed, so that their care was planned and delivered in a consistent way. The management staff and care staff were knowledgeable about the people they supported and knew their care needs well. Staff offered people choices such as how they spent their day and the meals they wished to eat. These choices were respected and actioned by staff.
People experienced a good quality of life because staff received training that gave them the right skills and knowledge to meet their needs. People were supported and assisted with their daily routines, shopping and accessing places of their choice in the community.
People received appropriate support to maintain a healthy diet and be able to choose and help prepare meals they preferred. People had access to a range of health care professionals, when they needed them.
Staff were clear about the values of the service in relation to providing people with compassionate care in a dignified and respectful manner. Staff knew what was expected of them and staff supported people in a respectful and dignified manner during our inspection.
The provider had processes in place to assess, monitor and improve the service. People had been consulted about how they wished their care to be delivered and their choices had been respected. People, their relatives and staff were provided with the opportunity to give their feedback about the quality of the service provided.
Further information is in the detailed findings below.
Yewdale Farm is registered to provide accommodation and personal care for up to nine people. Nursing care is not provided. There were nine people living at the home when we visited.
This unannounced inspection was carried out on 05 February 2015. The last inspection took place on 06 June 2014, during which we found the regulations were being met.
At the time of our inspection a registered manager was 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected as DoLS applications were in progress where required and had been submitted to the relevant local authorities.
People who lived in the home were assisted by staff in a way that supported their safety and that they were treated respectfully. There were health care and support plans in place to ensure that staff had guidance to meet people’s individual care needs. The care and support plans recorded people’s individual choices, their likes and dislikes and the assistance they required. Risks to people who lived in the home were identified and assessed to enable people to live as safely and independently as possible.
Staff cared for people in a kind, cheerful and sensitive way. Staff assisted people with personal care, activities/hobbies, cooking and domestic tasks throughout our visit to the home.
Members of staff were trained to provide care which met people’s individual needs and wishes. Staff understood their roles and responsibilities. They were supported by the registered manager to maintain and develop their skills and knowledge through regular supervision, appraisals and ongoing training.
People and their relatives felt able to raise any suggestions or concerns they might have with the registered manager. People felt listened to and reported that communications with the registered manager and members of staff were open and very good.
Arrangements were in place to ensure that the quality of the service provided for people was regularly monitored. People who lived in the home and their relatives were encouraged to share their views and feedback about the quality of the care and support provided.
As part of this inspection we spoke with four people who used the service, two family members of people who use the service, the registered manager and four members of care staff. We reviewed records relating to the management of the service which included two care plans, daily records, medication administration records staff training records and quality assurance monitoring records.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at
Is the service safe?
Risk assessments regarding people's individual needs and activities were carried out and arrangements were in place to minimise potential dangers. Staff understood their roles and responsibilities in making sure people were protected from the risk of abuse. The provider ensured that all staff were kept up to date with safeguarding training and accompanying reporting procedures. The premises were well maintained and met the needs of people living in the home.
Is the service effective?
We found that carers were knowledgeable about people's individual care and support needs. Observations we made during our inspection confirmed that the care staff provided friendly and consistent support when assisting people with personal care. People were also able to make choices regarding how they wished to spend time during the day either at home, or when accessing facilities in the wider community.
Is the service caring?
Observations made during our inspection showed that people received warm, consistent and respectful support from care staff and they were enabled to make choices and changes when required. One person told us that 'I really like living here.' Staff told us that they were very well supported and supervised by the manager and senior staff so that they could provide safe care and support to people.
Is the service responsive?
We saw that people's personal care and social support needs were assessed and met. This also included people's individual choices and preferences as to how they liked to be supported. We observed that people could make changes to their support and had been involved in reviews of their support as much as possible. We saw that regular reviews were in place to update people's care and support needs.
Is the service well led?
The home was effectively managed and staff told us that they felt well supported and were regularly trained to safely provide care and support. Observations made during our inspection showed that staff were responsive and attentive so that people were supported consistently and safely. Health and safety checks were in place to monitor the services provided. The service gathered opinions from people who used the service, their relatives and staff to identify any improvements that could be made to the service.
Care and support was being regularly reviewed to ensure that peoples' needs were met. There was evidence of people's involvement in the planning of their care and support. However, some improvements were needed to the reviewing and completion of some care documentation.
The premises were kept clean and were generally well maintained to meet the needs of people.
There were appropriate recruitment procedures in place to ensure that only staff that were suitable to work with vulnerable people were employed.
The home had an effective system to effectively deal with complaints.. People regularly had access to staff to resolve any concerns that they had.
Although some people did not verbally tell us their views about living in the home, we observed that there was a happy rapport between staff and people living at Yewdale Farm, with care and support being provided sensitively managed by staff. The atmosphere in the home was positive and social with people cheerfully engaged with staff.
home and was complimentary about the staff and the care and support he was given. He
was particularly pleased with his bedroom which has been decorated and furnished to
meet his personal wishes and preferences. Although some people did not verbally tell us their views about their experiences of living at the home, we noted that the relationship between staff and people living in the home was friendly and support provided was sensitively managed by staff. The atmosphere in the home was happy and caring and people were cheerful and busily engaged with staff.