Archived: Blamsters Farm

Updated 8 November 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The first day of the inspection visit was completed by two inspectors and an Expert by Experience. The second day was completed by one inspector. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Blamsters Farm is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service however due to people's limited communication skills we spent time observing people with their staff team.

We spoke with eleven members of staff including the registered manager and another manager also about to register and the area manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people's care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality audits, maintenance records, and training information.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training and contacted four relatives.

Updated 8 November 2019

Blamsters Farm is a residential care home that provides accommodation and support for up to 31 people who have a learning disability and or autistic spectrum disorder.

The service is made up of two larger properties and five smaller houses spread across the grounds. At the time of the inspection there were 30 people living at the service.

The service was a large site and it was registered for the support of up to 31 people. 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 being separated into more domestic style houses across the site. The service followed the principles to 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 and what we found

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 some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

At the last inspection we found the service did not have effective systems in place to assess and monitor the environment and ensure people were kept safe from harm. Where problems had been identified it was not always clear to see the action that had been taken to rectify the issue. We were concerned that hot water temperatures posed a potential risk to people that were vulnerable and action to mitigate were not effectively in place. At this inspection effective systems were in place and water temperatures were monitored and action taken when temperatures were outside of the recommended temperatures.

Staff focused on providing person-centred care to enrich people’s lives and support them to promote their wellbeing. They were supported by staff who overcame barriers to people's participation in activities which were socially important to them. Relatives and professionals described people's care in a positive way, telling us people experienced new skills and experiences through the support of staff. Care plans supported staff to provide extremely personalised care to people.

People were protected from abuse. Staff understood how to recognise and report any concerns they had about people's safety and well-being. There was enough staff to keep people safe. Staff were visible throughout the day and they responded to people’s needs in a timely way. Risks to people health and well-being were assessed and mitigated. People's medicines were managed safely.

Staff had access to relevant training and regular supervision to equip them with the knowledge and skills to care and support people effectively. Nutritional needs were met, and people were supported to access healthcare services if they needed them. People's health needs were closely monitored and any changes to their needs were immediately reflected in their care plans and the care they received. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were comfortable and relaxed when interacting with staff and they were happy to ask them for help or support. People's privacy and dignity was protected. When people had specific needs about eating and drinking, these were met. Staff demonstrated a good understanding of the people living there and created opportunities for maximising their independence and life skills. Staff worked in partnership with other social care and health care professionals to ensure people received the support they needed.

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.

A range of audits and checks helped ensure service quality was maintained and areas for improvement identified. Learning was shared with staff and used to develop the service.

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

The last rating for this service was good (published 04 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.