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  • We are currently investigating concerns about this service. We will publish a new report and rating here once we have completed our inspection.
We are carrying out a review of quality at Tithe Barn. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 1 January 2020

About the service

Tithe Barn is a residential care home for people with learning disabilities.

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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 13 people. Eleven people were using the service at the time of our inspection. 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 residential area and the other large domestic homes of a similar size. 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

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service didn’t always (consistently) apply 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 did not fully reflect the principles and values of Registering the Right Support for the following reasons [lack of choice and control, limited independence, limited inclusion] e.g. People did not have choice in the food they ate or at what times meals were served. Menus were developed by staff with no input from people who lived at the service.

Since our last inspection the provider had started to make improvements in reducing risks to people’s safety. The risks to people's health, safety and welfare were now being reassessed, recorded and kept under review. Incident and accident records had been completed or signed off by the senior management to confirm all necessary actions had been taken.

Staff member’s knowledge and skills were being reassessed to ensure they had the skills to care for the people who lived at the home.

The provider's quality assurance systems and processes had started to address issues with documentation, medicines found at our last inspection. Although staff members felt more supported, professionals continued to express mixed views about and varying confidence in the management team.

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 Inadequate [published 15 November 2019].

At this inspection although the provider was making improvements to the areas we identified at the last inspection this needed to continue and evidence provided to show the sustainability of the improvements. The provider continues to be in breach of regulations

We reviewed the information we held about the service. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same. We have found evidence that the provider still needs to make improvements. Please see Safe and Well-led sections of this full repor

Inspection areas

Safe

Inadequate

Updated 1 January 2020

The service was not safe.

Details are in our safe findings below.

Effective

Inadequate

Updated 19 November 2019

The service was not effective

Details are in our Effective findings below.

Caring

Inadequate

Updated 19 November 2019

The service was not caring

Details are in our Caring findings below.

Responsive

Inadequate

Updated 19 November 2019

The service was not responsive

Details are in our Responsive findings below.

Well-led

Inadequate

Updated 1 January 2020

The service was not well-led.

Details are in our well-Led findings below.