26 March 2020
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.
The inspection was completed by one inspector.
Service and service type
The Farmhouse is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we had received about the service since our last inspection and sought feedback from the local authority.
We used this information to plan our inspection.
During the inspection
We spoke with and/or spent time with five people using the service. Most people using the service were unable to express their views verbally. We spoke with five members of staff including the registered manager, the service manager, a team leader and two care workers. We reviewed a range of records. This included two people’s care records and all the medication records. A variety of records relating to the management of the service were also reviewed.
After the inspection
We spoke with two relatives of people using the service. We reviewed training data, minutes of meetings and additional evidence the provider submitted.
26 March 2020
About the service
The Farmhouse is a residential care home providing accommodation and care to six people with a learning disability and/or autism at the time of the inspection. The service can support up to eight people.
The Farmhouse is an adapted house situated on a campus style service in rural Lincolnshire. There are several other houses located on the same site and a shared administration office. People living at The Farmhouse have their own room and access to a range of shared facilities. They can also use a range of facilities in the grounds of the complex.
The service follows 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 and what we found
Staff received supervision and appraisal; however, they were not always up to date with their training requirements. Following the inspection the registered manager took immediate action to expedite the action plan they had in place to address this.
Staff were kind and caring in their approach and people were relaxed and happy in their company. Staff were very knowledgeable about the needs and preferences of the people they supported; they were skilled at interpreting people’s wishes when they were not able to express themselves clearly verbally.
Where people received support with their meals, staff did so effectively and in line with dietary requirements. People had access to ongoing healthcare support and staff liaised effectively with other services to achieve this.
Staff assessed risks to people’s health and safety and had the knowledge to protect people from avoidable harm and abuse. Relatives felt their family members were safe at the service. Safe processes were in place for the management of people’s medicines. Staffing levels were planned to meet people’s care and support needs.
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. 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.
Staff were clear about their roles and responsibilities. They felt well supported by the registered manager and the management team. They were committed to improving the service provided and to increasing the involvement of people using the service and independent organisations to obtain feedback and implement improvements.
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 Good (published 25 October 2017)
Why we inspected
This was a planned inspection based on the previous rating.
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.