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Inspection carried out on 15 February 2017

During a routine inspection

The inspection took place on 15 February 2017 and was unannounced.

Tanners Farm House is a care home which provides care and support for up to seven people who have a learning disability, such as autism. At the time of our visit there were four people living at the home.

There was 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.

Our last inspection was in October 2015 where we identified concerns with medicines management, the application of the Mental Capacity Act (2005) and a lack of quality assurance systems in place. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

People’s medicines were managed and administered safely by trained staff. The registered manager carried out regular medicines audits and staff kept up to date records of medicines. Staff worked alongside healthcare professionals to meet people’s needs.

There were sufficient numbers of staff present to meet people’s needs safely. Staff supported people to take part in activities and to go out regularly. Appropriate checks were in place to ensure that staff were suitable for their roles.

The provider had systems in place to audit the quality of the care that people received, as well as the safety of the premises and measures in place for emergencies such as fire. Plans were in place to protect people should an emergency situation occur.

People were supported by staff who knew them well and were kind and compassionate. Care plans were person-centred and where people’s needs changed this was responded to by staff. Reviews took place regularly.

People lived in an inclusive atmosphere in which their independence was encouraged. People were supported by staff to carry out household tasks as well as develop skills such as preparing meals. Staff knew people’s food preferences and people’s dietary requirements were met. Risk assessments were in place to keep people safe whilst maximising their independence.

Staff felt well supported by management and had input into how the home was run. Staff had access to training courses and were knowledgeable in how to support people with autism. Staff had regular supervision.

People’s privacy and dignity was respected by considerate staff. Staff knew how to respond if they had safeguarding concerns. People and relatives were informed of how to make a complaint and where complaints had bene made, they were responded to appropriately.

Inspection carried out on 26 October 2015

During a routine inspection

Tanners Farm House is a care home which provides care and support for up to seven people who have a learning disability, such as autism. At the time of our visit there were four people living at the home, all of whom were male.

There was no registered manager in post. The new manager was in the process of applying to become the 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 and associated Regulations about how the service is run. The manager assisted us with our inspection on the day.

Proper medicine management procedures were not always followed by staff. We found one person had not received their medicines and one medicine was not labelled or dated.

There were enough staff working to meet people’s needs. Staffing levels were such that people were not kept waiting when they needed care and support. People were enabled to go out or remain in the home because of the staffing levels. However, we found staff were not always deployed appropriately in the home.

Staff were not provided with regular training to assist them with carrying out their role and staff did not have the opportunity to meet with their line manager regularly to check they were following best practice, or to discuss any aspect of their work.

Staff did not have a good understanding of the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards, which meant people had restrictions in place without the proper procedures being followed.

Accidents and incidents were recorded and monitored by staff to help ensure they could mitigate against further incidents happening. People’s dietary requirements had been identified by staff and these were taken into account when developing the menus or doing the shopping. However, people were not involved in choosing their meals and the food they would like to eat.

Quality assurance monitoring wasn’t always completed as often as it should be and actions from provider visit audits had not always been addressed by staff.

We found that where there was a risk to people this had been identified and action taken by staff. Staff had a clear understanding of how to safeguard people and knew what steps they should take if they suspected abuse. There was an effective recruitment process that was followed which helped ensure that only suitable staff were employed.

People were supported to access external health care professionals when required in order to help them maintain a good level of health. In the event of an emergency or the home had to be evacuated people’s care and support would not be interrupted.

Staff showed people kindness and compassion. They recognised people’s individual characteristics and respected their privacy when they wished it. Visitors were made to feel welcome in the home.

Meaningful activities were arranged for people and activities were flexible to fit with what people chose to do on a daily basis. Care records in relation to people were detailed and comprehensive and focused on the person.

Staff were involved in all aspects of the home and attended regular staff meetings. Staff felt supported by the manager and felt things were improving in the home now the new manager was in post. There was complaint information available for people should they have any concerns about the care they were receiving. Relatives were asked for their feedback in relation to Tanners Farm.

During the inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.