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Inspection carried out on 7 October 2019

During a routine inspection

About the service

Tanners Farm is a residential care home providing personal care to seven people aged 18 and over at the time of the inspection. The service can support up to seven people.

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.

People’s experience of using this service and what we found

The service provided to people was safe. Staff had been trained in safeguarding and had a good understanding of safeguarding policies and procedures. The administration and management of medicines was safe. There were sufficient numbers of staff working at the service. The risk posed to people had been assessed and suitable action had been taken to minimise the risk posed to people using the service.

Staff had received appropriate training. People were supported to access support from health professionals when required. They could choose what they liked to eat and drink and were supported on a regular basis to participate in meaningful activities.

Staff were kind and caring and were motivated to offer person-centred care. People and relatives, we spoke with told us staff were caring. The principles of respect, dignity, compassion and, equality and diversity were embedded in the service. People were treated as equals regardless of age, gender or personal beliefs.

The service was responsive to people’s needs. Care plans were person-centred to guide staff to provide consistent, high quality care and support. Daily records contained good levels of details and provided evidence of person-centred care. Where required, people were supported to make decisions about end of life care which met their individual needs and preferences.

The service was well led. People, staff and relatives spoke positively about the manager. Quality assurance checks were in place and identified actions to improve the service. The registered manager sought feedback from people and their relatives to improve the service. There was a positive culture throughout the service which focused on providing person-centred care.

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 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

Rating at last inspection

The last rating for this service was Good (published 7 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.

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.