Penrose Farm

Updated 12 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 19 and 22 September 2017 and was unannounced on the first day of inspection. The inspection was undertaken by a single adult social care inspector, with learning disabilities experience.

Before the inspection we reviewed previous inspection reports and other information we held about the service including any notifications. A notification is information about important events which the service is required to send us by law. We requested and were provided with a Provider Information Return (PIR) from the provider prior to the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make.

Not everyone who lived at the service was able to verbally communicate due to their healthcare needs. During the inspection we spent time with four people who lived at Penrose Farm and spoke with one person. We also received feedback from seven relatives and four external professionals who had experience of the service following the inspection. We looked around the premises and observed care practices on the day of our visit.

We also spoke with four support staff, the registered manager and two additional registered managers who were supporting the service and the operations manager for the organisation. We looked at three records relating to the care of individuals, four staff recruitment files, staff duty rosters, staff training records and records relating to the running of the service.

Updated 12 October 2017

We inspected Penrose Farm on 19 and 22 September 2017, the inspection was unannounced. The service was last inspected in August 2015 when it was rated as 'Good'. At this inspection we found the service remained ‘Good’.

Penrose Farm provides accommodation for up to five people with complex needs. There were five people living at the service at the time of our inspection. Not everyone who lived at the service was able to verbally communicate due to their healthcare needs.

At the time of this inspection the service was undergoing a change in the way it was managed. The registered manager explained that the service had gone through a period of several months over the summer with limited management support. This had led to a drop in monitoring of aspects of the running of the service. For example, outstanding maintenance issues and background cleaning of the fabric of the service had been overlooked. The registered manager had recognised that the level of scrutiny required, in order to manage the size and complexity of the service required additional resource. We have made a recommendation in the well led section of this report about this.

We walked around the main house and noted areas of maintenance, such as a faulty tap that needed to be fixed. We also noted that communal areas such as the utility room had not been well maintained and were not clean. This was pointed out to the registered manager at the time. By the second day of inspection all outstanding maintenance issues had been rectified and the service had been fully deep cleaned to a high standard.

People had regular routine access to visiting health and social care professionals where necessary. People attended an annual health check with a GP and had access to specialist medical services to ensure their health needs were met. Two relatives of people living at Penrose Farm told us there was not always appropriate communication about appointments that people needed to attend outside of the service. Comments included, "Communication could be better. There have been instances when [Person’s name] has not made it to medical appointments because there has been a mix up about times. It has been frustrating at times” and “There was some confusion over a booked appointment and the appointment had to be re-booked. I think the communication between management/staff and other professionals could be better at times”. The registered manager acknowledged there had been confusion regarding two people’s activities and booked appointments which had led to a situation where appointments needed to be re-booked.

People were relaxed, engaged in their own choice of activities and appeared to be happy and well supported by the service. One person told us they were happy and felt safe living at Penrose Farm. Relatives of people who lived at the service were generally positive about the care and support provided to people. Comments included, “I am generally pleased with the care [Person’s name] receives. It’s clear [they] are happy there and I would say my impression is staff genuinely like [Person’s name].”

Penrose Farm is made up of four separate accommodation areas with a main house accommodating two people, an annex accommodating one person and two independent living spaces on the grounds of the service, each accommodating one person.

The service was comfortable and personalised to reflect people's individual tastes. People were treated with kindness, compassion and respect. Staff demonstrated they had an excellent knowledge of the people they supported and were able to appropriately support people without limiting their independence. Staff consistently spent time speaking with the people they were supporting. We saw many positive interactions and people enjoyed talking to and engaging with staff. One staff member said, "I get a lot of pleasure from my job. One of the best parts of my job is making sure every customer’s life is as enjoyable and safe as possible. Our role is to ensure people live happy and fulfilled lives.”

Staff had completed training in how to recognise the signs of abuse. People received their medicines safely and as prescribed.

Staff were well supported by a system of induction, training and supervision. We found there were areas of training that required updating and saw this had been identified and scheduled. Staff meetings were an opportunity to contribute to the running of the service. Staff told us they were well supported by the management team and each other.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s communication styles were understood and staff were patient and respectful in encouraging people to communicate in the way that was most appropriate for them. Information was produced using easy read techniques, e.g. limited text and photographs and pictures. Support plans were available in an accessible format.