We carried out a review of the data available to us about Palace Farm on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Palace Farm, you can give feedback on this service.
About the service
Palace Farm is a residential care home providing personal care for up to three people with learning
disabilities or autistic spectrum disorders. At the time of this inspection there were three people living there. The property is a period farmhouse situated on the edge of Chudleigh. The house is set in large gardens and fields, with various buildings offering a range of work and leisure opportunities. Palace Farm is also the providers' family home.
People’s experience of using this service and what we found
Right Support
The service supported people to be independent and they had control over their own lives. People were fully involved in discussions about how they received support.
Staff communicated with people in ways that met their needs, and supported people to make decisions following best practice in decision-making. Staff focused on people’s strengths and promoted what they could do, supporting them to achieve their aspirations and goals. They supported people to take part in activities and pursue their interests in their local area.
Staff enabled people to access specialist health and social care support in the community. They supported people with their medicines in a way that achieved the best possible health outcome.
Right Care
People received kind and compassionate care from staff who understood and responded to their individual needs. Staff knew how to protect people from poor care and abuse. They had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.
People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. They could take part in activities and pursue interests that were tailored to them, as well as trying new activities that enhanced and enriched their lives. Staff and people cooperated to assess risks people might face.
Right Culture
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. They received good quality care and support because trained staff and specialists could meet their needs and wishes. Staff knew and understood people well. People, and those important to them, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people's views.
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 02 March 2020)
Why we inspected
We received concerns in relation to the management of risk; a lack of person-centred care; staff induction and support, and risks related to the environment. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We found no evidence during this inspection that people were at risk of harm from these reported concerns. Please see the safe and well-led sections of this full report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for this service is good.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Palace Farm on our website at www.cqc.org.uk.
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.
Palace Farm is a residential care home providing personal care for up to three people with learning disabilities or autistic spectrum disorders. At the time of this inspection there were three people living there. The property is a period farmhouse situated on the edge of Chudleigh. The house is set in large gardens and fields, with various buildings offering a range of work and leisure opportunities. Palace Farm is also the providers’ family home.
Palace Farm was previously registered as "Home Orchard", which remains as a brand name, but changed it's registration with the Care Quality Commission in 2016 and is now operated under a registered partnership. The home is in close proximity to three other homes which share some administrative facilities and the brand name but are registered under the provider name Dalskats Limited.
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
Palace Farm offers people a wide range of opportunities to lead an active and fulfilling life. There are large grounds surrounding the home where people were able to pursue activities such as gardening, bee keeping, animal care, tractor renovations, games, arts and crafts. People also enjoyed activities in the local community such as clubs and churches. A member of staff told us, “If a resident has an interest it is actively encouraged”. People told us they enjoyed living at Palace Farm.
There was a stable, happy and well-trained staff group. People told us they liked all the staff. They said staff were always kind. There were enough staff to support people in their daily activities. Care was taken when recruiting staff to ensure new staff were entirely suitable for the job. People living in the home were involved in choosing new staff. Staff praised the providers and management team for the support they received. Comments included, "It’s a lovely place to work".
The home was comfortable, clean, well maintained and safe. People were involved and consulted in the decoration and furnishings. Risk assessments had been carried out on the environment, equipment, and on people’s health, wellbeing and daily activities. Staff knew how to support people to stay as safe and healthy as possible.
People were supported to eat a healthy diet. They grew many plants and vegetables in the gardens which were used in their meals. They also used eggs from their own chickens and honey from their own bees. People were supported to plan and prepare their own meals as far as they were able.
Each person had their own support plan setting out clearly how they wanted to be supported in all areas of their daily lives. Support plans were regularly reviewed and updated. Relatives were involved and consulted. A relative praised the detailed records completed by staff, saying, “Their recording is second to none. (When an incident occurs, the records show) ‘How did we get to that incident?’ Their review packages - ABC charts - it’s all written down. Everyone knows what to do if he has an episode”.
The service was well-led. People, staff and relatives praised the providers and management team for their caring ethos. A member of staff told us, “{The provider’s} ethos is good. Independence, dignity and respect. {The providers} are always looking to improve. They want the best for everyone." There were systems in place to ensure the service was well run. The providers sought the views of people living there, staff and relatives through questionnaires, meetings, supervisions and reviews. A relative told us, “...in our book they get massive ticks for all that they do and definitely are a top of the heap – ‘Five Star Outfit’ and richly deserve the utmost respect and recognition for the peerless work that they’re doing - They’re ‘Simply the Best’.”
People were supported to have maximum choice and control of their lives and staff supported support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported/ did not support this practice.
The service applied 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 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 23 June 2017)
Why we inspected
This was a planned inspection based on the previous rating.
This inspection took place on 6 June 2017 and was announced. We gave the provider 15 hours notice as the home is small and people are out for much of the day. We needed to ensure someone would be there to meet with us.
Palace Farm was previously registered as “Home Orchard”, which remains as a brand name, but changed it’s registration with the Care Quality Commission in 2016, and is now operated under a registered partnership. The home is in close proximity to three other homes which share some administrative facilities and the brand name but are registered under the provider name Dalskats Limited.
The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager is also one member of the partnership, and is referred to throughout the report as a provider.
The home had a happy, positive and welcoming atmosphere. Palace Farm was set up with the aim of enabling people to enjoy a ‘normal family lifestyle’ rather than more traditional or institutional care, and the provider’s website states they wanted people to be able “to access a fulfilling outdoor life”. We saw this happening, with people following full and active lifestyles of their choosing. Palace Farm is a working farm with livestock, and people were able to participate as much or as little as they wish in this. People had lived at the home for many years and were very familiar with the provider’s family members.
People were protected from the risk of abuse as staff understood the signs of abuse and how to report concerns. Systems were in place and well understood to help staff or people report concerns, including independent advocacy. We saw people had built positive relationships with staff. Staff told us they were confident they understood how if people were unhappy about something it would show through their behaviour.
People were supported safely because risks to people were identified and plans were put in place to minimise these risks. These included changes that had been made to the building as assessments of risks from activities, health conditions, supporting animals on the farm as well as assessments of people’s own vulnerability.
People received their medicines as prescribed. The systems in place for the management of medicines were safe and protected people who used the home. This included the management of emergency medicines to support one person with epilepsy and clear protocols for staff to follow to ensure the person was supported safely.
There were enough staff to support people to follow their chosen lifestyle, activities and keep people safe. Staff had the skills and support they needed to ensure people’s individual care needs were met. People knew in advance who would be working with them which helped reduce their anxieties. Staff were chosen as far as possible to reflect people’s interests, and we saw staff supporting people well. Staff had attended courses with one person and were enthusiastic about supporting them with their hobby.
People’s rights were respected. Staff had clear understanding of the Mental Capacity Act 2005 and where a person lacked capacity to make an informed decision, staff acted in their best interests. Applications had been made to ensure people’s rights were protected under the Deprivation of Liberty safeguards. We saw staff were supportive, compassionate and caring in their relationships with people. People were treated with kindness and respect and valued fo their contributions to the running of the home.
The premises were reflective of the home’s ethos – to provide a family living experience. The building was a listed farmhouse, adapted to provide a comfortable family home. People had single bedrooms with en-suite facilities and some shared space, including the lounge and kitchen / diner. They had free access to the kitchen to prepare their own snacks and hot drinks. Mealtimes were social experiences and people were involved in the planning, and choosing of their meals. People were supported to have enough to eat and drink, and the provider ensured wherever possible people ate good quality food, fresh picked from the farm and which they had grown themselves and local organic meats.
People were treated with dignity and respect. Staff used different methods of communication to speak with people and include them in conversations, and ensure they were understood. This included for some people supported communication using pictures and symbols, for example to help with choosing food.
People were actively supported to follow hobbies and interests of their own choosing. Both people living in the home had some one to one staff allocation which helped ensure someone was always available. Staff supporting one person had been on courses to help understand their hobby so they could support the person better.
Systems were in place to ensure complaints were responded to and managed. The home had not received any formal complaints and felt if people had any issues they would be raised and addressed informally.
People told us the providers and management team were approachable and always contactable in case of emergency or advice needed. Up to date advice and support on good practice was sought and the provider had commissioned a social care consultant to provide management support to the team and oversee some areas of the home. They reviewed this regularly.
The provider had systems in place to assess, monitor and improve the quality of care and services provided. The provider sought feedback from people, relatives, staff and healthcare professionals in order to improve the home. Feedback from this process was made available on the home’s website and given to people so they could see the results of any suggestions they had made.
Records were well maintained and kept securely.