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8 Acres Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 26 March 2020

About the service

Westward Barns in the process of being named Eight Acres provides care and support to up to 18 people, 18 to 65 who have a learning disability, physical disability, autism and or mental health need. At the time of inspection there were 14 people with two in hospital. Accommodation was on a large site with offices, and individual dwellings, a barn converted into flats, a house converted into flats and a number of self-contained units. Staffing was provided on a 1-1 one basis and occasionally 2-1 staffing.

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

The service had previously been rated as good but in the last year had seen a lot of changes. This included changes to both operational and registered managers. There had also been a change in company which had meant a period of instability which had not been effectively communicated and staff felt they had not been sufficiently supported through the changes. There had been a number of staff who had left and other staff who were working long hours to cover vacancies. Agency usage meant people did not always receive predictable care and support from staff who knew them well. Staff sickness was also affecting service delivery.

At the time of our inspection the service was being overseen by an area manager who had been in post for six weeks. We were impressed with the actions they took immediately following the concerns we raised and the actions they had taken since. A robust action plan was in place which gave us confidence in the service moving forward. However, we found issues across all key questions and a number of breaches of regulation.

Risks were not always effectively managed and communicated across the organisation including risk relating to the environment, distressed behaviours or how staff would deal with an emergency situation.

We were concerned about staffing levels, staff were not always on time and it was not clear that staff were informed about or had the necessary skills to meet people’s needs. This included staff competence in relation to the administration of people’s medicines.

People received their medicines as intended but a lack of sufficiently trained staff meant shift planning was difficult and some staff said shifts were busy which increased the risk of medicine errors. Audits helped to determine that people received their medicines as required but we identified a number of gaps.

Staff knew how to raise concerns but there was poor oversight of this. Accidents and incidents had not been adequately recorded to show if they had been effectively managed and there was insufficient governance to monitor events affecting the safety of staff and people using the service.

People’s health care needs were mostly met particularly where people had complex needs and a core team of staff supporting them. Some staff were not working consistently in line with specific guidelines provided by other health care professionals. or with best practice.

People were not supported to have maximum choice and control of their lives and staff supported did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service didn’t always consistently apply 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. We found people had a lack of choice and control, in terms of their staff and how their day should be organised. We found for another person they had poor choices in terms of moving in and limited inclusion. Some practices were restrictive.

Staff worked hard and show a commitment to the people they were supporting. We found however the service was not sufficiently personalised or peoples care needs set around clearly defined obje

Inspection areas

Safe

Requires improvement

Updated 26 March 2020

The service was not always safe.

Details are in our effective findings below.

Effective

Requires improvement

Updated 26 March 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 26 March 2020

The service was not always caring.

Details are in our effective findings below.

Responsive

Requires improvement

Updated 26 March 2020

The service was not always responsive.

Details are in our effective findings below.

Well-led

Requires improvement

Updated 26 March 2020

The service was not always well led.

Details are in our effective findings below.