Roughcote Hall Farm

Roughcote Hall Farm is a residential care home providing personal care for up to 9 people with Learning disabilities or autistic spectrum disorder, older people and younger adults. There were 9 people living at the home at the time of the inspection. The service can support up to 9 people.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

Staff worked with people to plan their own care and manage risks to their safety. The staff ensured the home was safe, clean and well-maintained environment. 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.

Right Care:

Staff understood how to protect people from abuse. There were enough staff to meet people’s needs and keep them safe. Staff assessed people’s needs for support with medicines and this was provided. People were encouraged to engage with staff on how they wanted to be supported.

Right Culture:

The registered manager checked the quality of support provided to people and made changes as a result of feedback. People, relatives and staff told us they felt listened to and involved in the service. People received person centred care and had their needs and preferences met by staff who knew them well. We made a recommendation about seeking advice on window restrictors.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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 requires improvement (6 August 2021).

Why we inspected

We carried out an unannounced focussed inspection of this service on 6 August 2021. The provider was rated requires improvement. We undertook this focused inspection to check they had made the required improvements.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Roughcote Hall Farm on our website at www.cqc.org.uk.

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.

Recommendations

We have made a recommendation about window restrictors.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Roughcote Hall Farm is a residential care home providing personal care for up to nine people who were living with a learning disability and/or autism. Eight people were living there at the time of our inspection.

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

Quality assurance systems had not been fully embedded and some areas for improvement had not been fully identified but the registered manager had been making improvements since they started at the end of March 2021. Medicines were not always managed safely as there were some unexplained stock discrepancies, although we found no one had come to harm as a result of this and action was taken in response to this. There had been a high turnover of management and staff, so there was a reliance on agency staff, but recruitment was ongoing, although a registered manager had now started. There were enough staff to support people. COVID-19 testing for agency staff required more robust recording and the infection control policy required updating, however government guidance around COVID-19 was being followed.

Risks to people were assessed and planned for although one person had not had a professional involved in developing one part of their care plan to support them when they became upset. People felt safe and happy in the service. Staff understood their safeguarding responsibilities.

Lessons were learned when things went wrong. Care plans were in the process of being updated; those which had been updated contained personalised details. An action plan was in place to make improvements to the service. People, relatives and staff felt positive about the management and were aware of the improvements being made. Staff felt supported and able to approach the registered manager if they had concerns. The registered manager was aware of the duty of candour.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of safe and well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were supported to be as independent as possible. People were supported with dignity. Staff knew people’s needs and their preferences.

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 12 March 2019).

Why we inspected

We received concerns in relation to the management and the way people were supported when they were experiencing periods of being upset. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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 have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. The registered manager was responsive and acted on our feedback.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Roughcote Hall 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.

Roughcote Hall Farm provides accommodation in a converted older property for people who require personal care with a learning disability. The service can accommodate up to eight people.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. The values of choice, promotion, independence and inclusion, which the guidance promotes were being provided for people who used the service at Roughcote Hall Farm. This meant the people they supported with learning disabilities and autism were able to live as ordinary a life as any citizen.

On the day of our inspection eight people were using the service.

People’s experience of using this service:

People were supported by enough staff to ensure their needs were met. Staff had time to interact with people in a positive way. People’s medicines were managed safely. Risks associated with people’s care had been identified and were managed in a way that did not restrict their freedom.

We carried out a tour of the home and found it was clean and predominantly well maintained. However, we identified some areas which required attention. The registered manager told us they had already made many improvements and had more planned to ensure the environment met the needs of the people they supported.

People were supported by staff to make their own decisions and choices. Staff were knowledgeable and understood the principles of The Mental Capacity Act. People received a nutritious and balanced diet and their dietary needs and choices were met.

Staff received effective training to fulfil their roles and responsibilities and there were sufficient staff to meet people’s needs.

People spoke positively about the relationships they had with the staff team. People told us staff were kind and caring, maintained their dignity and respected them.

Care plans were person-centred and people were involved in developing their plans.

There was a varied and appropriate activity programme and people had regular access to the community.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

People’s feedback was used to make changes to the service.

The home had a registered manager who conducted a range of audits in areas such as infection control, medicine management, health and safety and documentation. Actions raised as part of the audits were addressed.

More information in Detailed Findings below.

Rating at last inspection:

This was the first inspection since the new provider registered with CQC in September 2017.

Why we inspected:

This was a planned inspection based on the registration date. The service has met the characteristics of good in all key questions.