We carried out a review of the data available to us about Lady Dane Farmhouse 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 Lady Dane Farmhouse, you can give feedback on this service.
Lady Dane Farmhouse is a two-storey building with a passenger lift to rooms on the first floor. There is a separate building in the grounds used as an activity centre and sensory room. The service is designed to meet the needs of people who have a learning disability or autistic spectrum disorder, dementia, old age and physical disability. The service is fully accessible and has been adapted to meet the specific needs of people with physical disabilities.
The service has been developed and designed in line with the principles and values that underpin Right Support, Right Care, Right Culture and other best practice guidance. 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 received planned and co-ordinated person-centred support that is appropriate and inclusive for them. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
The service was registered to support up to 15 people. There were 14 people were using the service at the time of our inspection. The service is larger than recommended by best practice guidance. However, the size of the service having a negative impact on people was mitigated by the bespoke building design.
People's experience of using this service and what we found
People were interacting with one another and staff were engaging with people. One person said, “It is good living here, the staff are quite lovely and so is the manager”.
At the last inspection risks to people health and safety had not been fully mitigated. At this inspection improvements had been made. Risks to people had been identified. Risk assessments contained all information needed to ensure risks were kept to a minimum and detailed the action staff needed to take, if risk did occur.
Medicines were managed safely. The provider had introduced new medicine dispensing technology and procedures. This had addressed previous shortfalls in safe management of medicines.
The management and staff had clear understanding of their roles and responsibilities. The registered manager had a clear vision for the service and had developed an action plan for ways to improve the service.
Staff understood how to recognise signs of abuse and actions needed if abuse was suspected. There were enough staff to provide safe care. Safe recruitment checks were completed to ensure staff were suitable to work with people.
The registered manager and staff knew people well and quickly identified when people's needs changed. People who were unwell or needed extra support, were referred to health care professionals and other external agencies appropriately.
Care plans had been transferred to an electronic system. This technology was understood by staff. The electronic system contained up-to date and relevant information to ensure people were safe and their choices recorded. This enabled staff to safely support people and understand how people wished to be supported.
People received care and support that was personalised to their individual needs. Staff had training to meet these needs and identify areas of concern.
Infection Prevention and Control policies and procedures were being followed. The premises looked clean and tidy and we were assured that the service had controls in place to minimise the risks posed by COVID-19.
Rating at last inspection
The last rating for this service was requires improvement (published 25 November 2019). We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
We undertook a focused inspection to look at the key questions of safe and well-led only, following up on a previous breach in regulation and areas identified for improvement. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. Therefore, we did not inspect them.
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.
Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has improved 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 Lady Dane Farm House 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.
Lady Dane Farmhouse is a two-storey building with a passenger lift to rooms on the first floor. There is a separate building in the grounds used as an activity centre and sensory room. The service is designed to meet the needs of people who have a learning disability or autistic spectrum disorder, dementia, old age and physical disability. The service is fully accessible and has been adapted to meet the specific needs of people with physical disabilities. The service had started to provide respite care to people providing short stays. Nobody was staying for respite care when we inspected
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.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people. Thirteen people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area.
People’s experience of using this service and what we found
Risks to people had been identified but some of the risk assessments did not contain all the information needed to ensure risks were kept to a minimum and the action staff needed to take if the risk did occur.
Medicines were not always managed safely. This had been identified by the provider and more safety checks had been but in place. However, at the time of the inspection there were still some shortfalls in the safe management of medicines.
The service had an open and positive culture that encouraged involvement of people, their families, staff and other professional organisations. Leadership was visible and promoted teamwork. There were systems of daily, weekly and monthly quality assurance checks and audits to check that the service was safe and effective. However, these checks had not identified the shortfalls we found at the inspection. People and staff were positive about the registered manager and the changes they had made since they had started at the service. The management and staff had a clear understanding of their roles and responsibilities.
People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff were compassionate and caring and people felt respected and valued as a result. People had developed relationships with staff, who knew people well and promoted equality and diversity in care. People told us that they felt the staff cared about them. Staff were patient, kind and caring and interactions were warm and friendly.
People were supported to make choices about their care on a daily basis and there was a culture that promoted dignity and independence. People said they were happy living at Lady Dane Farmhouse that staff had a good understanding of their needs and preferences.
Activities were based on people's individual interests, hobbies and wishes. People's individual communication styles and methods were identified and respected.
The registered manager and staff knew people well and quickly identified when people’s needs changed. When people were unwell or needed extra support, they were referred to health care professionals and other external agencies.
People received the support they needed to eat and drink and maintain a healthy and balanced diet. Staff knew people's dietary needs and people enjoyed the food. People told us they could choose alternative meals if they did not like what was on the menu.
Assessments were completed before people joining the service to make sure staff could meet their needs. Care plans were developed from these assessments and staff had clear guidance on how to meet those needs. The staff were in the process of transferring the care plans onto an electronic system.
People received care and support they wanted and needed. People were confident to raise any concerns with the registered manager or staff and felt confident that they would be listened to. People were satisfied and happy with the care and support they received.
The registered manager and staff team were committed to providing a high standard of care to the people they supported. They understood their responsibilities.
Staff understood how to recognise signs of abuse and actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment safety checks were done to ensure staff were suitable to work with people.
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. People received care and support that was personalised to their individual needs.
Rating at last inspection
The last rating for this service was requires improvement (published 24 October 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected:
This was a planned inspection based on the registration date of the service.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lady Dane Farm House on our website at www.cqc.org.uk.
Enforcement
We have identified a breach of the regulations in relation to safe care and treatment at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.