The Care Quality Commission (CQC) has rated The Farmhouse inadequate, and placed it into special measures to protect people, following an inspection in September.
The Farmhouse, run by R G Care Ltd, is a care home for up to seven autistic people and people with a learning disability.
At CQC’s last inspection of the home, CQC issued warning notices to focus the provider’s attention on making urgent improvements to people’s risk assessments and staff training. This inspection was carried out to follow up on the progress of these improvements and see what learning had been identified and implemented to keep people safe after a specific incident in which a person was seriously injured.
CQC are currently deciding whether further regulatory action around this specific incident needs to be taken and will report on this when legally able to do so.
As well as dropping from requires improvement to inadequate overall, the home’s ratings have also dropped from requires improvement to inadequate for how safe, effective, and well-led it is. It has dropped from good to requires improvement for how caring and responsive it is.
CQC has placed the service into special measures to focus the provider’s attention on making rapid and widespread improvements. CQC are also taking further regulatory action to protect people and will report on this when legally able to do so.
Rebecca Bauers, CQC’s director for people with a learning disability and autistic people, said:
“When we inspected The Farmhouse we were deeply concerned to find leaders hadn’t acted on the warnings we issued at our last inspection and still weren’t supporting staff to make sure people received safe, person-centred care.
“Inspectors found people’s care plans lacked detail on their individual needs, risks and preferences, and some contained conflicting information for staff.
“Leaders also relied heavily on agency staff due to a severe shortage of permanent staff but didn’t give agency staff the support or training needed to understand and meet people’s needs safely.
“When things went wrong, inspectors found no evidence that the provider was learning from these incidents to protect people in future. In one incident inspectors found the service had failed to recognise abuse against a resident who suffered a head injury, and also failed to alert the CQC of the incident as legally required.
“We’ve told the provider exactly where improvements are needed and will closely monitor the home to make sure people are being cared for safely during this time. We’re also taking further regulatory action which we’ll report on when we’re legally able to do so.”
Inspectors also found:
- Inspectors saw care plans that were unclear about people’s capacity to make decisions in their own care, which risks people’s human rights being ignored. There wasn’t evidence that people were always involved in their care decisions and there was no record of the decisions taken by the Farmhouse on people’s behalf
- Staff didn’t meet people’s communication needs. Inspectors saw some people attempting to communicate with staff who didn’t recognise or respond to this, and some people’s care plans lacked detail on their ways of communicating
- Staff didn’t always engage with people they were caring for, particularly people with no or limited verbal communication. For example, some staff didn’t talk to or smile at people while serving their meals
- People weren’t always offered meaningful and fulfilling ways to spend their time. People’s care plans didn’t include their goals or future plans, and inspectors saw people sitting down for most of the day while staff were on their phones. Due to the low number of permanent staff, staff didn’t always know people well enough to support them outside the home
- Leaders hadn’t always identified or fixed environmental risks to people’s safety, such as a window restrictor which wasn’t fully secured to prevent people falling out
- Staff didn’t always manage people’s medicines safely.
However:
- The home worked well with other healthcare professionals such as speech and language therapists, learning disability teams, and psychologists to support people.