Old Dairy

Updated 26 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

Our inspection was completed by one inspector.

Service and service type:

About the service: Old Dairy is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was the manager for the Old Dairy and other services operated by the provider.

Notice of inspection:

The inspection was announced. We informed the provider 24 hours before our visit to enable them to ensure people living at the home were comfortable with our visit. Additionally people are often out in the community and there may be no one in the home for us to engage with.

What we did:

Before the site visit:

We reviewed information we had received about the service since the last inspection. This included previous inspection reports and details about incidents the provider must notify us about, such as abuse, serious injuries and deaths. We used information the provider sent us in their Provider Information Return. Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the site visit:

We spoke with four people about the Old Dairy. We spoke with one person’s relative who was visiting the home and a day centre employee from another of the provider’s services. We observed staff interacting with people throughout the day, including preparing meals and other friendly discussions. We reviewed a range of records. This included three people's care records, one staff recruitment file and staff training and supervision records. We also reviewed records relating to the management and monitoring of the service. We spoke with the registered manager, senior support worker and three support workers.

Following the site visit:

We sought feedback from a GP who regularly visited the service and has worked with the service to increase the effectiveness of people’s care pathways. We spoke with two people’s relatives about the Old Dairy.

Updated 26 March 2019

About the service: Old Dairy is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. It provides personal care to adults living with a diagnosis of autism or Asperger's.

The Old Dairy consists of a care home for five people and a self-contained flat (The Flat) for one person. The service supports people with a diagnosis of autism or Asperger’s. The service size reflected the principles and values of Registering the Right support, although the service was commissioned before this 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.

There were no deliberate signs to indicate the Old Dairy was a care home. Support staff wore their own clothes when working with people including accessing the community. Six gentlemen were living at Old Dairy at the time of our inspection.

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways:

• Staff understood how to communicate with people effectively to ascertain and respect their wishes.

• People’s independence was respected and promoted. Staff prompted people during household tasks and activities, to enable them to do things for themselves and learn new skills.

• People's support focused on them having opportunities to be part of their community, meet others and maintain existing relationships.

• Health and social care professionals guided staff to support people with their behaviour in accordance with national best practice guidelines.

• Risks to people had been assessed and plans were in place and followed by staff to keep people safe.

• Safe recruitment practices were followed to protect people from unsuitable staff. There was minimal staff turnover which promoted a high continuity of care and support.

• Staff were knowledgeable around safeguarding and understood provider policies and procedures in this regard. There were good links with local safeguarding bodies.

• Systems were in place to ensure people received appropriate support to take their medicines safely.

• Staff received supervision, felt supported in their role and received the training they needed to support people’s needs.

• All staff had a good understanding of the principles and application of the Mental Capacity Act. No one was living under the Deprivation of Liberty Safeguards.

• Staff attitudes and behaviours were responsive, respectful and caring.

• People were supported through appropriate communication methods by staff that knew how to involve people in their own care.

• People were supported to take positive risks and their goals and wishes were acknowledged and worked towards.

• Interactions between staff and people demonstrated personalised, collaborative, action-oriented care and support.

• There were processes in place to manage adverse incidents and complaints. There was evidence that learning from incidents was shared across the service.

• Effective quality monitoring systems were in place and regular audits and checks supported the registered manager and senior staff to identify concerns promptly to take action to improve the service.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

We received positive feedback about the service and the care people received. The service met the characteristics of ‘Good’ in all areas. For more details, please see the full report which is at the CQC website at www.cqc.org.uk

Rating at last inspection: We last inspected Old Dairy on 31 January 2018. This was a focused inspection, which followed up on our last comprehensive inspection in August 2016. At the last inspection the service was rated Good (this report was published on 30 March 2018). At this inspection the service remained ‘Good’.

Why we inspected: We inspected this service as part of our ongoing Adult Social Care inspection programme. This was a planned inspection based on the previous ‘Good’ rating. Previous CQC ratings and the time since the last inspection were also taken into consideration.

Follow up:

• We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.