Church Farm Bungalow

Church Farm Bungalow is a care home without nursing registered to accommodate up to 12 people with a learning disability and/or autistic people, people living with dementia, physical disability, and sensory impairment. There were 11 people living at the home at the time of our inspection.

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

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support

People’s care was provided in a safe, clean, and well-maintained environment. Staff managed risks well to keep people safe. People’s medicines were managed safely and staff supported people to access healthcare services when they needed them. 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

People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. There were always enough staff on duty to meet people’s needs and keep them safe. People were supported by a consistent staff team who knew their needs well. Staff understood their responsibilities in protecting people from abuse and knew how to report any concerns they had. The provider’s recruitment procedures helped ensure only suitable staff were employed.

Right culture

The registered manager promoted a culture in which staff valued people’s individuality and protected their rights. The views of people who lived at the home and their relatives and staff were sought and listened to. Staff were well supported in their roles and had opportunities to contribute to the development of the service. Monitoring systems were effective in keeping people safe and ensuring they received good quality care. The registered manager and staff worked well with other professionals to ensure people received the care and treatment they needed.

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 28 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

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

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 11 September 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People were safe and were protected from avoidable harm. Staff were aware of the risks people faced and followed agreed guidelines to reduce these risks. Health and safety and fire safety were carried out regularly checks to ensure the home was safe and well maintained. Accidents and incidents were recorded and reviewed to any necessary remedial actions had been taken. People received their medicines safely and as prescribed.

Staff were always available when people needed them. People were protected from abuse because staff understood their roles in protecting people and knew how to raise concerns if they witnessed abuse or poor practice. People were protected by the provider’s recruitment procedures. The provider carried out appropriate checks on staff before they were employed.

Staff had the training and support they needed to carry out their roles. All staff attended an induction when they started work and had access to ongoing training. The provider encouraged and supported staff to attend achieve further qualifications relevant to their roles.

People’s rights under the Mental Capacity Act 2005 were respected. Staff understood the importance of gaining people’s consent to their care and how people communicated their decisions. People who lacked capacity received appropriate support when decisions that affected them were made. The provider ensured that all relevant people were consulted to ensure decisions were made in people’s best interests. Applications for DoLS authorisations had been submitted where restrictions were imposed upon people to keep them safe,

People were able to make choices about the food they ate and were supported to maintain a healthy diet. Staff ensured that individual support guidelines around diet and nutrition were followed. People were supported to maintain good health and to obtain treatment when they needed it. Staff had developed good working relationships with health and social care professionals and involved these professionals in people’s care where necessary. Each person had a health action plan which detailed their health needs and the support they needed.

Staff were kind, caring and compassionate. People had positive relationships with the staff who supported them. Relatives told us that staff knew their family members well and provided care and support that enhanced their family members’ lives. Staff treated people with respect and maintained their dignity. They respected people’s individual rights and promoted their independence. People were supported to make choices about their care and to maintain relationships with their friends and families. People who wished to remain at the home towards the end of their lives were supported to do so. Staff had worked closely with healthcare professionals to ensure people received high quality care when they had life-limiting conditions.

People received care that was personalised to their individual needs. Support plans reflected people’s needs, preferences and ambitions. People’s needs were kept under review and their support plans updated if their needs changed. Staff understood people’s individual communication needs, which was important in ensuring people received the care and support they needed. People had opportunities to take part in activities they enjoyed and were supported to access their local community.

The provider adopted a proactive approach to seeking people’s views and listening to relatives and other stakeholders. People were encouraged to speak up if they were dissatisfied and the provider responded positively to feedback. There were appropriate procedures for managing complaints.

People and staff benefited from strong leadership provided by the registered manager. Relatives told us the service was well run and that communication from the home was good. Staff said the registered manager had had a positive effect on the home since taking up their post. They told us they received good support from the registered manager and their colleagues. There was a strong team ethos and individual staff spoke positively about the work they did.

The provider’s quality monitoring systems were effective in ensuring people received good quality care and support. Key aspects of the service were audited regularly and quality monitoring reports shared with the provider’s senior leadership team. The standard of record-keeping was good. Staff had established effective links with health and social care professionals to ensure people received the care they needed.

Further information is in the detailed findings below.

We saw that staff treated people with respect and dignity. We observed staff giving people choices. For example, we saw staff painting one person's nails. They showed them nail varnish in three different colours and asked 'which colour would you like?'

We noted that throughout the day people were smiling and looked happy and relaxed. We saw that staff treated people kindly and attended to people's needs promptly. For example, one staff member noticed a person's foot had dropped off the footplate of their wheelchair, and placed it back to avoid them getting injured.

We saw that the home was clean and tidy and people's bedrooms were well kept. Toilets and bathrooms were clean and with no unpleasant odours.

We saw that most staff training was up to date and supervisions and appraisals were almost completed. We saw minutes of staff meetings that took place regularly.

We saw that the provider had a complaints policy and that there was a complaints log to record any complaints received. However, we were told that there had not been any complaints.

One relative told us that they felt the home was not as homely looking as they would like. They told us that the staff always 'Made a fuss' of the people who lived there.

Another relative told us that they wanted to be more involved in the persons care plan. Both the relatives told us that they were not consulted in the plan of care for the people who lived there.

We also spoke to two health care professionals who had visited the service. They all told us that they felt that staff were caring. One person told us that the staff were 'Absolutely brilliant.'

During our inspection we saw that people were being treated with respect and there was a happy and relaxed atmosphere.

We found that that care plans were not up to date and there were very few risk assessments for each person who used the service. Staff told us that care plans and risk assessments were not up to date because they had not had the time to do them.

During our inspection we saw several examples of staff acting in a caring and supportive manner.

We saw that each person's room was decorated individually and were told that people could personalise their rooms in the way that they wanted to.