This inspection took place on 19 November 2015, and was unannounced. The previous inspection on 29 January 2014 was a follow up inspection to check on breaches found during an inspection on 10 September 2013. The inspection found no breaches in the legal requirements.
Farm House provides accommodation and personal care for up to five people with a learning disability. At the time of the inspection there were five people living at the service and no vacancies. The service is provided in a detached old farm house and is not suitable for people with poor mobility. It is set in a rural area on the outskirts of Woodchurch village on Highlands Farm, which is a tourist attraction and where the provider has other registered services located. Each person has a single room and there is a communal bathroom, separate shower room, toilet, kitchen/diner, laundry, snug and lounge. There is an enclosed garden and paved seating area.
The service is run by a registered manager. 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.
People received their medicines safely and when they should. However we found one shortfall relating to medicine storage.
People were involved in the planning of their care and support. Care plans contained information about people’s wishes and preferences. They detailed people’s skills in relation to tasks and what support they required from staff, in order that their independence was developed. People had regular reviews of their care and support where they were able to discuss any concerns or aspirations. Risks were assessed and staff took steps to keep people safe whilst enabling their independence.
People told us their consent was gained through discussions with staff about their support. People were supported to make their own decisions and choices and these were respected by staff. Staff had received training in the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood this process.
People were protected by safe recruitment procedures. New staff underwent an induction programme, which included shadowing experienced staff, until staff were competent to work on their own. Staff received training relevant to their role. Staff had opportunities for one to one meetings, staff meetings and appraisals, to enable them to carry out their duties effectively. Some staff had gained qualifications in health and social care. People had their needs met by sufficient numbers of staff. Staff rotas were based on people’s needs, health appointments and activities.
People were relaxed in staff’s company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. Staff were kind and patient in their approach. Some staff had worked at the service for some considerable time and had built relationships with people and were familiar with their life stories and preferences.
People had a varied diet and were in control of budgeting, planning, shopping, preparation and cooking their meals. Staff encouraged people to eat a varied and healthy diet. People had a varied programme of work based and leisure activities that they had chosen; they regularly accessed the community and staff worked with people to develop their independence in a number of areas.
People were supported to maintain good health and attend appointments and check-ups. Appropriate referrals were made to health professionals if and when required. People did not have any concerns, but felt comfortable in raising issues. Their feedback was gained both informally and formally. The registered manager worked alongside staff and took action to address any concerns or issues straightaway to help ensure the service ran smoothly.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.