A comprehensive inspection of Farfield Drive, took place on 15 and 19 October 2018. This inspection was unannounced.Farfield Drive 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 care service was developed and designed many years ago. The provider was working towards ensuring the service is in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
Farfield Drive is a short break residential care service which aims to provide a holiday style atmosphere for up to five people who have a learning disability. Accommodation is in a purpose-built house with five bedrooms, each with en-suite facilities. Communal lounges, kitchen and dining areas are provided.
During our inspection there were three people staying at the respite service. The PIR received from the provider PIR said 56 people accessed the respite services within a 12-month period. At our last inspection the service was rated as good. At this inspection we found the level of compliance had not been sustained and we have rated the service as requires improvement. This is the first time the service has been rated requires improvement.
There was a registered manager in post at the time of our inspection, but they were moving to a new post within the company. A new manager was in the process of registering with Care Quality Commission (CQC). It was the new manager who we spoke with during this inspection. A registered manager is a person who has registered with the CQC 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.
Some people using the service did not have capacity to consent to their care. We found people's care records did not include information to reflect that assessments had taken place where people lacked capacity, and there was not always evidence that best interest's decisions had taken place, where relevant. We also found DoLS applications had not been applied for when people lacked capacity to make certain decisions.
The provider had robust systems and procedures in place to keep people safe and staff were competent in their knowledge of what constituted abuse and how to safeguard people. There was a whistleblowing policy in place and staff knew how to raise concerns should this be required.
Medicines were managed safely with checks carried out to prevent possible medicine errors. ‘As required’ medicines were administered when needed.
Risk assessments had been completed and reviewed regularly. Accidents and incidents were managed effectively and actions taken to mitigate future risks.
Staffing levels were sufficient to meet people’s needs and robust recruitment processes were in place to ensure people were of suitable character. Staff carried out training to ensure they had adequate skills and knowledge to meet people’s needs. Staff were supported with regular supervisions and appraisals.
Health and safety checks were completed regularly and staff followed the providers procedures for infection control.
Staff were caring, kind and respected peoples wishes. We saw people were encouraged to remain as independent as possible using alternative communications to allow people to make choices about their care.
Pre-admission forms were completed to ensure people’s needs could be met before their stay. Care plans were person centred and reviewed regularly with people and their relatives. Care plans included people’s preferences, likes and dislikes.
People’s privacy and dignity was respected. Staff knocked on people’s doors before entering and did not wear identity badges when in public to respect peoples wishes.
Activities took place with people accessing the service to prevent social isolation.
People’s nutritional needs were met and health professionals were involved in people’s care when required. Hospital passports were in place which meant people’s needs could be met when accessing care in another environment to ensure consistency.
The manager and team leader were honest and open. Staff told us they felt supported and felt confident to raise any concerns. Complaints were managed and actions taken to prevent future occurrences.
Regular meetings took place with people, staff and ‘city wide’ staff within the provider’s company to obtain feedback and inform people of changes within the organisation.
The provider carried out audits to ensure quality assurance checks had been completed. This meant the provider had oversight of what was happening at the respite service. A customer involvement officer attended the service regularly to gather people’s views and ensure actions were taken to improve the quality of care being provided.
The provider made improvements to enhance the quality of care being provided. They also had positive links within the community to ensure people did not feel isolated.
We found the service in breach of one regulation. You can see what action we directed the provider to take at the back of this report.