Archived: Foxhills Farm

Updated 19 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 2 inspectors.

Service and service type

Foxhills Farm is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Foxhills Farm is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, a new manager had been recruited and had been in post for 4 weeks. They were planning to apply to become the registered manager.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 27 June and ended on 7 July 2023. We visited the service on 27 June and 4 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We carried out observations of people's experiences throughout the inspection. We received feedback from 3 relatives about their experience of the care provided. We looked at 6 staff files in relation to recruitment and staff supervision. We reviewed a range of records. This included 3 people’s care records and 3 people’s medication records. A variety of records relating to the management of the service, including policies and procedures were also reviewed. We spoke with 8 members of staff including the nominated individual, the operations director, the manager and 4 care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 19 September 2023

About the service

Foxhills Farm is a residential care home providing personal care to up to 5 people. The service provides support to people who live with learning disabilities and complex needs. At the start of our inspection there were 4 people using the service in 1 adapted building. During the inspection this reduced to 3 people using the service. The home has 2 floors accessed via stairs, communal areas and a large garden.

People’s experience of using this service and what we found

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.

Based on our review of key questions safe, effective and well-led, the provider was not able to demonstrate how they were meeting all of the underpinning principles of Right support, right care, right culture.

Right Support: People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Right Care: The service was close to a busy road, with no pavements, the nearest bus stop was over half a mile away along this road and there was no access to local shops, the closest place being a garden centre. However, since our last inspection the manager had worked on ensuring people were able to get out more often. People were at risk of harm because staff did not always have the information, they needed to support people safely.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff did not fully ensure people using services lead confident, inclusive, and empowered lives.

At the last inspection assessing risk to the health, safety and wellbeing of people, medicines management and infection prevention and control were not managed safely, at this inspection this remained the same.

Recruitment was not managed safely, and people were at risk of being supported by staff who had not had the appropriate checks.

The service was not maximising people's choices, control, or independence. There was a lack of person-centred care.

The provider did not have enough oversight of the service to ensure that it was being managed safely and that quality was maintained. Quality assurance processes had not identified all of the concerns in the service, and where they had, sufficient improvement had not taken place. Records were not always complete. People and stakeholders were not always given the opportunity to feedback about care or the wider service. This meant people did not always receive high-quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 7 March 2023) and identified 9 breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of 7 regulations.

At our last inspection we recommended the provider sought current guidance on menu planning and updated their practice accordingly. At this inspection we found improvements had been made.

We also recommend the provider sought reputable guidance around the Data Protection Act and updated their practice accordingly. At this inspection improvements had been made.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

We carried out an unannounced focussed inspection of this service on 27 June and 4 July 2023. Seven breaches of legal requirements were found. We issued the provider with 4 warning notices in relation to Safe Care and Treatment, Need for Consent, Safeguarding Service Users from Abuse and Good Governance.

We undertook this focused inspection to check they had met the requirements of the warning notices and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Foxhills Farm on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to assessing risk, medicines management, safeguarding people, consent to care, staff recruitment, training, person centred care and governance and oversight at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’. This is the second consecutive inspection with an 'Inadequate rating' and the service remains in ‘special measures.’ This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Following our inspection the provider notified us that they were closing and de-registering the service. The service was de-registered on 31 August 2023.