Background to this inspection
Updated
30 December 2021
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 Care Act 2014.
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
The inspection was carried out by one inspector.
Service and service type
Rose Farm House 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.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke two people who used the service about their experience of the care provided. We spoke with six members of staff including the operations director, registered manager, deputy manager, team leader and support workers.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with two relatives and a healthcare professional who visits the service regularly. We looked at training data and quality assurance records.
Updated
30 December 2021
About the service
Rose Farm House is a residential care home providing personal care to five people with learning disabilities and autism at the time of the inspection. It is a specialist service for people that have anxious or emotional behaviour that has limited their quality of life and experiences. The service can support five people. The accommodation is spread over one main building which contains two bedrooms and one flat and two annex's each of which contained a one person flat.
People’s experience of using this service and what we found
People had been exceptionally well supported to reach goals that had been previously deemed unattainable. People could display high levels of behaviour of distress, which had previously impacted on every part of their life, however no longer did. People had been supported to reduce the frequency and severity of their behaviour of distress through staff adapting their approach and learning lessons on how to support people more effectively. As a result, the volume and frequency of physical intervention that needed to be used had decreased for everyone living at the service. Staff told us this was important to keep people as safe and distress free as possible.
People had been supported to review and reduce medicines they were taking. Some people had taken medicines for long periods of time, to support them to reduce behaviours of distress. Staff had worked with healthcare professionals to reduce and remove these medicines with no adverse effect on the person, and no increase in distress. People were supported by a core staff team who knew them well and had developed their approach to support people in the most positive way. People were at the centre of everything within Rose Farm House, including the recruitment of new staff.
Staff and the registered manager demonstrated a positive culture within the service which supported people to achieve their goals. For example, one person was supported to be baptised. Staff worked with external agencies to provide the best outcomes for people. Health escalation plans were put in place to anticipate people’s needs and make getting support fast and effective. People were listened to, and their aspirations championed by staff. Relatives told us they were kept informed about every part of their relatives’ care.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence. People had been supported to gain new skills and take more control of their life for example with finances.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights. Staff demonstrated a person-centred approach and supported people to uphold their human rights, for example contesting their DoLS.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. There was a clear culture of striving for excellence and supporting people to lead the best life.
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 3 September 2018).
Why we inspected
The inspection was prompted in part due to concerns received about restrictions on people and concerns of a closed culture. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.