Tithe Barn

Updated 18 November 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

The inspection team consisted of 1 inspector and an Expert by Experience on the first day and 1 inspector on the second day.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Tithe Barn is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Tithe Barn 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 a registered manager in post.

Notice of inspection

This inspection was unannounced on day one and announced on day two.

Inspection activity started on 30 August 2023 and ended on 4 September 2023. We visited the location’s service on 30 August and 4 September 2023.

What we did before the 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 (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 spoke with 2 people who used the service and observed how other people were being supported. We spoke with 7 members of staff including senior operational staff, the registered manager and care staff. We also spoke with 3 relatives. We reviewed a range of records. This included 5 people’s care records and multiple medication records. We looked at 3 agency staff profiles and 3 staff files in relation to safe recruitment. We reviewed a variety of records relating to the management of the service, including policies, procedures and safeguarding incident records.

Updated 18 November 2023

About the service

Tithe Barn is a residential care home providing personal care to up to 13 people. The service provides support to people with learning disabilities or autistic spectrum disorder.

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.

Right Support:

Risk management needed improvement. There was improvement needed in the oversight of lessons learnt and the actions taken to reduce the risk to people.

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. The provider’s governance systems were not always effective in identifying the actions needed to reduce the risk to people.

Right Care:

Care was person-centred and promoted people’s dignity, privacy and human rights. Safeguarding procedures were followed and appropriate action had been taken to protect people from abuse and poor care. Care was delivered in line with standards, guidance and the law.

Right Culture:

The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives.

The systems for reporting were open and transparent.

Rating at last inspection

The last rating for this service was good (published 5 August 2021)

Why we inspected

The inspection was prompted in part due to concerns received about a safeguarding incident. A decision was made for us to inspect and examine those risks.

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.

You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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

Enforcement and Recommendations

We have identified breaches in relation to management of risks and management and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.