Archived: Bawden Manor Farm

Updated 4 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 July 2016 and was unannounced. The inspection was carried out by one inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed previous inspection reports and other information we held about the home including any notifications. A notification is information about important events which the service is required to send us by law.

Due to people’s health care needs we were not able to verbally communicate with people who lived at the service to find out their experience of the care and support they received. Instead we observed staff interactions with people. We spoke with the registered manager and four care workers. Following the inspection visit we contacted two relatives and an external healthcare professional to hear their views of the service.

Updated 4 August 2016

We inspected Bawden Manor Farm on 12 June 2016, the inspection was unannounced. The service was last inspected in December 2013, we had no concerns at that time. Before the inspection the Care Quality Commission had received concerns about the service regarding staffing levels.

Bawden Manor Farm provides care and accommodation for up to seven people who have autistic spectrum disorders. It is part of the Spectrum group who have several similar services in Cornwall. They are providers of specialist care for people with autistic spectrum disorders and learning disabilities. At the time of the inspection six people were living at the service. There was a registered manager in post. 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.

The service was due to close and this was being planned for September/October 2016. Five people were moving to a new Spectrum property and the sixth to a newly developed flat in another Spectrum service.

The service was short staffed with three full time vacancies and another member of staff due to leave in the next two weeks. Attempts to recruit new staff had not been successful. The registered manager told us the HR department were aware of the situation but they did not know if any new staff members had been identified to start the induction process. Some members of staff were working long hours to cover shifts.

We looked at rotas for the previous month and saw there were many occasions when staffing levels had fallen below the commissioned hours. A contingency plan outlined what staffing levels needed to be in ‘extreme’ circumstances. The rotas showed these were met on all but one occasion. However, these were being used routinely rather than as a last resort. Staff told us people were unable to take part in activities in the community as often as they would like due to staff shortages.

Recruitment practices helped ensure staff working in the home were fit and appropriate to work in the care sector. Staff had received training in how to recognise and report abuse. The registered manager reported any safeguarding concerns to the appropriate local authority when necessary.

People were assessed in line with the Deprivation of Liberty Safeguards (DoLS) as set out in the Mental Capacity Act 2005 (MCA). DoLS provide legal protection for vulnerable people who are, or may become deprived of their liberty. 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 when appropriate. Staff demonstrated a good understanding of the main principles of the Mental Capacity Act (MCA).

Roles and responsibilities were well-defined and understood by the staff team. The registered manager was supported by a deputy manager who had a clear set of responsibilities. There was a key worker system in place. Key workers are members of staff with responsibility for the care planning for a named individual. There were systems in place to help ensure a planned move was carried out in a way which would not cause people unnecessary anxiety. Spectrum had communicated with local residents in the village where people were moving to in order to help alleviate any concerns.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the end of the full version of the report.