This unannounced, comprehensive inspection took place on 28 and 29 November and 11 December 2018. We carried out the inspection as we had received concerns about some of the care at the home. This was in relation to:

• one person being restricted in terms of their movement around the home,

• restrictions about the times when one person was allowed to eat;

• restrictions about the frequency and times of when one person was allowed to smoke;

• one person not having a choice about whether they wished to shave or not and how they spent their money

• insufficient staff to meet people’s needs and keep them safe and

• a culture at the home which did not support staff being listened to when they raised issues and concerns.

Similar concerns had also been raised by the same complainant about two other homes owned by the same provider. The concerns about the other homes were not addressed during this inspection, but have been considered separately in line with our inspection methodology.

Prior to the inspection, we had raised a safeguarding alert with the local authority about the concerns we had received. The local authority undertook their own investigations into each of the allegations during the same time period as the inspection. Since the inspection, we have received outcome information from the local authority, who have closed all the safeguarding concerns. The outcomes described how either the service had worked with them and where necessary, taken action to address the concerns.

We did not find evidence of unnecessary restrictions being placed upon people, although some formal processes had not always been followed in line with the Mental Capacity Act (2005) and documentation did not fully describe these restrictions. This meant there was a risk that people were being restricted without the legal requirements and authorisations being in place.

We did not find evidence that there were insufficient staff to meet people’s needs and deliver good quality, safe care.

We found no evidence to support the claim that staff were not listened to when they raised issues and concerns.

At the last inspection in February 2018, we rated the service as requiring improvement overall as we found a breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because people were not kept completely safe as the service did not have fully robust recruitment procedures. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions “Is the service safe?” and “Is the service well-led?” to at least good. At this inspection, we found there were systems in place to ensure appropriate checks were carried out before a new member of staff started working at the service. We also found that audit processes to monitor these systems were in place. This meant the requirements of Regulation 19 had been met.

Burridge Farm is a residential care home for people who live with a diagnosis of learning disability and/or autism. Some people living at Burridge Farm also have physical disabilities. The service is registered to provide accommodation with personal care (without nursing) for up to six people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the service, there is a main building with six bedrooms and communal areas. Across a courtyard from the main building is an annexe which provides living and sleeping accommodation for one person. On the same site, but slightly further away is another registered care home, Kite House, owned by the same provider. Kite House is managed by the same registered manager and most staff work in both care homes. Another building located beside Burridge Farm provides office space for

This unannounced comprehensive inspection took place on 6 and 8 February 2018. Burridge Farm is a residential care home without nursing for up to six people who live with a diagnosis of learning disability and/or autism. Some people living at Burridge Farm also have physical disabilities. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of the inspection there were six people living at the service, all of whom had lived at the service for a number of years. The home was made up of a main building with a separate annexe where one person received support. On the same site, but slightly further away was another registered care home, Kite House, owned by the same provider. This was managed by the same registered manager and most staff worked in both care homes.

At the last inspection in November 2015 the service was rated overall Good. The Safe domain was rated as requiring improvement as some aspects of recruitment were not fully safe. At this inspection we rated the service as requiring improvement. Although we found there had been some improvements in recruitment processes, the processes were still not fully robust.

The home had been developed and designed 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.

People were relaxed and happy with staff, communicating with them about the activities they wanted to do. Staff were knowledgeable about each person and their needs. This included how people communicated, using both verbal and non-verbal methods. Staff were able to describe how each person should be supported to keep them safe and enjoy life at Burridge Farm. A professional commented “I observed [staff member] supporting this [person]. [Staff member] provided person with time and sufficient space to work at their own pace.”

Care records contained risk assessments and care plans which described people’s risks, needs and preferences as well as how these should be met. Each person’s care plan provided information about their family background and history as well as the care and support they required. People had been involved in developing the care plans. Staff were able to describe how they worked with people to deliver the care in the care plans. A professional said staff “engage and work with the risk plan.”

People were supported to have choice and control of their lives; staff worked with them in the least restrictive way possible; policies and systems in the service support this practice.

People were encouraged to take part in a range of activities both in the home and in the community. Staff worked with people so they could choose what they wanted to do and who they wanted to do it with. People were treated with dignity and people’s right to privacy was respected by staff. Staff supported people with diverse needs, for example, helping people fulfil their religious preferences. Staff understood their responsibilities in terms of safeguarding vulnerable adults and how to report issues if they were identified.

People experienced effective care that promoted their health and wellbeing. People were encouraged to eat a healthy diet of their choice. Staff prepared meals to meet people’s preferences and dietary needs. People were offered drinks throughout the day to ensure they remained well hydrated. People’s health needs were monitored and health professionals were involved where necessary. Medicines were stored and administered in a safe way. Staff recorded accurately when medicines were given.

People, their families, staff, health and social care professionals were asked

This unannounced inspection took place on 5 November 2015 and was completed by one inspector. Burridge Farm is registered to provide care and support for up to six people with learning disabilities and/or autism. This service has not previously been inspected by the Care Quality Commission. At the time of the inspection, there was six people living at the service.

A registered manager oversees this service and another belonging to the same provider. 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.

Recruitment was not robust and had not included all the checks needed to ensure new staff were suitable to work with vulnerable people. The registered manager rectified this within a week. He ensured all staff recruitment files had checks and references in place to show staff were suitable and that their previous work history had been fully explored.

Care and support was well planned and followed good guidance and best practice. People’s healthcare needs were closely monitored. Where people’s needs had changed, advice and support was sought from specialist healthcare professionals in a timely way.

Staff understood the needs and preferences of people they supported and spoke passionately about their role and the people living at Burridge Farm. There were good relationships between staff and people who lived at the service. Care and support was being provided in a sensitive and caring way. There was sufficient staff available throughout the day and night to meet people’s needs. People were supported to eat and drink in a relaxed and unhurried way.

The ethos of the service was centred on enabling people to live fulfilling lives. Staff worked in a way which showed this ethos was being promoted. People were given opportunities to do activities of their choice. People were also helped to gain skills and interact with the local community.

Staff undertook training and received support to do their job safely and effectively. Risks had been fully considered and actions put in place to minimise any assessed risks. Medicines were being safely managed and administered. Complaints were acted on swiftly and relatives said they were able to voice their opinions and views.

The registered manager and senior team promoted an open culture and strong leadership. Staff felt valued and listened to. Systems were in place to ensure the quality of the service was reviewed including the views of people and their families. The premises and equipment were managed to keep people safe.