This comprehensive inspection took place on 18 and 25 July 2017 and was unannounced on the first day.

The home provides accommodation and personal care for up to 12 adults who have a diagnosis of learning disability and/or autism. At the time of our inspection 12 people were living at Easterbrook Farm, all of whom had lived there for a number of years.

The home is situated in a rural setting close to the village of Exbourne. Accommodation is centred around a courtyard, with bedrooms located in three separate buildings called the Farmhouse, the Granary and the Shippen. The Shippen provides accommodation for one person, four people live in the Farmhouse and seven people live in the Granary. Each building has its own lounge, kitchen and dining area, but meals are served in the farmhouse. The main office is located in the granary.

The home had a manager who had registered with the Care Quality Commission (CQC) in January 2017. A registered manager is a person who has registered with the CQC 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 previously inspected in May 2015 when the service was rated as good overall. However the safety of the service was rated as requiring improvement. This was because some aspects of medicine administration were not carried out safely and staff had not always been recruited safely. . At this inspection we found that improvements had been made and medicines were now administered safely. Systems had been put in place to ensure staff were recruited safely.

People and their relatives were very positive about the home and said they were safe and very well cared for at Easterbrook Farm. People were happy and laughing with staff, who knew them well. Comments included “…they are brilliant.” and “The most important metric is [person’s] view of how he feels at Easterbrook. Without exception, every time we ask him how he feels and whether he is happy at Easterbrook his reply is very positive.”

The manager had been appointed in the last year and had registered with the CQC in 2017. They spent time working alongside staff. People and staff were very complimentary about the registered manager and how they were improving the service. Resident meetings, staff meetings and surveys were undertaken and provided people and staff with a means to make suggestions. Each person had a personalised complaints procedure using communication methods which were adapted to their needs. Complaints were managed in line with the provider’s complaints policy. There had been no complaints in the last year.

There were sufficient staff to support people safely, although a new member of staff had been scheduled to undertake a night duty when they had not completed their induction. The registered manager assessed the risks associated with this and revised the rota so that this did not occur.

Staff worked with people in a calm and unrushed manner and knew people well. People were supported to do a range of activities both inside and outside the home, which included working on the farm. People were supported to be as independent as possible and undertake meaningful activities which they clearly enjoyed. Staff understood people’s individual communication skills, abilities and preferences and ensured they took these into account when providing care.

People’s health was monitored and, where necessary, staff ensured that health professionals were contacted for advice and support. People were supported to attend appointments with the GP, their dentist and other health professionals.

People were provided with a healthy balanced diet with food of their choice. People were involved in growing vegetables and salads which were incorporated into meals. A relative commented “The food at Easte

At our previous inspection on 2 November 2013 we found that people were not always protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the recording of medicines. During our most recent visit we found that improvements had been made.

People did not comment or raise concerns about how the home managed medicines. Ten of the eleven people living at Easterbrook Farm were away for Christmas staying with relatives.

We met most of the people who used services and talked with the staff on duty and checked the provider's records.

Before people living in the home received any care or treatment they were asked for their consent and staff acted in accordance with their wishes. We saw and heard staff speak to people in a way that demonstrated a good understanding by staff of people’s choices and preferences.

We saw that people's care records described their needs and how those needs were met. We saw that people's rights were promoted and they were protected through legal safeguards, such as 'best interests' meetings to determine if they were able to make particular decisions.

We saw that medication was administered by suitably qualified staff. People were not always protected against the risks associated with medicines because the provider had not made appropriate arrangements for the recordings of medication.

During our visit to the home we saw sufficient staff on duty to meet the needs of people living in the home. We spoke with most of the staff working during our visit and all agreed that they were supported by the registered manager.

We saw that Easterbrook Farm held all records securely to protect people’s confidentiality.

We spoke to two people at length and met many others. People told us, “Don’t want to do anything different, I love working with farm animals. I love living here, I’m happy” and “I like the staff here, I have a bit of fun, I like it”. They told us about the wide choice of activities available to them, which included hobbies, arts and crafts, working outside of the farm, farm work and education.

Care professionals told us that they had no concerns about the home, their clients were "very happy" and the registered manager and staff had people's best interests at heart. People's rights were promoted and they were protected through legal safeguards, such as 'best interests' meetings. People's health care needs were fully met.

People told us that they felt safe at the home and would take concerns to the staff or manager. One said, “I get on with (the manager). She likes me very much”. There were good arrangements to safeguard people from abuse.

Staff were liked, skilled and knowledgeable. One person said “It’s nice that staff come and have dinner with us”.

The accommodation was in a good state of repair, warm, clean, well maintained and appeared comfortable. People liked their rooms. One was excited that they had chosen a new colour for the walls. Other buildings provided activities, such as a gym and woodworking.

Records were complete, fit for purpose and secure.

As part of this inspection we conducted an unannounced visit to Easterbrook Farm on 4 January 2012, spending four hours there in total. Most of the 11 people who used the service were away from the home. However, we met three people who used the service and had meaningful conversations with two of them. We also talked to four support workers, the registered manager and office administrator.

One person had a 'lie in' the day we visited. She said that she "loves the animals" and "loves it" at Easterbrook Farm. The second person said "We all choose the food we have". Both were extremely relaxed with the support workers; laughing, chatting and joking with them. There was clearly caring and affection on both sides and people were treated with respect.

We saw that people had warm, fresh, well furnished and very personalised bedrooms which they lock if they choose. The menu was varied.

There were many activities regularly available to people, including: work placements, farm work, horse riding, using a woodland observation hide, entertainments and shows, shopping, computer use and visits to the local pub.

The registered manager had a good understanding of how to promote people's independence and protection and worked hard to do so. Health and welfare needs were met, with health and safety well managed in the home and farm environment.

People's rights to make decisions on their own welfare were not always maximised and some confidential information may be being shared without their consent.

The inspection took place on 27 May and 2 June 2015 and was unannounced. The service had been previously inspected in December 2013 and found compliant.

Easterbrook Farm provides accommodation with personal care for up to 12 people over the age of 18 who have a diagnosis of a learning disability and/or autistic spectrum disorder. The home is located on a farm with several accommodation buildings including the original farmhouse where four people live, a unit called the Granary where seven people live and a third unit called the Shippen where one person lives. The main office is located in the Granary building. All the people living at Easterbrook Farm had done so for over a year and some had lived there for four or more years.

The previous registered manager had left in July 2014. At the time of the inspection in June 2015, the Care Quality Commission (CQC) was in the process of de-registering the registered manager. This was because the registered manager had not de-registered themselves voluntarily despite requests by both the provider and the CQC.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers and nominated individuals, 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 nominated individual said they were in the process of making arrangements for a new registered manager. In the interim, they had taken an active role in the day to day management and were supported in this by a deputy manager who had taken on additional responsibilities.

The service provided to people living at Easterbrook Farm was delivered by sufficient knowledgeable staff, who had been trained to support people with learning disabilities. Many of the staff had supported the people living there for many years and showed an in-depth knowledge of people’s needs and aspirations. Staff were supported to undertake training to support them in their role, including nationally recognised qualifications. Staff received regular supervision and appraisal.

Staff recruitment processes were not always safe as references were not always fully checked.

People said they liked living at Easterbrook Farm and found the staff kind. They were offered a wide choice of activities both on the farm and in the community and chose what they wanted to do each day. These activities included helping with horticulture and animals, swimming, attending drama workshops and music sessions, going to the pub and going away for weekends to music festivals. People had dedicated staff time where two people would be supported by a member of staff to do an activity of their choice. Staff communicated with people using a range of methods including the use of simple sign language and pictures to aid understanding.

People’s needs and risks were assessed and care plans were developed to support them to be as independent as possible. Daily notes reflected the care described in the care plan. Where concerns about a person were identified, staff discussed how they could best address them. Changes were then written up in care plans and in the staff communications book, which staff signed to say they had read. Staff were aware of the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguard requirements and took them into account when working with people.

Most medicines were stored, administered and recorded safely, although medicines which required to be kept refrigerated were stored in a locked food refrigerator, rather than in a dedicated medicines refrigerator. Staff said they would contact the pharmacy to arrange alternative chilled storage facilities specifically for medicines.

Although there were audits undertaken to ensure the safety and quality of the home, some audits did not identify some issues. These included checks which had been undertaken of new staff files and checks on the administration of medicines. However senior staff said they would review these checks and ensure that these areas were addressed.

People were supported to have their health needs met by health and social care professionals including their GP and dentist. People were supported to have a healthy balanced diet which they were involved in growing, shopping for and preparing.