A comprehensive inspection of Farfield Drive, took place on 15 and 19 October 2018. This inspection was unannounced.

Farfield Drive 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 care service was developed and designed many years ago. The provider was working towards ensuring the service is 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.

Farfield Drive is a short break residential care service which aims to provide a holiday style atmosphere for up to five people who have a learning disability. Accommodation is in a purpose-built house with five bedrooms, each with en-suite facilities. Communal lounges, kitchen and dining areas are provided.

During our inspection there were three people staying at the respite service. The PIR received from the provider PIR said 56 people accessed the respite services within a 12-month period. At our last inspection the service was rated as good. At this inspection we found the level of compliance had not been sustained and we have rated the service as requires improvement. This is the first time the service has been rated requires improvement.

There was a registered manager in post at the time of our inspection, but they were moving to a new post within the company. A new manager was in the process of registering with Care Quality Commission (CQC). It was the new manager who we spoke with during this inspection. 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.

Some people using the service did not have capacity to consent to their care. We found people's care records did not include information to reflect that assessments had taken place where people lacked capacity, and there was not always evidence that best interest's decisions had taken place, where relevant. We also found DoLS applications had not been applied for when people lacked capacity to make certain decisions.

The provider had robust systems and procedures in place to keep people safe and staff were competent in their knowledge of what constituted abuse and how to safeguard people. There was a whistleblowing policy in place and staff knew how to raise concerns should this be required.

Medicines were managed safely with checks carried out to prevent possible medicine errors. ‘As required’ medicines were administered when needed.

Risk assessments had been completed and reviewed regularly. Accidents and incidents were managed effectively and actions taken to mitigate future risks.

Staffing levels were sufficient to meet people’s needs and robust recruitment processes were in place to ensure people were of suitable character. Staff carried out training to ensure they had adequate skills and knowledge to meet people’s needs. Staff were supported with regular supervisions and appraisals.

Health and safety checks were completed regularly and staff followed the providers procedures for infection control.

Staff were caring, kind and respected peoples wishes. We saw people were encouraged to remain as independent as possible using alternative communications to allow people to make choices about their care.

Pre-admission forms were completed to ensure people’s needs could be met before their stay. Care plans were person centred and reviewed regularly with people and their relatives. Care plans included people’s preferences, likes

We inspected Farfield Drive on the 13 April 2016 and the visit was unannounced.

Farfield Drive is part of Aspire Community Benefit Society. It is a respite service which supports people with learning disabilities in a specially designed building. The service offers an opportunity for people to have short breaks from their family and also gives family carers a break from their caring responsibilities. The service provides respite care for up to five people at a time. At the time of our inspection there were four people using the service.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). 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.

Not everyone who stayed at the service was able to communicate verbally therefore; we observed how staff interacted with people over short periods of time throughout the day to ensure we caused only minimal disruption to their daily life. Three people, who were able, told us they enjoyed staying at the service and staff were friendly and supportive.

People we spoke with told us they felt safe at the home.

The provider had policies and procedures relating to the safe administration of medication. This gave guidance to staff on their roles and responsibilities. However, this was not always followed.

There were enough skilled and experienced staff. The staff had access to a range of training courses relevant to their roles and responsibilities and they were supported to carry out their roles effectively through a planned programme of training and supervision. Procedures in relation to recruitment of staff were followed and all required information was obtained to help the employer make safe recruitment decisions.

People’s care plans and risk assessments were person centred and the staff we spoke with were able to tell us how individuals preferred their care and support to be delivered. Care plans and risk assessments were reviewed on a regular basis to make sure they provided accurate and up to date information.

People were provided with a choice of healthy food and drinks ensuring their nutritional needs were met.

Staff received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards and were able to demonstrate a good understanding of when best interest decisions needed to be made to safeguard people.

People were encouraged to participate in a range of appropriate social, educational and leisure activities both within the service and the wider community and staff actively encouraged them to maintain and develop their daily living skills.

There was quality assurance monitoring system in place, however it did not identify the medication shortfalls and there were systems in place for staff to learn from any accident, incidents or complaints received.