Manor Farm provides personal care and accommodation for up to ten people who have a learning disability. Nine people were living at the service on the day of our inspection.

This unannounced inspection was undertaken on 21 July 2017 by one inspector. At the last inspection on 13 April 2016. The service was rated as 'Requires Improvement'. At this inspection we found the service was rated as 'Good'.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (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.

Staff knew how to respond to possible abuse and how to reduce risks to people. There were enough staff who had been recruited properly to make sure they were safe to work with people.

Medicines were stored and administered safely.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received a choice of meals and staff supported them to eat and drink enough. They were referred to health care professionals as needed and staff followed the advice these professionals gave them. People's personal and health care needs were met and care records guided staff in how to do this

Staff were caring and kind and treated people with respect. People's right to privacy was maintained by the actions and care given by staff members.

People were supported with enough social stimulation that they needed throughout the day including hobbies, interests and pastimes.

Complaints were investigated and responded to and people knew who to go to, to do this.

Staff worked well together and were supported by the management team. The monitoring process looked at systems throughout the home, identified issues and staff took the appropriate action to resolve these.

Further information is in the detailed findings below.

Manor Farm is registered to provide accommodation and personal care for up to 10 adults. People who live there have a learning disability. The home is a refurbished farm house located on the outskirts of a small village. There are shared facilities including a lounge, dining area, sensory room and kitchen. Nine single bedrooms, each with an en suite shower room, are located on the ground and first floors of the main house. There is a small bungalow next to the home, which has one single bedroom with its own bathroom and a kitchen/lounge/dining room. A large enclosed garden at the rear of the home gives people space to play games such as football and grow vegetables and included a well-equipped sensory room.

This comprehensive inspection took place on 13 April 2016 and was unannounced. There were eight people living at the home when we visited.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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 home is run.

People were comfortable with the staff and people’s relatives were happy with the support provided to their family members. Staff liked working at Manor Farm and were well-supported by the registered manager.

Staff had undergone training and were competent to recognise and report any incidents of harm. Potential risks to people had not always been assessed, which meant that people were at risk of not always being kept as safe as possible.

There were sufficient staff on duty to make sure that each person had the support they needed to do whatever they wanted to do. Staff had been recruited in a way that made sure that only staff suitable to work in this care home were employed. Staff had undertaken a range of training in topics relevant to their role so that they were equipped to do their job well. Medicines were managed well so that people received their prescribed medicines safely.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had been assessed. For most people, appropriate applications had been made to the relevant authorities to ensure that people’s rights were protected if they lacked mental capacity to make decisions for themselves. In one instance, a decision had been made by staff, which meant that the person’s rights in this area had not been fully protected.

People’s healthcare needs were monitored and staff involved a range of healthcare professionals to make sure that people were supported to maintain good health and well-being. People were given sufficient amounts of food and drink and the nutritional needs of people who required special diets were met.

Staff showed that they cared about the people they were supporting. Staff treated people with kindness, respect and compassion and made sure that people’s privacy and dignity were upheld at all times. People’s personal information was kept securely so that their confidentiality and privacy were maintained.

People’s relatives were involved in the planning of their family member’s care and support. Staff gathered as much information as possible about each person so that their support plans were personalised. This meant that people received the support they needed in the way they preferred. Staff did not always utilise identified ways of communicating as fully as possible with each person.

A wide range of activities and outings was organised with each person to make sure they were supported to do whatever they wanted to do. People were supported to complain, if they needed to. People’s relatives knew how to complain and complaints were responded to in a timely manner.

The registered manager wa

An adult social care inspector carried out this inspection. The inspection was carried out to check whether the provider had made improvements to the service. The focus of the inspection was to answer one of the five key questions: is the service safe?

As part of this inspection we spoke with the senior member of staff on duty and we looked at the records relating to the way medicines were managed.

Below is a summary of what we found.

Is the service safe?

During our inspection of the service on 19 June 2014 we found that although a number of aspects of medicine management were carried out safely, the records showed that staff had made some errors in the recording. This meant that medicines were not managed as safely as they should have been.

During this inspection on 17 September 2014 we found that improvements had been made. This meant that people were given their medicines safely and as they were prescribed.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found.

Is the service safe?

We spoke with people’s parents and they told us they were satisfied that their sons were as safe as possible at Manor Farm. One parent said, “We wouldn’t have sent him there if we hadn’t felt he’d be safe.”

There were enough staff on duty to meet people’s needs while they were at home and to make sure that people could go out into the community, accompanied by the number of staff that were required as a result of the person’s risk assessment. Assessments of any possible risks to each person had been carried out, and guidance put in place for staff so that they knew how to minimise any risks.

Although a number of aspects of medicine management were carried out safely, the records showed that staff had made some errors in the recording. This meant that medicines were not managed as safely as they should have been.

Is the service effective?

Parents we spoke with told us how much their sons had developed since moving to or staying at Manor Farm. Staff also gave us a number of examples of the ways in which each person had progressed. It was clear from our observations that people were comfortable with the staff and that staff knew people’s needs well. A member of staff told us, “There are a lot of positive things, this place is lovely and has the potential to be really fantastic. It just needs a bit of tweaking.”

Support plans showed that people were encouraged and supported to make choices about all aspects of their lives. The plans also gave staff detailed guidance about the ways in which each person preferred their support needs to be delivered by the staff. This meant that people were supported consistently.

Is the service caring?

From their body language and their behaviour we saw that people got on well with the staff. Staff treated people with respect and kindness. They spoke to people in a friendly, professional way, which included a lot of fun and laughter.

Is the service responsive?

People’s needs were re-assessed each month and any necessary changes made to their support plans. Each year a full review was held for each person, by a multi-disciplinary team made up of a number of health professionals, including psychiatrists and behaviour psychologists.

People were encouraged to participate in a range of activities of their choice, both at home and in the wider community.

Is the service well-led?

There was effective leadership in place, which ensured that people’s needs were met, they were kept as safe as possible and the service provided to people by the staff was of a high quality. Staff praised the manager and team leader and told us they were happy to be working at Manor Farm.

A robust quality assurance system was in place, which ensured that all aspects of the service were monitored and improvements made where necessary.

We found that the provider was not compliant with the regulations in all the areas we assessed. If you wish to see the evidence supporting our summary please read the full report.

We visited the service on 11 April 2013. A few minutes before arriving a person cared for suffered an epileptic fit and required several hours rest, so we did not speak with the person or observe the care process. We did, however, speak with the manager, three staff members and checked documentation related to care.

The service had become active again at the beginning of March 2013 when a person moved in, after several months of being dormant as there were no people who used the service living in.

We saw the initial assessment and the care plan drawn up from it. It was detailed and individualised, promoting the person’s independence. Corresponding risk assessments provided a guide for staff to ensure that the person was safe whilst also being encouraged to explore all their abilities, learn new skills and express their wishes and individuality. We saw an example of how the person chose what to eat, what to wear, what activities to undertake and how they learnt new skills regarding personal care.

We spoke with staff who told us that they were well supported through their initial training, further personal development, training, supervisions and appraisals. We saw records that confirmed this.

Staff showed that they were aware of the safeguarding procedure and explained how they would react if there was a concern.

We saw the evidence of the audits carried out to ensure that the provider monitored quality of care.

During our visit we met a number of the people who use the service and we spoke with one person who said that they were satisfied with the support they received and found the staff to be helpful and caring. Other people we met did not share with us their views and opinions about the care and support they received. However, observations indicated that people using the service interacted well with members of staff and were engaged in activities in and around the home.

Relatives that we spoke with were positive about the care and support that was provided and felt that they were kept well informed of any changes in the home. People we spoke with said that they were satisfied with the accommodation and relatives also stated that they felt the accommodation met their relative's personal needs.