Miller Farm is a care home registered to provide care for up to 10 with learning disabilities who have complex support needs. On the day of our inspection there were seven people resident in the home.

We carried out this inspection on 4 June 2017. At the last inspection, the service was rated Good. At this inspection we found the service had met all relevant fundamental standards and remained rated as Good.

The service has a registered manager. 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 staff had a clear knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. We have made a recommendation around how the service records people’s best interest decisions and their mental capacity assessments for people.

There were processes in place for the safe storage and management of medicines.

The staff had received training regarding how to keep people safe and they were aware of the service safeguarding and whistle-blowing policy and procedures. Staffing was arranged in a flexible way to respond to people’s individual needs.

People were provided with regular opportunities to express their needs, wishes and preferences regarding how they lived their daily lives. Each person was supported to access and attend a range of social activities. People were supported by the staff to use the local community facilities and had been supported to develop skills which promoted their independence.

People’s needs were regularly assessed and resulting care plans provided guidance to staff on how people were to be supported. Support in planning people’s care and support was personalised to reflect people’s preferences and personalities.

There was a robust staff recruitment process in operation designed to employ staff that would have or be able to develop the skills to keep people safe and support people to meet their needs.

Staff demonstrated a detailed knowledge of people’s needs and had received training to support people to be safe and respond to their support needs. We saw that the service took time to work with and understand people’s individual way of communicating in order that the service staff could respond appropriately to the person. Staff respected people’s privacy and we saw staff working with people in a kind and compassionate way responding to their needs.

There was a complaints procedure for people, families and friends to use and compliments could also be recorded.

The provider had quality monitoring systems in place which were used to bring about improvements to the service.

Further information is in the detailed findings below.

This inspection took place on the 7th May 2015 and was unannounced

Miller Farm is a care home providing personal care and support for people with learning disabilities. The home is registered for up to 10 people. At the time of the inspection they were providing personal care and support to eight people.

There was a registered manager at the service at the time of our inspection. 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.

People and their relatives told us they felt safe and were happy with the care and support provided. Systems were in place to help ensure people were safe. For example, staff had a good understanding of what constituted abuse and the abuse reporting procedures. People’s finances were managed and audited regularly by staff.

People were supported by sufficient numbers of staff. Appropriate recruitment checks were in place which helped to protect people and ensure staff were suitable to work at the service. Staff told us they felt well supported in their role and received regular supervision.

Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Care plans were sufficiently detailed and provided an accurate description of people’s care and support needs. The management of medicines within the service was safe.

Appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves and to help ensure their rights were protected. People had good healthcare support and accessed healthcare services when required.

People were supported to be able to eat and drink satisfactory amounts to meet their nutritional needs. The mealtime experience for people was positive. People were treated with kindness and respect by staff. Staff understood people’s needs and provided care and support accordingly. Staff had a good relationship with the people they supported.

An effective system was in place to respond to complaints and concerns. The provider’s quality assurance arrangements ensured that where improvements to the quality of the service was identified, these were addressed

There were 10 people living at Miller Farm at the time of our inspection. They had varying degrees of learning disability and verbal communication skills.

We observed people were free to make their own choices regarding their day to day living. This included personal care routines, clothing, meals and leisure activities. We saw staff respected and acted on people’s decisions. Where people did not have the capacity to consent to certain decisions staff acted in accordance with legal requirements.

From our observations and what people said they appeared happy and contented with the care and support provided. One person said “I’m looked after OK. My key worker is very good”. Another person said “I’m alright”. Staff spoken with had a clear understanding of each person’s support needs and how they should be met.

People who were able to speak with us confirmed they felt safe and were well treated by staff. All the people we observed looked at ease with the staff supporting them. Staff spoken with knew how to recognise signs of abuse and how to report any concerns.

Staff said they felt competent and trained to carry out their roles. Staff told us the provider offered “excellent training and development”.

The provider maintained accurate and appropriate care records and other records relevant to the management of the service. This helped protect people from the risks of unsafe or inappropriate care.

There were nine people living at Miller Farm at the time of the inspection. We met and talked with four people and because people varied in their abilities to communicate verbally we also observed the care provided to help us understand their experience. Three people told us they liked living at Miller Farm. During our visit at least four people were supported to access the local community. People moved around the home freely and staff offered people choices about how to spend their time in a person-centred way.

Staff were competent, knowledgeable and sensitive in their interactions with people, adapting the way they communicated according to people's communication needs. One person told us "I like staff". Another person told us "I talk to my key worker if I have a problem". Information about people's needs was kept up to date in key worker packs and there was consistency in the care provided due to detailed staff handovers.

People were protected from the risk of abuse because safeguarding procedures were in place and staff identified changes in people's behaviours and implemented behaviour management plans to prevent situations from escalating.

There was an effective system in place to monitor the quality of service provision through a range of methods including satisfaction surveys, monthly residents meetings and internal audits. People's concerns or suggestions were acted upon in order to continually improve peoples' experience of the service.