We carried out a review of the data available to us about Glebe Farm on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Glebe Farm, you can give feedback on this service.
Glebe Farm is a care home providing personal and nursing care to nine people aged 18 and over who have a learning disability. Eight young men were living at the home at the time of our inspection.
Each person living at Glebe Farm had their own one-bedroom flat, with en-suite bathroom and living space. There were three buildings surrounding an enclosed courtyard. Each building had three flats and some shared spaces. The home also had a shared kitchen and dining room.
Although this is a new home (built in 2018), it is registered to support nine people, which is larger than recommended by current best practice guidance. The provider worked closely with the local authority during the planning stages and designed a home to meet the needs of people with complex needs.
People’s experience of using this service and what we found
We received positive feedback from relatives and staff, and an external care professional, about the service provided. One relative said, "[The staff are] very good. It’s quite amazing how they have managed to deal with [my family member]. It's an amazing place. The management are very good. I would recommend it 100%.”
The provider had effective systems in place which helped ensure that staff delivered a service that met people's needs and kept them safe. Systems were in place to help staff minimise risks to people. Staff understood the identified risks and followed the guidance in place to keep people safe. This was regularly reviewed and updated.
Senior staff reviewed accidents and incidents to ensure learning happened when things went wrong. They took additional actions to reduce risk as necessary.
Measures were in place to manage the risks of COVID-19 including policies and risk assessments. Staff told us they had access to sufficient personal protective equipment (PPE) and had received training on how to keep themselves, and others, safe from the risks of COVID-19. The provider had robust contingency plans in the event of an outbreak.
This was a targeted inspection that considered assessing risk, safety monitoring and management, and preventing and controlling infection. Based on our inspection of these areas the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were encouraged and supported to make decisions. People’s care was person-centred and their privacy, dignity, and human rights were protected.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (report published 26 June 2021).
Why we inspected
The inspection was prompted in part due to concerns received about the safety of people. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Each person living at Glebe Farm has their own one-bedroom flat, with en-suite bathroom and living space. There are three buildings surrounding an enclosed courtyard. Each building has three flats and some shared spaces. The home also has a shared kitchen and dining room.
Although this is a new home (built in 2018), it is registered to support nine people, which is larger than current best practice. The provider worked closely with the local authority during the planning stages and designed and built a home to meet the needs of specific individuals who have very complex requirements.
People’s experience of using this service and what we found
We found the service provided to people at Glebe Farm had improved in all areas since our last inspection. People who lived there now received good, personalised care and support by staff who were kind, caring and compassionate. Relatives of people who lived at the home all made very positive comments, including that there had been noticeable improvements. They were very satisfied with the service delivered by the staff and felt their family members were safe and well cared for. One relative said, “[The service is] fine, considerably better. They have residents’ best interests at the heart of what they do.”
Staff worked hard to enable each person to live the life they wanted to live. Staff knew how to keep people as safe as possible and carried out detailed assessments of potential risks. This meant each person was enabled to take positive risks and do what they wanted to do. Staff supported people to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff were motivated, knowledgeable and skilled to provide care and support to each person. They had undertaken training in a wide range of subjects relevant to their role and were encouraged to develop further. All staff understood how to support people's privacy, dignity and independence. One member of staff said, “I really enjoy it here. I enjoy the [staff] I work with and the guys as well. No day is the same – it’s fun, interesting, different, challenging.”
Staff offered each person a range of opportunities for meaningful activity, based on the person’s preferences. Each person decided what they wanted to do and when, and staff encouraged people to undertake new challenges. Staff were developing links with the local community so people living in the home could feel involved. Any concerns were listened to and addressed.
Management of the service had improved considerably since our last inspection. The service was very well-led by a registered manager who inspired the staff team to put people they were supporting at the heart of everything they did. One relative said, “The service is fantastic…and definitely improving for the better.”
The provider's values were put into practice by the staff and governance systems ensured the service provided was of high quality. People, their relatives and staff were involved in improving all aspects of running the service and their voices were heard. Another relative told us, “We now find it excellent and are very pleased with the complete management [team] that runs it far better.” The registered manager highly praised and thanked the staff. They said, “I can’t do this by myself – it takes all of us working together as a team – we’ve all worked really hard to achieve this.”
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were encouraged to make their own choices and their human rights were protected. The management team led by example and promoted a positive value based approach in providing people personalized care and support.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 19 September 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
Visitors to the service had their temperature taken and wore personal protective equipment (PPE). Visitors who were not regularly tested for COVID-19 as part of a testing programme were asked to undertake a Lateral Flow Test (LFT) before entering the building. These tests take 30 minutes to receive a result.
The service had an ample supply of PPE. All staff had received training in the correct use of PPE, and how to take it off and put it on safely.
People were supported to have regular contact with their families and friends either through 'socially distanced' visits outdoors or through video and telephone calls.
Regular COVID-19 testing for all people and staff living and working in the service was regularly carried out.
The building was clean and free from clutter. Cleaning of the service, including frequently touched surfaces, had increased to reduce the risk of transmission of infection.
Risks to people and staff in relation to their health, safety and wellbeing had been thoroughly assessed. The service layout ensured that staff did not mix, as staff were allocated to work with one person in their self-contained ‘apartment’. This reduced the risk of potential infection transmission between people living at the service and between staff members.
Glebe Farm is a residential care home providing personal and nursing care to up to 9 people aged 18 and over. Four people were living at the home during our first two visits. A fifth person was admitted prior to our third visit.
Each person living at Glebe Farm has their own one-bedroom flat. There are three buildings surrounding an enclosed courtyard. Each building has three flats and some shared spaces. One flat has its own enclosed garden.
Although this is a new home, it is registered to support nine people, which is larger than current best practice. The provider worked closely with the local authority during the planning stages and designed and built a home to meet the needs of specific individuals who have very complex requirements.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service should receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service did not support people effectively in line with positive behaviour support principles. Staff were not suitably trained to support people using positive behaviour support.
People’s experience of using this service and what we found
The service did not consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
Staff had not always supported people to carry out activities that were meaningful to them. Support plans were not person-centred and did not give staff enough guidance to ensure that they knew how people wanted their needs met.
People were not always safe. There were not always enough staff deployed to support people, so people and staff were at risk of harm. The correct safeguarding procedures had not always been followed. Risk assessments were not always in place or did not contain personalised information staff needed to keep people safe. There was not an effective system in place to learn lessons from incidents or accidents.
Leadership of the service was poor. The provider had not ensured that quality assurance systems were robust enough to identify and rectify shortfalls. The management team had not always worked collaboratively with external health and social care professionals. People, relatives and others were not asked for their views about the service. Staff felt their views were not listened to.
There were not always enough staff with the right knowledge, skills and experience deployed to ensure that people’s holistic needs were met. Staff had not received suitable induction, training or support to ensure they were able to effectively meet people’s needs.
There was not a caring culture in the home. Relatives and external professionals told us that most staff were caring, kind and tried to do their best for the people they were supporting. We saw that most people were comfortable with the staff and enjoyed their company.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not always support this practice. People’s choice of what they wanted to do was not always met.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 30 August 2018 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns raised by a whistle-blower and by the local authority. The concerns were about staffing levels; staff training and competence; care planning; lack of activity; and poor management. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report. Some actions have already been taken by the provider to reduce risks. Following the inspection the provider told us that they had changed the management arrangements. Additional training for staff is planned.
Enforcement
We have identified breaches in relation to governance, safe care and treatment, staffing, person-centred care and notifications at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.