Archived: Hillview Farm

Hillview Farm is a location with four houses on the same site. Three of the houses make up a care home without nursing that provides a service to up to nineteen people with learning disabilities and/or autistic spectrum disorder. At the time of our inspection there were 15 people living in the three houses. In the fourth house the provider offers a supported living service for two people. Attached to the service the organisation has a 6 acre smallholding where they offer day opportunities, including horse and other animal care, horticultural activities and weekly riding lessons. On the same site the organisation runs an educational service called "Experience Education". These services are open to people from outside Hillview Farm as well as those living there who are interested in attending. Although some of the people using the service attend the daytime activities and educational facility on site, those provisions do not come under the provider's registration and were not assessed as part of this inspection.

The service had a registered manager as required. 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 registered manager and the business and training development manager were present and assisted us with our inspection.

Staff showed skill when working with people and it was obvious they knew them well and people were treated with care and kindness. Staff were aware of people's abilities and encouraged them to be as independent as possible.

People received support that was individualised to their personal preferences and needs. Social care professionals told us they thought the service provided personalised care that was responsive to people's needs.

People received appropriate health care support. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way. Medicines were stored and administered safely.

People's wellbeing was protected and all interactions observed between staff and people living at the service were caring, friendly and respectful. People's rights to confidentiality were upheld and staff treated them with respect and dignity.

People were protected from the risks of abuse and from risks associated with their health and care provision. They were protected by recruitment processes and people could be confident that staff were checked for suitability before being allowed to work with them. There were sufficient numbers of staff on each shift to make sure people's needs were met.

People benefitted from staff who were well supervised and received training to ensure they could carry out their work safely and effectively

People's rights to make their own decisions were protected. Managers and staff had a good understanding of the Mental Capacity Act 2005. They were aware of their responsibilities related to the Act and ensured that any decisions made on behalf of people were made within the law and in their best interests.

People and their relatives knew how to raise concerns and felt they were listened to and taken seriously if they did. Staff recognised early signs of concern or distress from people living at the service and took prompt and appropriate action to reassure people when needed.

People benefitted from living at a service that had an open and friendly culture. People and their relatives felt staff were happy working at the service. Social care professionals felt the service demonstrated good management and leadership and worked well in partnership with them.

As part of this inspection we spoke with the registered manager, administration staff, and reviewed records.

Below is a summary of what we found. The summary describes what we were told, what we observed and the records we looked at.

Is the service safe?

There were effective recruitment and selection processes in place. Since our last inspection in April 2014 two members of staff were employed. Appropriate checks had been undertaken before staff began work. Staff had undergone induction training which included working for a period of time with an experienced member of staff.

We reviewed the recruitment files of eight members of staff. Records we looked at were accurate and fit for purpose and contained the information required by Regulation 21, Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Below is a summary of what we found.

The summary is based on our observations during the inspection, speaking with people who use the service, their relatives, the staff and management supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe and trusted the staff who came to support them. Safeguarding policies and procedures we reviewed were robust and staff we spoke with understood how to safeguard the people they supported. People who use the service told us they felt their rights and dignity were respected.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Staff knew how to help people to remain safe. Risk to people was reduced to a minimum. People who use the service also had choice and control of their lives and how their support was planned.

The service had appropriate information in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). At the time of our visit no one was subject to DoLS and no applications were submitted. Staff had understanding and knowledge of MCA and DoLS. They had training to understand and make sure people were able to make their own decisions and were supported when necessary, for example, to carry out best interest meetings with the person or their representatives if appropriate. This meant that people were safeguarded as required.

We looked at the recruitment of new staff. This showed that some required recruitment checks into employment and experience were not being completed. This put people at risk of being supported by inappropriate or unfit staff who may not have appropriate skills.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to recruiting new staff.

Is the service effective?

People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs.

The service made sure staff were trained appropriately and were able to meet people’s individual needs in a timely manner.

People we spoke with were complimentary about the care they received and felt the staff were supporting them when needed.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. We saw there was good communication between staff and people who use the service. People told us the staff were helping them be independent and understood their needs.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. The service had its own vehicles that helped keep people involved with their local community.

People knew how to make a complaint if they were unhappy. One person said they had made a complaint. They told us it had been dealt with and they were satisfied with the outcome. We looked at how these complaints had been dealt with, and found that the responses had been appropriate. People can therefore be assured that complaints are investigated and action is taken as necessary.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were in the process of being addressed.

Is the service well-led?

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

People were treated with respect. They were involved in planning their care and support. We saw they were encouraged to make choices and independence was promoted.

People were protected from the risks of abuse. Appropriate processes were in place to safeguard people and staff we spoke with were aware of their responsibilities.

Staff were supported and offered appropriate training and development.

There was a process in place to monitor and assess the quality of the service that people received.

Records were not always accurate and so not fit for purpose.