Palace Farm is registered to provide care and accommodation for up to three people. At the time of the inspection there were two people living there. People living at Palace Farm are young adults who may have a learning disability or autistic spectrum disorder. The providers live at Palace Farm with the people being supported there. This inspection took place on 6 June 2017 and was announced. We gave the provider 15 hours notice as the home is small and people are out for much of the day. We needed to ensure someone would be there to meet with us.
Palace Farm was previously registered as “Home Orchard”, which remains as a brand name, but changed it’s registration with the Care Quality Commission in 2016, and is now operated under a registered partnership. The home is in close proximity to three other homes which share some administrative facilities and the brand name but are registered under the provider name Dalskats Limited.
The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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. The registered manager is also one member of the partnership, and is referred to throughout the report as a provider.
The home had a happy, positive and welcoming atmosphere. Palace Farm was set up with the aim of enabling people to enjoy a ‘normal family lifestyle’ rather than more traditional or institutional care, and the provider’s website states they wanted people to be able “to access a fulfilling outdoor life”. We saw this happening, with people following full and active lifestyles of their choosing. Palace Farm is a working farm with livestock, and people were able to participate as much or as little as they wish in this. People had lived at the home for many years and were very familiar with the provider’s family members.
People were protected from the risk of abuse as staff understood the signs of abuse and how to report concerns. Systems were in place and well understood to help staff or people report concerns, including independent advocacy. We saw people had built positive relationships with staff. Staff told us they were confident they understood how if people were unhappy about something it would show through their behaviour.
People were supported safely because risks to people were identified and plans were put in place to minimise these risks. These included changes that had been made to the building as assessments of risks from activities, health conditions, supporting animals on the farm as well as assessments of people’s own vulnerability.
People received their medicines as prescribed. The systems in place for the management of medicines were safe and protected people who used the home. This included the management of emergency medicines to support one person with epilepsy and clear protocols for staff to follow to ensure the person was supported safely.
There were enough staff to support people to follow their chosen lifestyle, activities and keep people safe. Staff had the skills and support they needed to ensure people’s individual care needs were met. People knew in advance who would be working with them which helped reduce their anxieties. Staff were chosen as far as possible to reflect people’s interests, and we saw staff supporting people well. Staff had attended courses with one person and were enthusiastic about supporting them with their hobby.
People’s rights were respected. Staff had clear understanding of the Mental Capacity Act 2005 and where a person lacked capacity to make an informed decision, staff acted in their best interests. Applications had been made to ensure people’s rights were protected under the Deprivation of Liberty safeguards. We saw staff were supportive, compassionate and caring in their relationships with people. People were treated with kindness and respect and valued fo their contributions to the running of the home.
The premises were reflective of the home’s ethos – to provide a family living experience. The building was a listed farmhouse, adapted to provide a comfortable family home. People had single bedrooms with en-suite facilities and some shared space, including the lounge and kitchen / diner. They had free access to the kitchen to prepare their own snacks and hot drinks. Mealtimes were social experiences and people were involved in the planning, and choosing of their meals. People were supported to have enough to eat and drink, and the provider ensured wherever possible people ate good quality food, fresh picked from the farm and which they had grown themselves and local organic meats.
People were treated with dignity and respect. Staff used different methods of communication to speak with people and include them in conversations, and ensure they were understood. This included for some people supported communication using pictures and symbols, for example to help with choosing food.
People were actively supported to follow hobbies and interests of their own choosing. Both people living in the home had some one to one staff allocation which helped ensure someone was always available. Staff supporting one person had been on courses to help understand their hobby so they could support the person better.
Systems were in place to ensure complaints were responded to and managed. The home had not received any formal complaints and felt if people had any issues they would be raised and addressed informally.
People told us the providers and management team were approachable and always contactable in case of emergency or advice needed. Up to date advice and support on good practice was sought and the provider had commissioned a social care consultant to provide management support to the team and oversee some areas of the home. They reviewed this regularly.
The provider had systems in place to assess, monitor and improve the quality of care and services provided. The provider sought feedback from people, relatives, staff and healthcare professionals in order to improve the home. Feedback from this process was made available on the home’s website and given to people so they could see the results of any suggestions they had made.
Records were well maintained and kept securely.