Homeleigh Farm

Accommodation is laid out over a single ground floor bungalow and each person had their own bedroom. At the time of inspection this was an all-male household and there were no vacancies.

This service was last inspected on 25 November 2015 when we found the provider was not meeting all the regulations inspected at that time in regard to ensuring staff had the right information about peoples specific health needs, staff recruitment and ensuring the quality monitoring and assessment of service quality was more effective. We asked the provider to send us an action plan of what they intended to do to address these shortfalls which they did. This inspection found that the provider had implemented all the improvements they had told us about.

There was a long established registered manager in post who gave continuity to the way in which the service operated and was managed. A registered manager is a person who is 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 told us they were happy and settled living at the service; some had aspirations to move to greater independence, and staff helped people to set achievable goals for themselves for things they wanted to learn or do. Staff were proactive in helping people to maintain and develop independence but their focus was for this to happen at a pace to suit each person.

People were provided with a safe, clean environment that was maintained to a high standard, with all safety checks and tests routinely completed. There were enough skilled staff to support people and the low staff turnover provided continuity to people of staff who knew them well. Recruitment processes ensured only suitable staff were employed. A training programme was in place so that new staff were inducted appropriately into their role. Staff received training to give them the knowledge and skills they needed to meet people's needs. Staff felt listened to and supported and were given opportunities to meet regularly with the registered manager on an individual basis and with other staff in staff meetings.

Staff understood how to keep people safe and protect them from harm, they understood how to respond to emergencies that required them to evacuate the building quickly and safely. It was recognised that for people, with behaviour that could be challenging, some restrictive practices were necessary to maintain their safety, for example people only going into the community when accompanied by staff. There was a clear culture of least restrictive practice embedded in the service and restraint was not used except in an emergency to keep someone safe. Risks were appropriately assessed to ensure the control measures

implemented kept people safe and were kept under review. Medicines were managed appropriately.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The provider and registered manager understood when an application should be made and one person had a DoLS authorisation in place. The service was meeting the requirements of the Deprivation of Liberty Safeguards and staff understood and were working to the principles of the Mental Capacity Act (MCA) 2005.

People's privacy and dignity was respected. Whilst there was an element of banter between people and staff, interactions were positive and staff were respectful in the way they spoke about and to the people they supported. Staff intervened discreetly if they observed situations that might escalate. Staff demonstrated kindness and patience, they took time to listen and interact with people so that they received the support they needed.

People's health needs were monitored and referrals to health professionals made where needed. People were provided with a varied diet of their choice that took account of any specialist requirements they may have. A comprehensive pre-admission process was in place in the event of new people referred to the service. People had input into their care plans which provided staff with a detailed and personalised guide about each person's needs and how they wanted these to be supported.

Staff were enabled to spend time with people and enable them to make use of community activities. People felt able to raise concerns if they had them and their views were sought through service user groups and surveys. Relatives were also asked for their views. Issues highlighted through surveys were minimal but were acted upon immediately. Staff were also asked for their views and felt listened to. Accidents and incidents were few but staff responded and reported on these appropriately. A range of audits provided assurance to the provider and registered manager that service quality was being maintained.

The five questions we ask about services and what we found