Blamster's Farm

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support: The service is made up of a series of houses in a campus style setting on the outskirts of the town of Halstead, which enables people to access the local community and its amenities. People had exclusive possession of their own rooms, in shared accommodation.

The provider had continued to invest in improving the premises, including installing new kitchens, new bathrooms and laundry facilities. These improvements ensured people received care and support in a safe, well equipped, well-furnished and well-maintained environment. Revised cleaning schedules, and improved infection control practices provided a cleaner and safer environment for people.

Work undertaken to reduce restrictive practices in the service enabled people to have choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The use of PRN medicines which affect people's behaviours, mood, thoughts, or perception had significantly reduced since our last inspection. This ensured people's behaviour was not controlled by excessive and inappropriate use of medicines.

Right Care: Systems to protect people from poor care had improved. Staff had greater leadership, training and support and understood their role in promoting safe, consistent, and predictable care which met people's needs, including managing complex needs and feelings of anxiety or distress.

The provider had successfully recruited a significant number of new staff, reducing vacancies and the need to use temporary agency staff. More regular, and consistent staff had led to improved outcomes for people. Recruitment systems were robust ensuring the right staff were recruited to safely work with people using the service.

Improvements in staff training ensured staff had the knowledge and skills to meet the needs of the people using the service. Some new staff felt they needed more shadowing with experienced staff before supporting people with complex needs, on their own. People were supported to live healthier lives, through maintaining a balanced diet and access to healthcare services. Staff worked with health professionals to provide consistent, effective, timely care.

People were treated by staff with kindness, respect and compassion. Staff knew the people they were supporting well, including how they communicated. Staff demonstrated true insight into people's needs and understood the effectiveness of good communication to achieve positive outcomes. People were supported to access activities, with meaningful interest to them. People's privacy, dignity and independence was encouraged and respected.

Right Culture: Since the last inspection, the registered provider had been incorporated into Ivolve Group Limited, an existing adult social care provider with established governance arrangements in place to assess, monitor and improve the quality of the service. Although significant improvements have been made across the service, these systems have not yet been fully embedded. Audits at service level had not been robustly completed. Therefore, these did not always feed into the provider's overarching quality and risk governance system to identify where quality and safety was compromised and what actions were needed to drive improvement.

Recruitment of the area manager and registered managers had resulted in better leadership and support for people and staff. Where a registered manager had been appointed to the Oak and the Green, these houses were operating better than the Lodge, Coach House and Farmhouse. Leadership and governance arrangements were inconsistent across these houses. A new manager had been recruited to manage the Lodge, Coach House and Farmhouse and is due to start in post on 18 September 2023.

The area manager and registered managers had worked hard to improve the culture in the service. Staff told us staff morale had greatly improved.