Blamster's Farm

Updated 7 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and an operations manager reviewed the care provided in 4 of the 5 houses currently occupied. A third inspector looked at infection and prevention control measures and medicines management across the service. An Expert by Experience also supported the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Blamster's Farm is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of the regulated activity at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were 2 registered managers in post.

Notice of inspection

This first day of the inspection was unannounced. Inspection activity started on 10 July 2023 and ended on 18 July 2023.

What we did before inspection

We reviewed information we had received about the service since their last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 4 relatives about their experience of the care provided. We observed the experiences of people who were unable to talk with us. We spoke with the area manager responsible for supervising the management of the service on behalf of the provider and the 2 registered managers. We also spoke with 15 care staff and 2 team leaders. We reviewed a range of records, including 8 people's care records and 6 people's medicine administration and associated records. We looked at 3 staff files in relation to recruitment and staff supervision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, and a variety of records relating to the management of the service, including policies and procedures.

Updated 7 September 2023

About the service

Blamster's Farm is a residential care home providing personal care to people with a learning disability and autistic people. The service can support up to 31 people accommodated across seven individual houses, all within the grounds. The houses are known as Oak, Green, Farmhouse, Lodge and Coach House. The Bungalow and Cottage were currently closed for refurbishment. There were 24 people using the service at the time of the inspection.

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.

People’s experience of using this service and what we found

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

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.

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 4 February 2022) and there were 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.

At our last inspection we made recommendations about decision making in accordance with the Mental Capacity Act 2005, and about the management of medicines. At this inspection we found improvements had been made. Where people were deemed to lack capacity to make significant decisions about their health and welfare, records now clearly showed who had been involved in making decisions in the persons best interests. Where people were prescribed medicines, as needed (PRN) improved protocols were in place providing guidance for staff to safely administer these medicines.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. It was also prompted by a review of the information we held about this service to assure ourselves people were receiving safe, good quality care. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Blamsters Farm on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.