CQC report explained · a residential care home
What the CQC found at Cocklebury Farmhouse
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2022
Rated Requires Improvement; inspectors found kind and consistent care, but serious weaknesses in restrictive practices, staff training and people's rights.
This was an unannounced inspection. It began as a focused review of safe and well-led care after concerns about restrictions on people's freedom. Inspectors widened it to a comprehensive inspection after finding further concerns about training, culture and management knowledge.
The home supported 10 people with learning disabilities and communication difficulties. Inspectors found enough consistent staff, kind relationships and support with health care, activities, food and family contact. However, care was often over-protective and did not always help people build independence or make their own choices.
Inspectors found unsafe and unsuitable use of some restrictive practices. Records did not always explain what happened, staff were not all trained, and some paperwork used disrespectful language. Risk assessments, communication support, consent records and governance checks also needed improvement.
All five areas were rated Requires Improvement. This means the home was not consistently safe, effective, caring, responsive or well-led, and improvement was needed to meet people's needs. The previous overall rating was Outstanding, published on 30 May 2018.
Consistent staffing
There were enough staff, with low turnover and no agency staff being used. This meant people were supported by staff who knew them well.
“People were supported by enough, consistent staff. The provider increased staffing during the COVID-19 pandemic to allow for absences.” from the report
Kind relationships
Inspectors saw people receiving warm, compassionate support. Relatives and staff said relationships were strong and people appeared comfortable with staff.
“People received kind and compassionate care from staff which people understood and responded well to.” from the report
Health and medicines support
Staff noticed changes in people's health and involved health professionals. Medicines were managed safely and were reviewed in line with the principles of avoiding over-medication.
“The service ensured people's behaviour was not controlled by excessive and inappropriate use of medicines.” from the report
Family contact and activities
People were supported to enjoy activities, holidays and community links. The home also helped people stay in touch with relatives during the pandemic.
“People were supported throughout and prior to the COVID-19 pandemic to maintain contact with their family members and those important to them.” from the report
Restrictive practices
seriousSome restraints were not in line with training or best practice. Records did not always explain how long restraints lasted or their emotional impact, and staff training was incomplete.
“People were at risk of being abused through staff using restrictive practices and not following current guidance and not best practice.” from the report
Staff training
seriousStaff lacked important training about autism, learning disabilities, communication and health conditions. Inspectors also found that a new member of staff had not started the Care Certificate.
“People supported by staff who had not received adequate training to ensure support was in line with current legislation, standards and guidance.” from the report
Rights and independence
needs fixingThe culture was described as paternalistic and risk averse. People were not always supported to develop independence, pursue aspirations or make choices as adults, and shared bedrooms had not been regularly reviewed.
“Four people's choice and dignity had not been considered in relation to sharing bedrooms.” from the report
Management checks
needs fixingAudits were basic and had not identified key risks, including restrictive practices, infection control and health and safety checks. The home also lacked adequate legionella risk assessment and water testing.
“Governance processes were basic and had not identified key themes found during the inspection.” from the report
Communication support
needs fixingThe home did not fully follow the Accessible Information Standard. Alternative communication methods had not been properly explored or used consistently.
“Staff and management lacked awareness, training, skills and understanding of personalised communication system which considered people's processing abilities.” from the report
- 01What changes have been made to prevent restrictive practices, and how are any restraints now recorded, reviewed and discussed with the person?
- 02Has every staff member completed training in positive behaviour support, restrictive practices, autism and epilepsy, as the provider said after the inspection?
- 03How does the home help each person build independence, life skills, education, employment or other long-term goals?
- 04How are people's communication preferences recorded and supported using signs, objects, symbols, pictures or other methods?
- 05Have the shared bedrooms been reviewed with each person, and what choice do people now have if they want a private room?
The inspection began as a focused review of Safe and Well-led after concerns about restrictive practices, then widened to a comprehensive inspection covering all five key questions. This explanation was written from the published report of 23 July 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2018
Rated Outstanding; inspectors found exceptional caring and personalised support, with safe and well-managed care.
This was a comprehensive, announced inspection on 6 March 2018. The inspector spoke with four people living at the home, four relatives and nine staff. They reviewed three support plans and other records.
The home supported 10 adults with learning disabilities and complex needs. Inspectors found people were safe, had their health needs met and received suitable food and drink. Staff understood people very well and supported them to take part in activities based on their interests.
Care and support were rated Outstanding. The home was rated Good for safety, effectiveness and leadership. The home was also rated Outstanding overall, and had kept its Outstanding overall rating since the previous inspection.
Personalised activities
People were supported to enjoy activities and outings that matched their interests, including sport, music, animals and cooking. Staff also helped people build skills and confidence.
“People using the service were given opportunity to take part in a range of activities which contributed positively to their wellbeing.” from the report
Strong relationships
Staff understood people's communication and behaviour needs very well. Inspectors saw a calm atmosphere and strong relationships between staff and the people they supported.
“Due to the close relationships staff had built with the people they supported, staff understood and were able to respond to people's communication needs.” from the report
Family contact
People were supported to keep in touch with relatives and to visit them regularly. Relatives said communication with the home was good.
“People were able to stay in contact and regularly visit their families.” from the report
Safe use of restraint
The home had clear instructions and trained staff for situations where restraint might be needed. Any use was recorded so it could be reviewed.
“Restraint was only used when absolutely necessary for the safety of the person or other people in the service.” from the report
Open leadership
Staff said managers were available and listened to their ideas. The home used audits and feedback to identify improvements.
“There was an atmosphere of transparency and openness where staff felt able to offer their ideas and opinions” from the report
Medicines recording
minorA medicines audit had found some recording errors. Inspectors said people had not been put at risk, and the home updated records and arranged annual checks for staff.
“Although these were recording issues and people hadn't been put at risk, the registered manager told us they took steps to make improvements.” from the report
- 01How do you decide when restraint may be needed, and how do you review any incident afterwards?
- 02What checks are now in place to make sure medicines are recorded correctly every time?
- 03How will you make sure activities continue to match my relative's interests and changing needs?
- 04How do you involve people and their families in reviewing support plans?
- 05How do staff recognise and respond to changes in a person's health or behaviour?
This was a comprehensive inspection covering all five CQC questions and the overall rating. This explanation was written from the published report of 30 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Cocklebury Farmhouse
3 rated inspections over 7 years: the service has slipped, from Outstanding to Requires improvement.
- July 2022Requires improvementcurrent ratingdown from OutstandingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018Outstandingstayed OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- August 2015OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- October 2014
Registered with the Care Quality Commission on 22 October 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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