Cambrian

Updated 30 October 2019

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 Care Act 2014.

Inspection team

This inspection was conducted by one inspector.

Service and service type

This service is a supported living service. It provides personal care to people with a tenancy living in their own home within a communal building. This service provides care and support to 14 people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period of notice for the inspection because we needed to give people the opportunity to speak with the inspector.

What we did before inspection

We reviewed information we had received about the service since the service first registered with CQC. This included any statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted local commissioners of the service to gain their views. 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 of this information to formulate a ‘planning tool’; this helped us to identify key areas we needed to focus on during the inspection.

During the inspection

We spoke with seven people who used the service about their experience of the care provided. We spoke with six members of staff, one of the directors and the registered manager.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at one staff file in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records and information to show how staffing levels were calculated to meet people's needs.

Updated 30 October 2019

Cambrian provide personal care to people living in supported living. At the time of the inspection 14 people were receiving personal care. Supported living describes the arrangement whereby people are supported to live independently with their own tenancies.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service met the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Staffing levels had not been calculated to meet people's dependencies and packages of care. Following the inspection, the registered manager submitted evidence of peoples level of care to demonstrate they had suitable numbers of staff on duty.

We found that some processes needed improvement to evidence more effective quality assurance systems. Governance checks had not identified issues raised during the inspection with regards to managing staffing levels, reviewing the model of support within a communal environment and management of notifications. Following, the inspection the registered manager submitted appropriate updates to CQC.

We received positive feedback from people being supported. They told us staff were supportive and always consulted them about their support plans.

Support plans provided person-centred information, which included people's preferences and choices. We found that people were supported to maintain as much independence as possible.

People were protected from the risk of abuse or neglect. Staff were well trained in safeguarding vulnerable adults. Staff were skilled and knowledgeable. Systems and processes were in place to reduce the risk of harm. Thorough recruitment practices were in place to provide safe systems to ensure new staff were suited to working with vulnerable people. Staff recorded incidents and accidents in sufficient detail to aid analysis and reduce risk.

Medicines were well-managed and regularly audited to provide safe checks and support. Some people were supported to self-administer their medication.

We found that staff had received training in the Mental Capacity Act 2005 (MCA). People were supported to make their own decisions whenever possible.

The service was well-led. People knew who the registered manager was and felt able to raise any concerns with her. Staff told us that they felt well supported

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 January 2017)

Why we inspected

This was a planned inspection following the service's last rating of their inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.