Background to this inspection
Updated
6 April 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2012, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
The inspection was carried out on 21 January and 29 February 2016 by one Inspector and was announced which meant that the registered manager was given a short period of notice due to the nature of the service. The purpose of this was to help facilitate the inspection and make sure that some people who used the service and staff members were available to talk with us.
Camphill St. Albans provides domiciliary care and support to people in their own homes. During the inspection we spoke with six people who used the service, five staff members, the registered manager and a senior representative of the provider (general manager). We spoke with three relatives and received written feedback from another 12. We also received feedback from social care professionals, stakeholders and reviewed the commissioner’s report of their most recent inspection. We looked at care and support plans relating to five people who used the service and three staff files.
Updated
6 April 2016
The inspection took place on 21 January and 29 February 2016. The visit was carried out by one Inspector and was announced which meant that the registered manager was given a short period of notice due to the nature of the service. The purpose of this was to help facilitate the inspection and make sure that some people who used the service and staff members were available to talk with us.
At our last inspection on 23 July 2013, the service was found to be meeting the required standards in the areas we looked at. Camphill St. Albans is a domiciliary care service that provides personal care and supported living for people in their own homes. Care is provided to people with learning disabilities, mental health conditions and other complex needs who live in privately rented houses and flats; the majority of which are situated within a mile radius of the registered office and St. Albans town centre. At the time of our inspection 31 people, who lived in 14 different properties, received care personal care and support.
The service is part of the Camphill Village Trust (CVT) which previously used a ‘life sharing’ model of support. This meant that in many cases staff members, known as ‘co-workers’, lived with the people they supported and their family members to provide care on behalf of the Camphill St. Albans CVT. However, people now receive care based on a ‘supported living’ model to help them live as independently as possible. This means that staff employed by the service visit people in their own homes, and elsewhere in the local community, to provide them with the support they need to help meet their individual health and social care requirements.
People are encouraged to view themselves and others who used the service as being part of a ‘community’ network, one that not only provides them with care and support, but also access to a range of local facilities relevant to their needs which include an art studio, allotments and café. However, people are free to decide the extent to which they use these facilities or join in with the wide range of other activities and social opportunities provided by the service.
There was a manager in post for the service who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The registered manager was supported by two assistant managers and a team leader in the day-to-day operation of the service. They were also supported by a senior representative of the provider, known as the ‘general manager’, based at offices in close proximity to the service.
During our inspection some relatives of people who use the service expressed significant levels of concern, disappointment and frustration about the way in which care and support was currently provided. In their view the service had, over a period of time, moved away from its original ethos and founding principles.
Some relatives felt that these change had a detrimental effect on the levels of care and support their family members received. A number of these concerns had already been raised with and addressed by the relevant local authority. People’s relatives and other interested parties have had a number of opportunities, over a long period of time and in different forums to discuss the changes made to the service, how it has evolved and how it currently operates.
The relatives of other people who use the service, together with social care professionals who provided us with feedback, were very positive about the service, staff who provided support and the overall quality of care people received.
Although people were supported to take their medicines safely by trained staff, medicines were not always managed in a safe and proper way. This was because the processes, systems and checks used to manage medicines were not as safe or effective as they could have been in all cases.
People told us that staff helped them stay safe, both in their homes and when out and about in the local community. Staff received training about how to safeguard people from abuse and were knowledgeable about the potential risks and how to report concerns. Robust recruitment practices were followed and there were sufficient numbers of suitable staff available to meet people’s care and support needs at all times.
Plans and guidance were in place to help staff deal with unforeseen events and emergencies in a safe and effective way. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.
People who received support, most relatives and social care professionals were positive about the skills, experience and abilities of staff employed at the service. Staff received training and refresher updates relevant to their roles. They had regular meetings with managers to discuss and review their personal development and performance.
People were encouraged and helped to maintain good health and were supported to access health and social care professionals when necessary. They were also encouraged and supported to eat a healthy balanced diet that met their individual needs.
Staff obtained people’s agreement and consent to the care and support they provided. They supported people in a kind and caring way that promoted their dignity. Staff had developed positive relationships with the people they supported and were clearly very knowledgeable about their needs and personal circumstances.
People who received support, and some of their relatives where appropriate, were involved in the planning and reviews of the care provided. The confidentiality of information held about people’s medical and personal histories was securely maintained at the service.
People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences and routines. People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at home and in the local community.
People who received a service and some of their relatives told us that the registered and general manager and staff listened to them and responded positively to any concerns they had. People were encouraged to raise any concerns they had and knew how to make a complaint if the need arose.