The Mount Camphill Community

The service also provides living accommodation in five houses, four on site and one within a short walking distance from the community. At the time of the inspection there were 18 people staying at the college in three houses all of whom were aged 18 or over and a further 9 people living in two houses receiving personal care. Although the two parts of the service were separate, they shared the same staff leadership team and the same policies and procedures.

We found the following examples of good practice.

There had been an outbreak of COVID-19 at the service which resulted in staff and one resident being supported to isolate for 14 days before re-testing. Despite there having been up to 70 staff and people on site the service had managed to prevent the spread of the virus. At the time of the inspection the period of isolation needed following the outbreak had ended.

Staff spent time with people reassuring them. Staff had managed anxieties and communication challenges caused by wearing personal protective equipment (PPE) by creating a safe distance between them to occasionally lower their mask to speak and show facial expressions. This helped reassure people and helped them recognise and understand staff.

PPE and hand sanitisers and posters with key messages were at the entrance to all buildings and used PPE was safely disposed of. Any visitors to the service had to show a negative COVID-19 test within the previous 24 hours. Staff were responsible for daily cleaning of all areas of the service including frequently touched and high reach areas. The service was clean throughout. All staff had completed training in infection prevention and control.

The service was set in a large rural area and usually benefitted from communal activities for example, open days, summer fairs and events associated with Christmas and other festivals. During the pandemic, although these events could not take place, the service still ensured there were activities for people. For example, an art therapist regularly attended as did a local pianist. All activities were conducted observing social distancing guidelines. Staff and people used technology for virtual meetings, annual health checks and to enable people to maintain contact with families and loved ones.

Similarly, government guidelines had been followed for family members to visit. An area in the garden had been put aside to facilitate visits with people maintaining social distancing and wearing PPE. Rooms at the service had been further risk assessed to calculate the maximum number of occupants who could safely enter. This was clearly marked on every door and offices had large Perspex screens separating workstations.

Risk assessments had been carried out for all staff and people. The service supported several people who were clinically vulnerable to COVID-19. Risk assessments included for example, where people were unable to take part in some group activities they were supported with alternative, individual activities for example, walking in the grounds of the service, or using online tools and activities.

At the time of the inspection staff and people were being tested twice a week. The registered manager kept records of all tests and results.

Contingency plans were in place and lessons had been learned from the pandemic. Some aspects of reviews and pre-assessments were now done via video calls. People were using video calling more frequently to keep in touch with loved ones which had helped relieve some anxiety caused by separation.

The Mount Camphill Community is a residential home providing accommodation and personal care for 30 people. The service is split into an independent specialist college for people with learning disabilities that provides education and learning for people aged 16 to 25 to promote and develop their independence. This part of the service runs during term time only. The service also provides living accommodation in five houses, four on site and one within a short walking distance from the community. At the time of the inspection there were 20 people staying at the college all of whom were aged 18 or over and a further 10 people living in the five houses receiving personal care. Although the two parts of the service were separate they shared the same staff leadership team and the same policies and procedures. The students in the college reside in three of the five houses and people who only receive personal care reside in two of the houses.

The service has been developed and designed in line with 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

People told us that they felt safe and protected from harm and abuse. The service had a safeguarding manager and all staff had been trained and were able to tell us what amounted to abuse and the steps they would take if necessary. Staff were aware of the whistleblowing policy. Accidents and incidents were reported, recorded and causes analysed with learning being taken forward. All safety checks were up to date. People were supported with their medicines. Bespoke risk assessments were in place for people and were subject to regular reviews.

A comprehensive induction process involved staff living within the community and getting to know people and the role. Staff had been safely recruited and ongoing support was provided through supervision and appraisal meetings. All staff training was up to date and regular refreshers had been completed. People had annual health checks and were supported throughout the year to access health and social care professionals. People were encouraged to help prepare meals and everyone was provided with choice of healthy foods appropriate to them. Mental capacity assessments and best interest meetings had taken place where appropriate and Deprivation of Liberty Safeguards were in place for some people. People were given choice and opportunities.

People’s dignity, privacy and independence were all respected and promoted. A relative said, “No words to thank them enough. (My loved one) is a different person, they understand their surroundings, they are positive and their speech has improved tremendously.” People were treated with respect. We saw everyone being included and involved in conversations and activities and everyone looked happy and content.

Person centred care was practised and staff knew people well. People were involved in a range of activities across the community. The college provided individual study programs that people could access which included a variety of academic, physical and practical elements. There was a range of on-site activities for example, gardening, pottery, baking and carpentry. A relative said, “It’s opened (my loved one’s) eyes to whole new world, I would recommend this place to anyone.” A complaints policy was in place and was accessible to people and relatives and everyone knew how to complain and raise concerns if needed.

Everyone spoke well of the registered manager who provided a positive and visible presence throughout the service. Auditing processes were in place and were all carried out or were overseen by the registered manager. Feedback was sought from people and relatives / guardians in the form of meetings and questionnaires. Feedback was also sought from staff and professionals. The service is set in a rural setting but maintained strong links with the local community

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

Rating at last inspection

Good. (Report published 15 February 2017)

Why we inspected

This was a planned inspection based upon the previous rating.

Follow up

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

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.

There were safeguarding policies in place and staff were aware of the safeguarding procedures in relation to safeguarding children and adults and all were aware of the need to inform the manager or senior staff immediately.

Staff were recruited correctly using safe checks such as criminal records (DBS). There was an induction programme in place which included training staff to ensure they were competent in the role they were doing. Staff received on going and regular training to enable them to work safely and effectively.

Staff knew what to do if any difficulties arose whilst supporting somebody, or if an accident happened. Incidents and accidents were recorded and learned from.

The provider complied with the Mental Capacity Act 2005 and its associated codes of practice in the delivery of care. We found that the staff followed the requirements and principles of the Mental Capacity Act 2005 (MCA). Staff we spoke with had an understanding of what their role was and what their obligations where in order to maintain people’s rights. The service was providing support to people who did not have the capacity to make their own decisions in different areas of their lives and required staff support.

The opinions of people who spoke with us were that the service was good. People told us they were happy with the staff and felt that the staff understood their educational, care and support needs. All of the people we spoke with had no complaints about the service.

The staff employed by The Mount Camphill Community knew the people they were supporting and the care they needed. People and the staff told us that the community was well led and staff told us that they felt well supported in their roles. We saw that the registered manager and senior staff had a visible presence and it was obvious that they knew the people who they supported and cared for really well.

We inspected records and concluded that record keeping was exemplary and well planned. Information was updated as required and intervention from outside agencies was timely.

We saw that people were actively involved in planning all activities within Mount Camphill, including meal preparation and the planning of healthy diets.

We saw that medication was stored correctly and that procedures were in place which managed medications in a safe way. From speaking with staff we could be sure that the management of medication was taken seriously, whilst still seeking to empower people.

We saw that staffing levels were appropriate with trained staff who were regularly supervised and monitored. We spoke with staff who confirmed that the training they received was timely and appropriate to the tasks required of them.

We observed staff assisting people in making choices and in offering choices, such as a choice of food. We read in people's records how their wishes, likes and dislikes were taken into account in their care and support plans.

We saw detailed care plans and risk assessments and saw that people were helped to be involved in their care planning and in expressing their wishes. We read that plans had been put in place which involved families and external professionals in making major decisions for some people.

We read recent annual surveys of people, families and carers, outside professionals and staff. Actions were placed against areas where people had raised issues.

We looked quality assurance and governance systems and found that there were suitable processes in place to monitor and improve the service.