Cambian Lufton Manor College

Updated 9 December 2020

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.

This was a targeted inspection to check on specific concerns we had about staffing and safeguarding. 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

This inspection was carried out by one inspector. An Expert by Experience made phone calls to relatives following 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

Cambian Lufton Manor College main site and Manor Farm were part of the ‘care home’ registration. 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 service also provided care and support to people living in two ‘supported living’ settings, 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. The registered manager was the head of care.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with two students and carried out observations. We did have informal interactions with other students. We spoke with 11 staff members in detail and had informal conversations with others. This included the registered manager, the principal, the nominated individual and staff from various levels. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records whilst on site and further were looked at off site. This included one student’s care plan, safeguarding records, policies and procedures and records relating to the management of the college.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records, policies and procedures and information relating to the themes of the inspection. Following the site visit the Expert by Experience spoke with ten relatives on the phone.

Updated 9 December 2020

Cambian Lufton Manor College is a college for students aged 16 to 25 with learning disabilities or autism and other complex needs. The college is spread across two sites, the main house site and Manor Farm. On each site there are several communal areas plus accommodation buildings. There are also three community houses for students to develop independent living skills. Not everyone who lived in the community received personal care. The Care Quality Commission (CQC) only inspects where students receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

At the time of inspection there were 40 students receiving a regulated activity. There were also 15 day students who did not receive either regulated activity. Students were placed by 18 different local authorities. Many of the students had limited verbal communication skills to express their experience.

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 students who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for anyone with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. Students using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

The college was a large service, with many smaller buildings used for accommodation. The main house site and Manor Farm are registered for the support of up to 74 students. Over ten people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the layout and purpose of the college and the fact the accommodation buildings had capacity for up to six students.

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

Students were comfortable in staff presence and those able to tell us were positive about the support and care they received. Relative feedback was equally as positive. One student told us it was “Awesome” living with their friends and staff looked after them to keep them safe.

There had been significant improvements since the last inspection throughout many areas at the college such as staffing, safeguarding, health and safety, and quality assurance systems. However, it was not clear how sustainable these improvements were. Medicine management had improved although we made a recommendation to ensure the best practice was applied consistently.

Students were not always supported to have maximum choice and control of their lives and staff were not always aware how to support them in the least restrictive way possible and in their best interests. The policies and systems in the service were set up to drive improvement in this practice.

Students were still found to have actions taken when restrictions were placed on them to keep them safe by staff not fully understanding the legislation. One condition had been placed on an authorisation to restrict a student’s liberty without it being followed.

Staff were recruited in a way to keep students safe. The management were in control of driving improvements since the last inspection.

The service applied the principles of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion although at times these were not consistent with other legislation. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 inadequate (published 9 November 2019) and there were seven breaches in regulation. Following the inspection, we added conditions to the providers registration. This meant they had to provide a monthly report, so we could monitor the progress of improvements. At this inspection we found significant improvements had been made and the provider was now only in breach of one regulation.

This service has been in Special Measures since the last inspection in June 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to restricting student’s liberties in line with current legislation at this inspection. Please see the action we have told the provider to take at the end of this report.

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.