An unannounced inspection was carried out of Cambian -The Fields on Wednesday 7th 2014. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people using the service, and the staff told us, what we observed and the records we looked at during the inspection.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People's needs were assessed and treatment was planned with the help of individuals and their representatives. Care files we checked confirmed that initial assessments had been carried out by experienced staff before people were accepted into the service. This was to ensure the service could meet identified needs, thereby promoting their safety
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The aim was to promote independence and help people become involved in the community and improve their leisure and work opportunities in a safe way. People told us the care workers were their 'mates'.
People were looked after and cared for by staff who were suitably qualified, skilled and experienced. We checked staff supervision and training files and found the provider had made arrangements to ensure staff received training and sufficient supervision so that people received care which was safe and appropriate.
Is the service effective?
During our observations we noted that people's views and experiences were taken into account and their privacy and dignity was respected by staff. Staff listened to people; they explained the choices available to them in the way people found it easy to understand. We saw staff explaining each time when they carried out care tasks.
Although some people have had assessments of their capacity and deemed needing help to make decisions, none of the people at the home had been referred to be deprived of their liberty to safeguard them from harm. The manager told us the assessment of people were ongoing. This meant people's changing needs were recognised and assessed to meet their needs.
People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and they knew how to meet them.
Is the service caring?
We were informed by people and care staff that people were able to express their views and be involved in making decisions about their care and treatment each day. They were able to change their mind and not be worried. Care workers appreciated and respected their wishes.
People were supported by staff who were attentive and friendly. We saw care workers showing patience and gave encouragement when supporting people. We observed people were able to take their time, do things at their own pace and were not rushed. During administering medication we observed staff staying with people and making sure they had taken the medicine without rushing them.
People's care and treatment was planned and delivered in a way that protected them from unlawful discrimination. This is because staff had received training and received supervision to make sure staff followed the correct procedure when caring for people.
Is the service responsive?
People's views and experiences were taken into account and their privacy and dignity was respected by care workers who looked after them. The manager told us that they were looking into obtaining disabled parking permits for those who were entitled to them, so people could be more independent. We observed staff supporting people and promoting their independence and community involvement. People went out in a mini bus on the day of our inspection. This was because the weather was sunny and staff decided to take people out instead of carrying on with indoor activities. People were very happy to go out.
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Appropriate professionals were involved at the correct time to make sure people were in receipt of appropriate care and treatment promptly.
Records confirmed people's preferences, interests, aspirations and diverse needs had been taken into account when care and support had been provided in accordance with people's wishes.
Is the service well-led?
People's views and experiences were taken into account and their privacy and dignity was respected in the way people were cared for. We witnessed this during our inspection. We also saw evidence that people who used the service understood the care and treatment choices available to them. They were explained to by staff and people were happy to take part and get involved.
People's needs were assessed and care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People's care needs were followed up by risk assessments to make sure the plan of care minimised the risk to people.
There were arrangements in place to deal with foreseeable emergencies. This included during adverse weather condition transporting staff to and from their homes so that people would continue to receive appropriate support and care.
The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.
Staff had a good understanding of the ethos of the home and quality assurance processes which were in place. We saw the outcome of the last customer satisfaction survey. The comments by people and their relatives were positive. Staff told us they were clear about their roles and responsibilities. They said the management had listened to them and had implemented changes. Staff told us they were well supported to do their jobs by the manager and the deputy.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.