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Inspection carried out on 24 January 2018

During a routine inspection

Cambria House is a residential care home for eight people with learning disabilities or autistic spectrum disorders. At the time of the inspection, seven people were living at the home. Accommodation is provided within a large detached house with communal areas, lounge, dining room and kitchen with a secure garden to the rear of the property and is located close to the town centre of Winchester. The service is not registered to provide nursing care.

There was not a registered manager in post. The previous registered manager had left the service the week before this inspection. The service had engaged a new manager and their application to become registered manager for this service was being processed by the Care Quality Commission. 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

There was a strong emphasis on enabling people to live their lives to the full and to be fully involved in all aspects of the care and support they received.

People had excellent community links and regularly enjoyed trips to the theatre, cinema, pubs and other local services. They were able to follow their own interests and hobbies and enjoy an active social life.

The service had taken appropriate steps to protect people from the risk of abuse, neglect or harassment.

People received their medicines safely. People’s medicines were reviewed regularly by their GP and specialist health care providers.

People had access to health care and staff ensured that they saw specialists. For example, consultants, occupational therapists, dieticians, dentists and opticians.

There were enough suitable staff deployed to meet people’s needs.

People's needs were assessed and care plans in place. People received appropriate care and support because care plans were detailed and responsive to their needs.

Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others.

Accidents and incidents were monitored and analysed and action taken to reduce risks.

Staff received induction, training and supervision that helped them to deliver good levels of care and support. Staff were trained in principles of care in relation to people living with a learning disability and specialised care of people who also lived with a physical disability.

People were supported to eat and drink according to their likes and dislikes.

Consent was sought, where possible. The service followed the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff displayed a caring attitude and were affectionate, empathic and kind. People in the service responded warmly to them. Staff understood how to support people to maintain their dignity and privacy.

People received care and support which ensured they were able to make choices about their day to day lives.

People were supported to engage in activity programmes both in the home and in the community.

People knew how to complain and there were a range of opportunities for them to raise concerns with the registered manager and designated staff.

Inspection carried out on 21 September 2015

During a routine inspection

Cambria House is a service registered to provide accommodation and personal care for eight adults with a learning disability or autistic spectrum disorder. The people living in the service had complex needs and sometimes demonstrated behaviour which may challenge others. At the time of our inspection there were eight men using the service. Accommodation is provided within a large detached house including a garden and located close to the town centre of Winchester.

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.

Staff had completed safeguarding training. They understood how to recognise the signs of abuse and knew how to report their concerns if they had any. There was a safeguarding policy in place and records showed action was taken to keep people safe. People behaved in a way that indicated they felt safe and relatives told us people were cared for safely.

Risks had been appropriately identified and addressed both in relation to people’s specific needs and in relation to the service as a whole. Staff were aware of people’s individual risk assessments and knew how to mitigate the risks. Risks were monitored and reviewed and staff took actions to protect people from harm. People lived in an environment where they felt safe and were able to develop skills and confidence in leading their lives.

There were enough staff on duty to meet people’s needs and care for people safely. Recruitment was underway to achieve a full complement of staff. Staff vacancies were covered by existing staff who knew people well. People were cared for by staff who had undergone the required pre-employment checks to ensure their suitability.

Medicines were administered safely by staff that had been trained and were competent to do so. There were procedures in place to ensure the safe handling and administration of medicines.

Staff were supported in their role by the registered manager and completed a range of training to meet the specific needs of the people they supported.

Where people lacked the mental capacity to make specific decisions staff were guided by the principles of the Mental Capacity Act 2005. This ensured any decisions made were in the person’s best interests. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLs applications had been submitted for people to ensure restrictions on their liberty, to keep them safe, were legally authorised.

Staff involved people in meal choices. People were encouraged and supported to make their own meals where possible. Staff supported people to eat healthily and monitored their food and fluid intake to improve their health and wellbeing.

People’s health needs were met. The service worked with a range of health professionals to ensure effective health care was provided for people. This included working with a psychologist to develop and monitor the strategies used to support people to manage behaviours that might challenge.

People and their relatives told us staff were caring. People were supported by staff to do the things that were important to them and their choices were respected. Staff knew how to meet people’s needs and showed this through their caring actions and interactions with people. People were treated with dignity and respect by staff.

People were involved in developing their care plans to meet their individual needs and goals. The approach used with people helped them to manage behaviours which might challenge others, improve their quality of life and reduce anxieties. Care plans were reviewed with people and their families to ensure the strategies used to support people remained effective and led to positive outcomes for people.

People were supported to participate in a wide range of activities which reflected their individual preferences and interests.

Feedback from people, their relatives, staff and other professionals was used to monitor and improve the quality of the services. The registered manager and the provider operated systems to ensure the quality of care people received was reviewed and improved as required. Staff reflected the values promoted by the provider in their work with people. These included; treating people with dignity and respect and being committed and passionate about people achieving their person centred outcomes.

Staff spoke positively about the support they received from the registered manager. Regular staff meetings were in place and plans to drive improvement in the service were acted on. The registered manager was accessible to staff and people and they encouraged a positive atmosphere in the home. The registered manager ensured staff were aware of their responsibilities to the people they supported.

Inspection carried out on 30 August 2013

During a routine inspection

We found that the service supported people�s care and welfare effectively, by developing detailed care plans and monitoring people�s needs regularly. People were supported to develop their life skills and took part in a wide range of activities in line with their interests and goals. We observed that people using the service interacted well with staff and procedures were in place to keep people safe. These included procedures relating to the administration of medicines.

The service�s recruitment procedure was robust so that staff were assessed prior to their employment. People using the service were also involved in interviewing applicants.

We found that the service cooperated effectively with other providers of health and social care, to support people living at the service.

Inspection carried out on 30 November 2012

During a routine inspection

When we visited we spoke with the registered manager, three people using the service and two staff. We also looked at a range of documents. We found that staff involved people in their care and asked for their consent before providing care or support.

People experienced care and support that met their needs and protected their rights. Their care plans were individualised and reflected people�s specific needs, interests and wishes. Arrangements were in place in case of emergencies. One person showed us what was in their care plan, and said �We spent a long time on this bit� when discussing a particular aspect of their plan.

The environment was clean and people were protected from the risk of infection because appropriate cleaning and infection control measures were in place.

People were cared for by staff who were received appropriate training and support in their roles. One person said they would rate the staff �10 out of 10.�

There was an effective complaints system available, that staff and people using the service were familiar with. One person said, �I know how to make a complaint, and I have made one in the past. I had the right result.� Comments and complaints people made were responded to appropriately.

Inspection carried out on 10 February 2012

During a routine inspection

People said that they felt safe and that they liked living at Cambria House. One person said �it�s alright here�. They said that staff were good and said that staff let them choose what they wanted to do. During our visit we spent time in some communal areas observing the support that people received. We saw that staff interacted with people in a friendly way. Staff demonstrated through their responses that they had a good understanding of people�s interests, needs and wishes

Reports under our old system of regulation (including those from before CQC was created)