The Hatch Camphill Community

People had tenancy agreements for their home and support plans in respect of the care and support they received. A housing association managed the tenancy agreements. People could choose whether they wanted their care from staff working at The Hatch but could also choose another care provider. At the time of our inspection 30 people with a learning disability were receiving care and support.

There were three houses situated in close proximity of each other St Johns House, Thornbury Cottage and The Hatch House, one a short walk called Watch Oak Lodge and the other in the centre of Thornbury. The main office was separate from the houses but in the grounds of The Hatch.

Not everyone who used the service received personal care. CQC only inspects where people 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.

The service has evolved and 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 received care that was safe, effective, caring and extremely responsive. People and their relatives spoke extremely positively about the support they received. There was sufficient staff to support people who had the necessary skills and commitment to provide care that was extremely person centred. Staff and people lived and worked together as equals and in partnership.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People had information in a format to suit them as individuals enabling them to make decisions about the care and support they needed.

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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. The service was extremely responsive in this area encouraging people to be fully integrated in life at The Hatch and the wider community.

People were supported by staff that were extremely caring in their approach enabling them to lead the life they wanted. This included supporting people to keep in contact with friends and family. People led People were supported to make decisions not only about their care but life at The Hatch. People had a sense of belonging, ownership and a mutual respect for each other.

The service was well led. There were systems to check and monitor the quality. This again involved people, staff, family and other stakeholders.

The service was continually evolving to meet the needs of people enabling them to continue to live the life they wanted. This included keeping under review the extensive range of activities, work experience and the staffing arrangements. Consultation and involvement were very much embedded into this service ensuring positive outcomes for people.

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

Rating at last inspection. The last rating for this service was good (published February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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.

The Hatch is part of the Camphill Communities which is an international organisation. The ethos of the service is based on a 'life sharing' model of support. This meant that in some cases staff members and their families lived with the people they supported. People viewed The Hatch as their home and care was based on a ‘supported living' model to help them live as independently as possible. People had tenancy agreements for their home and support plans in respect of the care and support they received. A housing association managed the tenancy agreements. People could choose whether they wanted their care from staff working at The Hatch but could also choose another care provider. At the time of our inspection 29 people with a learning disability were receiving care and support.

There were three houses situated in close proximity of each other St Johns House, Thornbury Cottage and The Hatch House, one a short walk called Watch Oak Lodge and the other in the centre of Thornbury. The main office was separate from the houses but in the grounds of The Hatch.

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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. These included workshops such as woodwork or weavery. There were extensive grounds which people took an active role in growing vegetables. People were able to decide to what extent they wanted to participate in these activities or join in with the wide range of other social activities provided by the service. People were also supported to be part of the wider community and attend colleges and other social events in the local area. People lived and worked alongside each other and were actively involved in the day to day chores of running a home which promoted a sense of community.

There was a registered manager in post. 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.

Care plans were tailored to the person and provided staff with information to support the person effectively. People had been consulted about their care needs and their views sought about the service. People were supported to make decisions and take proportionate risks. Systems were in place to ensure that complaints and any concerns in respect of abuse were responded to. People had access to other health and social care professionals. People confirmed they could access an advocacy service if they wanted. Safe systems were in place to ensure that people received their medicines as prescribed.

We found the provider had ensured people’s homes were safe and comfortable. The Care Quality Commission’s role in these settings was to focus on the regulated activity of personal care and had no regulatory responsibility to inspect the accommodation for people living in these settings. Environmental risk assessments had been completed.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management and safe recruitment processes.

Staff were caring and supportive and demonstrated a good understanding of their roles in supporting people. Staff received training and support that was relevant to their roles. Systems were in place to ensure open communication including team meetings and one to one meetings with their manager. Staff were committed to providing a service that was tailored to each person they supported. Staff were enthusiastic and worked with people to enable them to achieve positive outcomes. They understood their roles in relation to encouraging people’s independence whilst protecting and safeguarding people from harm.

People were involved in the day to day running of the service. People were valued and supported to be as independent as possible. People’s rights were upheld, consent was always sought before any support was given. Staff were aware of the legislation that ensured people were protected in respect of decision making and any restrictions and how this impacted on their day to day roles.

People’s views were sought through care reviews, meetings and surveys and acted upon. Systems were in place to ensure that complaints were responded to and, learnt from to improve the service provided.

People were provided with a safe, effective, caring and responsive service that was well led. The organisation’s values and philosophy were clearly explained to staff and there was a positive culture where people felt included and their views were sought. The registered provider was aware of the importance of reviewing the quality of the service and was aware of the improvements that were needed to enhance the service.

A co-worker told us they felt that The Hatch offered people 'really good opportunities'.

People were involved in the running of the service and were given appropriate information about their tenancy. People's needs were assessed and they were provided with the support they needed. Appropriate records were maintained. People had active lifestyles with opportunities for employment and activities. Where they were able, people took their medicines with prompts from staff. Other people were supported to take their medicines by staff. There were effective arrangements for the recruitment of staff and monitoring the quality of the service.

One of the staff we met told us they felt things had changed for the better since the new manager was appointed. We met with some visitors. They told us they were very happy with the support their relative was given. They felt the accommodation and support were superior to some they had considered before their relative moved to The Hatch. They said their relative seemed much calmer since the move and always looked forward to returning to The Hatch after holidays with the family. There were a range of tools available for staff to use to enable them, to communicate with people who had limited verbal communication skills. People were encouraged to develop support networks to advocate for them when consent decisions were difficult.

People told us about the way they lived, the activities they participated in and their hobbies. We saw they were supported appropriately by staff and volunteers who had been recruited safely. Staff were supported and had opportunities for training to assist them in their role.

People knew how and to whom they could complain. Complaints were investigated appropriately.