Archived: Camden Park House

We found the following examples of good practice.

The service supported people in understanding risks related to the COVID-19 pandemic. When needed, staff gently reminded people about infection prevention measures. It was also discussed in people's one to one meetings with staff and in the home's residents' meetings. There was signage in the communal areas of the home reminding people about social distancing and other infection prevention measures.

There were suitable Personal Protective Equipment (PPE) available that was restocked weekly. We saw that staff were wearing masks when in the communal areas of the home. Staff encouraged more vulnerable people using the service to use masks in the communal areas so the risk of infection for them was reduced. Most people were happy with this arrangement and they wore masks as suggested. PPE was offered to visitors on the entry to the home. Hand sanitiser gels were available in staff offices and the main communal areas. We recommended that additional hand sanitiser gels were provided at the points of entry to the service and the corridors leading to people’s bedrooms. We also recommended that the sink in the staff office, which was used for the visitors to wash their hands on their arrival at the home, was solely used for this purpose.

All staff and all but one person using the service were participating in the care home testing programme. All professionals and people’s visitors visiting the home were offered lateral flow testing for COVID-19 (short term tests providing immediate results). They were required to do the test before conducting their visit at the home.

There was a cleaning regime at the home to ensure people lived in a clean environment. The domestic member of staff undertook wide-ranging cleaning tasks throughout the week. The home’s night staff were tasked with the cleaning of the service during the weekend. Staff were following a service users' room cleaning rota to ensure each person’s room was cleaned regularly. In one case, due to the person's vulnerable health, staff cleaned their room daily. This ensured the risk of any infection was further reduced.

The registered manager carried out daily visual checks to ensure staff and people using the service followed infection control and prevention measures. We recommended that these checks were recorded for audit and future reference purpose.

People told us they were happy with the service they received and they felt safe with staff who supported them. The registered manager and staff told us they aimed to support people to live an independent life as much as possible. We saw that people were encouraged to make an active contribution and decisions on how they would like staff to support them.

We identified some issues related to cleanliness of the service. This had been addressed shortly after our visit.

There were numerous systems in place to ensure people were safe and protected from harm from others. There were relevant and up to date risk assessments in place to guide staff on how to provide safe care. The procedures around medicines management were in line with current national guidelines, and staff had ensured people received their medicines safely. Appropriate recruitment procedures protected people from unsuitable staff.

There were enough staff deployed to support people to ensure people’s needs had been met with no unnecessary delay.

New staff had received appropriate induction to the service and their role before they started supporting people unsupervised. All staff were provided with regular training and supervision to help them to support people safely and effectively.

People were asked for their consent and encouraged to make decisions about their care and treatment. People’s voice had been heard across all areas of the service delivery. The staff team believed this was crucial in ensuring care and support provided was relevant to people and accepted by them.

People’s needs were assessed regularly and formed the base of their risk assessments and care plans which were referred to as goals. People’s goals were person centred and reflected matters that were most important to them. People said they could discuss any matters in regular meetings with their care workers.

We observed that staff when supporting people were kind and caring and people told us they felt respected. Staff knew people’s needs well and encouraged people’s independence at the same time respecting if people chose to turn down the support.

People, relatives and external stakeholders were encouraged to give feedback about the service they received, this was done through discussions in individual meetings, regular customers meeting, a suggestion box or a complaints procedure. We saw that complaints had been dealt with promptly.

The service was described by staff as well led. Staff told us the registered manager was supportive and encouraged professional development and participation in the service delivery.

There was a range of monitoring systems in place used by the registered manager to ensure the service had been provided effectively.

More information is in Detailed Findings below

Rating at last inspection: Good (report published 12 April 2016)

About the service: Camden Park House provides accommodation and personal care for up to 13 people who need support to maintain their mental health. At the time of our inspection there were 12 people using the service.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the home and we will revisit it in the future to check if they continue to provide good quality of care to people who use it.

We carried out an unannounced inspection on the 2 March 2016. At our last inspection on 12 September 2014, we found the standards inspected were met.

Camden Park House provides accommodation and personal care for up to 13 people who need support to maintain their mental health. At the time of our inspection there were 13 people using the service.

There was a registered manager in place at the time of the inspection. 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.

We found that the registered manager and staff worked in partnership with local mental health and social care teams to provide a person-centred service that encouraged independence. There was strong emphasis on social inclusion through organised activities as well as supporting people on a one to one basis in order that they were able to lead purposeful and meaningful lives and thus enhancing wellbeing.

Throughout the course of our inspection we observed staff treating people in a respectful and dignified manner. Staff as well as people themselves managed to create a homely and safe environment and people told us they very much considered it their home.

Staff received training on equality and diversity and aspects of peoples unique needs relating to this were included in peoples care plans, including race, sexual orientation and beliefs

There were systems in place to safeguard people and staff had a good understanding of the different types of abuse and how they would look out for signs of abuse.

Risk assessments formed part of the person’s agreed care plan and covered risks that staff needed to be aware of to keep people safe.

People had a Personal Emergency Evacuation Plan on their record (PEEP). Their PEEP identified the level of support they needed to evacuate the building safely in the event of an emergency.

Recruitment practices ensured staff were appropriately checked prior to employment to ensure they were suitable to work with the people using the service.

Medicines were stored, administered and recorded appropriately by staff who had undertaken relevant training.

There was sufficient mandatory training available to staff to support them with their role as well as the provider offering a number of specialist training courses for example, mental health, dementia, self-harm and diabetes.

Staff understood the principle of the Mental Capacity Act 2005 (MCA) and the Depravation of Liberty Safeguards (DoLS) and had received regular training.

People were supported to eat drink and maintain a balanced diet and were actively involved in menu planning as well as assisting in the kitchen. They received the food they liked and requested.

People were supported to keep well and had access to the health care services they needed. Care plans which identified their assessed needs and set out how to support them appropriately.

A copy of the complaints procedure was on display on the notice board at the service. Staff knew how to support people appropriately to make a complaint.

There was evidence of regular audits and surveys undertaken to ensure the service was providing high quality care and support.

There were opportunities for people’s voices to be heard. Regular house meetings were organised for people to share there views and contribute to change.

During our inspection on 3 June 2014, we found that the service was not meeting essential standards relating to the safe management of medicines. The provider submitted an action plan detailing what they would do to meet the standard. During this visit, on 12 September 2014, we checked whether the provider had carried out the actions and whether the standard was now being met.

We found that the provider had implemented a system of checks to ensure that medicines were administered appropriately and safely. Changes had also been made to the way people received their medicines, and how these were documented. There had been no medication errors since our previous visit.

As part of this inspection we spoke with six people who used the service, three care staff, the registered manager and an area manager from One Housing Group Ltd who own the home. We also reviewed records relating to the management of the home which included three care plans, daily care records, the records about the management of medicines and records about how the home monitors its own performance and the quality of care.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed during the visit and what we saw in the records we looked at.

Is the service safe?

There were enough staff on duty to meet the needs of people living at the home on the day of our visit.

There was a comprehensive plan in place for dealing with a wide range of foreseeable emergencies. This set out actions that would need to be taken and emergency contact details of additional staff, management and emergency services.

Staff records contained all the information required by the Health and Social Care Act 2008. This meant the provider could demonstrate that staff employed to work at the home were suitable and had the skills and experience needed to support the people living there.

CQC monitors the operation of the Deprivation of Liberty Safeguards. Whilst no application had needed to be submitted, staff had been trained on the requirements of the legislation and knew when an application should be made.

We found mistakes in processes used to record how medicines were given to people and accounted for. The incident book showed that previous incidents about medicines had been recorded correctly and where appropriate external agencies had been informed. However action plans drawn up as a consequence had not resolved the issues and mistakes were continuing to be made.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. One person told us, 'the staff are all really helpful'. Another person said, 'staff help you to do things; getting me out and about and cooking.'

It was evident from the records we saw and the conversations we had with staff that they understood people's care needs and knew what to do to support people to prevent their mental health from deteriorating.

We saw that people had signed to say that they consented to the care and support provided and people told us that they were fully informed about their care, their rights and the conditions of living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were courteous in their communication with people and had good relationships with people who used the service. People told us that the staff were 'very good and very helpful.'

Is the service responsive?

People's needs had been fully assessed and care plans drawn up on the basis of these needs. People told us that they met their key workers regularly. We saw from the files that clear goals had been set towards helping people achieve their aspirations and work towards greater independence where appropriate.

Care and support plans were modified when people's needs changed. People told us that the staff listened to their concerns and wishes and took action accordingly.

Is the service well lead?

Staff had a good understanding of the ethos of the home and the quality assurance processes that were in place. Staff were clear about their roles and responsibilities.

There was a recruitment process underway for permanent staff at the time of our inspection.

Feedback from people using the services was welcomed. One person said; 'staff listen to our views at the house meetings; we bring up things that need doing in the house and about meals.' Processes for carrying out customer satisfaction surveys was being adapted to improve the quality of information collected. Feedback from other stakeholders had led to changes; we were told that waking night staff had been introduced in addition to sleeping in cover in response to comments made.

We judged that this had a moderate impact on people using the service. We set compliance actions requiring the provider to take steps to comply with Regulations 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

When we inspected this time we found that the provider had taken sufficient action to ensure people who use the service were protected from the risk associated with the medicines.

At the time of our inspection, there were eleven people living at Camden Park House. People told us that they felt they were supported well and that their care needs were met. One person, when talking about staff said, 'they are all nice, they are friendly'. Another person said they 'like it here, we all get on well', when talking about other people who live in the home.

Care plans and risk assessments were up to date and sufficiently detailed. People were supported to express their views during weekly house meetings, key working sessions, or by participation in a customer survey.

Staff attended safeguarding training and had protocols and policies in place which informed them how to prevent people from abuse, and respond appropriately to concerns.

We noted that safe medication management practice was not followed. Staff did not always seek appropriate advice in relation to medication.

There was a sufficient number of knowledgeable and suitably qualified staff. A member of staff told us 'the team is good, we have more than enough staff and we all fit well with clients.'

The provider had systems in place to monitor quality of the care provided at the service.