Carmel Care & Support Limited Camborne

About the service

Carmel Care & Support Limited Camborne is a supported living service which supports people with learning disabilities and autistic people. The service supports people living in 3 different settings in Camborne. Two settings were shared houses where people had their own bedrooms with shared cooking, lounge and bathroom facilities. The other setting consisted of bedsit style flats where each person’s accommodation was self-contained.

At the time of our inspection 19 people were living in these settings, 16 of whom received support with 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.

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

Right Support

The model of care did not maximise people’s choice, control and independence. 2 of the 3 settings inspected were operating as if they were care homes as opposed to supported living settings. Rolling staff rotas had been developed which improved staff wellbeing but restricted people freedoms and choices. There was limited evidence people were supported to do as much as possible for themselves and in one setting a communal weekly menu was in use. This indicated people’s choices in relation to meals was limited.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Staff and managers did not fully understand their role in assessing people’s capacity to make specific decisions. Where people lacked capacity and there were restrictive care practices in place these practices had not been reported to the local authority.

People were supported to participate in work placements and encouraged to access the community independently where possible.

The service appropriately supported people to raise concerns about their rooms with the accommodation provider.

Right Care

The provider had not safely supported people with their medicines. Medicine administration records had not been accurately completed and staff had not been provided with clear guidance on the use of ‘as required’ and emergency medicines.

Staff cared for the people they supported and understood their role in ensuring people were protected from all forms of abuse and discrimination. People’s decisions and choices were respected.

Staffing levels had recently improved and, with support from agency staff, the service had been able to consistently provide the level of support people required. Recruitment practices were safe.

The providers infection prevention and control procedures were appropriate, and staff used PPE in accordance with current guidance.

Right Culture:

The service did not have a registered manager and there had been significant management changes in recent months. A new acting manager had been appointed two weeks prior to the inspection. Staff and relatives were complimentary of the new managers approach.

There were appropriate staff induction procedures in place and staff training had been regularly updated to ensure staff had the skills necessary to meet people’s needs. Staff told us they were well supported by the new manager.

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 the service was Good published on (20 July 2021). At this inspection the services rating has changed to Requires Improvement.

Why we inspected

This inspection was prompted by information we had received which indicated there had been issue in relation to management turnover at the service.

As a result, we undertook a focused inspection of Carmel Care & Support Limited Camborne to review the key questions of Safe, Effective and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carmel Care & Support Limited Camborne on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the management of risks and the assessments of people’s capacity to make specific decisions at this inspection.

Please see the action we have told the provider to take at the end of this report.

We have also recommended the provider seeks advice on how to ensure the service provides support in line with current best practice.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Carmel Care and Support Limited Camborne supports people living in the community in two houses in the town of Camborne. At the time of the inspection fifteen people were being supported.

People were tenants in houses located in residential streets. People had their own bedrooms. Some had their own bathrooms, others shared bathrooms. There were communal areas and gardens. The houses were staffed to support people 24 hours a day.

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

Effective auditing systems identified errors or failings in the operational systems being used. This had enabled swift action to be taken in order to improve medicine systems to ensure they were safe. Quality assurance processes ensured people were able to give their views of the service and improvements made when they were identified.

People’s independence would be improved if the service provided more cookers. This would support people to make their own meals either independently or with support. We have made a recommendation about this in the effective section of this report.

Care and support was planned to ensure that people’s needs, and wishes were taken into account. Risks were assessed and carefully monitored to ensure individuals safety.

People received support with their healthcare and nutritional needs. They 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.

Staff had access to a range of training which helped to ensure people received good care and support, in accordance with their needs. Community health and social care professionals worked with people using the service.

There was a COVID-19 infection prevention and control policy. It held all current government guidance. Staff followed infection control guidance to help ensure the safety of the people and visitors.

People were supported to make individual choices about the activities they took part in.

Staff understood people’s individual communication needs and supported people to engage with a range of activities both within the service and in the local community.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.

Right support:

• The model of care and setting didn’t always enable people to have choice and control over some parts of their lives. Limited catering facilities meant people did not always have the choice to make meals, snacks and drinks when they wanted to. People were supported to leave the service when they wished and were able to spend time on their own if they chose to.

Right care:

• People were complimentary of the support provided. They told us staff understood their needs and they were confident that staff had the knowledge and skills to provide personalised support.

Right culture:

• There was good oversight of the service from the management team. Staff told us they were able to access management support when they needed to. This meant there were opportunities to ensure support was provided in line with the service’s ethos and values.

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

This service was registered with us on 24 February 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on the first inspection since their registration.

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.