We carried out a review of the data available to us about Camberley Cottage on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Camberley Cottage, you can give feedback on this service.
Camberley Cottage is a care home providing accommodation and personal care for up to six adults with learning disabilities and/or a variety of associated health and support needs. People live in one large house built to meet people’s mobility needs. At the time of the inspection the service was supporting six people.
People’s experience of using this service and what we found
There were good systems in place to keep people safe. People were safeguarded from the risk of abuse or avoidable harm. Staff had appropriately assessed risks and took action to protect people.
People were cared for by a committed team of managers and staff who had the skills and knowledge to support them effectively. 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.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
The model of care and setting maximised people’s choice, control and independence. People were encouraged to develop their skills and independence. Staff had a good understanding of people’s individual needs and provided support that enabled them to lead happy and fulfilling lives.
Right Care
Care was person-centred and promoted people’s dignity, privacy and human rights. People received individualised care that was responsive to their changing needs. Staff were knowledgeable about people’s emotional needs and understood the link between their anxiety and behaviours and were skilled at managing these.
Right culture
Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. The culture of the service was open and transparent with staff and managers working together and with other professionals to deliver a service which placed people at the heart.
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 the service was good, report published on 13 April 2018. We also carried out a targeted inspection on 9 March 2021 to look at the standards of infection, prevention and control at the service.
Why we inspected
The inspection was prompted in part due to concerns received about staffing, management of risks and people’s health needs and how complaints were handled. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective, Responsive and Well-Led sections of this full report.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Camberley Cottage on our website at www.cqc.org.uk.
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.
We found the following examples of good practice.
People were supported by staff to understand and adhere to the government guidance around national restrictions and NHS shielding advice. People’s individual communication needs were addressed by staff who used simplified communication, easy read resources and individually tailored discussions with people to support them around infection prevention and control (IPC) measures in the service. For example, one person was supported to understand how to adhere to the government guidance when going out on their own and others were reassured around why staff wore personal protective equipment (PPE) when supporting them.
Staff supported people to minimise the impact of the current COVID-19 restrictions on their wellbeing. People could video call with their loved ones and their rooms were equipped with additional items which they liked to enable more indoor activities such as arts and crafts. Staff who played musical instruments brought them to work and played for people. People could also access the communal garden and were supported to go out for daily exercise. Staff supported people to redecorate their rooms and there were plans created by people to refurbish the garden area in the spring.
The registered manager reviewed the environment in the service and a range of changes were made to enable easy access to PPE, social distancing and effective IPC practice. For example, the spare communal bathroom was safely re-configured for additional storage of PPE and routine testing area for staff. The conservatory area was used as an alternative entrance to the service and was partitioned to enable safe screening of visitors and to facilitate staggered breaks for staff. The communal areas were re-arranged to provide socially distanced seating, a sofa was replaced by armchairs and additional seating area was organised in the home to enable social distancing for leisure and meal times.
There were clear contingency plans in place on how people’s individual needs and specifics of the service would be addressed to protect them from the spread of the infection should anyone test positive for COVID-19. This included a review of people’s daily routines to identify individual plans on how to minimise the impact of self-isolation on their wellbeing same time ensuring effective zoning and cohorting in the service.
At out last inspection, the service was rated Good. At this inspection we found the service remained Good.
People were supported by a sufficient number of skilled and trained staff to meet their needs. Risks to people had been identified and as such staff took appropriate steps to help mitigate any risk of harm or injury to people. Staff were aware of their responsibilities in safeguarding people from abuse and supported people to access health care professionals to ensure they remained healthy.
Staff received supervision and appraisal with their line manager to support them in their roles. Staff were knowledgeable in relation to infection control and what to do in the event of a fire. Should the service have to close there were arrangements in place to ensure people’s care would not be interrupted.
People were supported to make their own decisions about their care and encouraged to be independent as much as they could. Staff had followed legal guidance in order to help ensure any restrictions to people were agreed in conjunction with those involved in the person. Staff worked with external agencies to support people and before people moved into the home their needs were assessed in order to help ensure staff could care for them in the way they needed.
People received support from staff who knew them well and positive relationships had developed. Staff treated people with kindness and were aware of their preferences. Staff demonstrated a good understanding of people’s communication styles. People received the medicines prescribed to them and staff provided people with nutritious food of their choosing.
People’s care records were person centred and completed in detail and people had access to a range of individual activities in line with their interests. The manager planned to develop activities further to give people additional opportunities.
People lived in an environment that was homely and adapted for their needs. The service was clean and hygienic and people had access to communal areas, a garden and their own bedrooms which were individualised.
Systems were in place to monitor the quality of the service provided and ensure continuous development. People and staff were involved in the running of the home and relatives played an active role. The service had a new manager (herein known as the manager) who had submitted their application to register with the Care Quality Commission. The manager had a clear vision on where she wanted to develop the service and the introduction of an electronic records system and use of technology was already benefitting staff and people. Staff felt supported and valued by the management team.
This inspection was carried out on the 2 October 2015 and was unannounced. Camberley Cottage opened in October 2007 to provide specialist care for six people with learning and/or physical disabilities between the ages of 18 and 65 years. Camberley Cottage has been adapted to cater for people with severe physical disabilities with wheelchair access throughout the service which included a purpose-built lift. All bedrooms are for single occupancy and all six bedrooms have en suite wet room facilities. On the day of the inspection there were six people living at the service.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. On the day of our visit the registered manager was on leave. The deputy manager and the regional manager supported us on the day.
People told us they felt safe, we found that where there was an identified risk to people this had been identified and action taken by staff. Staff had a clear understanding of how to safeguard people and knew what steps they should take if they suspected abuse.
There were enough staff working to meet people’s needs. Staffing levels were such that people were not kept waiting when they needed care and support. There was an effective recruitment process that was followed which helped ensure that only suitable staff were employed.
Medicines were stored securely and administered by staff who had been trained and assessed as competent to do so. Medicines were reviewed regularly to ensure people with complex needs received them appropriately.
People said that staff understood them. People had access to external health care professionals such as physiotherapists which had improved their independence. People’s communication difficulties had improved with the input of staff that were well trained and knowledgeable about people’s needs.
Staff were well trained and had a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Consent was sought from people appropriately by staff in a number of different ways as not everyone was able to verbally communicate.
Staff had received an induction when they started work and had on-going training to help ensure that they had the necessary skills and knowledge to meet people’s needs. People had access to the food and drink they liked and were involved in how meals were prepared. There was regular monitoring of people’s nutritional intake and advice was sought from specialists such as dieticians if a concern was identified or advice was needed.
People told us that the staff were always caring and the atmosphere felt like that of a family home. People were made to feel important by staff who knew them extremely well and who had a good rapport with them which helped promote positive relationships between them. We observed friendly and good natured discussions taking place between people and staff and the atmosphere was warm and relaxing. People were involved in their care planning and told us that they always felt listened to by staff.
Staff consistently went the extra mile to ensure that people’s needs were met. Where people wanted to have support to be more independent this was given in a sensitive and caring manner which was appreciated by people and those that mattered to them. We saw that people’s privacy and dignity was maintained by staff who had great respect for people and what mattered to them.
Care planning was individualised and person-centred and detailed people’s likes, dislikes and personal history so that staff would have an understanding of how to meet their needs and understand them as a person. People’s care needs had been assessed prior to them moving into the service to ensure that they could be met.
The service was flexible when it came to meeting people’s needs and staff ensured that if a change occurred this was responded to quickly. People were supported to make choices about what they did and when and were given information by staff to help them make informed decisions. Where people wanted to take part in activities these were facilitated by staff wherever possible in a way that was not set in a particular routine which people told us suited them. Activities were extensive and people had been supported and encouraged by staff to be part of the community by raising money for a local charity.
People were able to make a complaint if necessary but had not done so in a formal way. They all said the deputy manager and the staff were very approachable which allowed concerns to be dealt with before they became problematic.
People, visitors and staff were positive about the leadership of the home. One person said “(The deputy manager) is nice.” Staff said they felt valued by the management team and enjoyed working at the home.
Senior staff communicated through team meetings, through supervision meetings and in recruiting staff to promote the values of the service. There was a culture within the service that valued the individual and placed caring for people at the centre of what they did.
Staff (including the deputy manager) were encouraged and supported to develop their skills and to undertake additional qualifications.
There was a comprehensive system of quality assurance in place that included residents meetings, staff meetings, questionnaires and a detailed auditing system. Any shortfalls that were identified were actioned.
We saw that the deputy manager and the regional manager were present and visible around the service throughout the inspection.
The last inspection was on 31 May 2013 where no concerns were identified.
We found, from documentary evidence supplied, that the service had carried out recruitment processes that ensured people were cared for by suitably qualified, skilled and experienced staff.
We found that the service had in place a complaints policy that supported people who used the service to make a complaint if needed. The procedure contained within that policy had been made available for persons who used the service and their relatives to read and follow. The complaint forms had been made available to people who used the service and other relevant people.
People said they were fully involved in all aspects of their care. People told us, 'We are involved in setting our goals and in the review of our care with the help of the registered manager or our support worker'. People told us their treatment included their total involvement in their care. People said, 'We like the support we receive from our support worker, and the registered manager'.
We found that the service sought people's consent prior to providing them with care and support. We saw systems in place that ensured that when information about people's treatment, care and support needs had been passed to another service, team or individual, this was organised so that the information included everything that the service, team or individual needed to ensure the needs of the person who used the service were met safely, even when the transfer of information was required urgently.
People told us they were happy with the cleanliness of their house in general.' They told us they had help in keeping their bedrooms clean and tidy.
We found that staff had not had all the relevant checks carried out prior to commencement of employment. Also the services complaints policy and procedure was not suitable for the service
People told us the staff were respectful of their privacy and dignity. One person said 'I always have my personal care carried out behind locked doors and no one is allowed to enter the room except the staff who are caring for me.' People told us they and their family were involved in their care. They said they made the decisions about their care with help and support of their carer.
One person told us 'My faith is very important to me and I am supported to attend Church every Sunday and I take Holy Communion. This is very important.'
People told us they loved their home, they did things they wanted to do and they had to obtain special permission to do some things because the manager wanted them to be safe.
One person told us 'I love baking and I hold cake sales for my charity.' People told us 'each member of the service suggests a main evening meal and the others vote for the one they prefer.'
People told us they felt safe and well looked after by staff. They described their relationships with staff as very good.
Two of the people who used the service whom we spoke with told us the staff always spoke to them in a calm and respectful manner.
One person told us they were encouraged to give their opinion on how the home was being run. For example, regular residents meetings took place. People said suggestions they had made were acted upon.