Archived: Camphill St Albans

At our last inspection on 23 July 2013, the service was found to be meeting the required standards in the areas we looked at. Camphill St. Albans is a domiciliary care service that provides personal care and supported living for people in their own homes. Care is provided to people with learning disabilities, mental health conditions and other complex needs who live in privately rented houses and flats; the majority of which are situated within a mile radius of the registered office and St. Albans town centre. At the time of our inspection 31 people, who lived in 14 different properties, received care personal care and support.

The service is part of the Camphill Village Trust (CVT) which previously used a ‘life sharing’ model of support. This meant that in many cases staff members, known as ‘co-workers’, lived with the people they supported and their family members to provide care on behalf of the Camphill St. Albans CVT. However, people now receive care based on a ‘supported living’ model to help them live as independently as possible. This means that staff employed by the service visit people in their own homes, and elsewhere in the local community, to provide them with the support they need to help meet their individual health and social care requirements.

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 which include an art studio, allotments and café. However, people are free to decide the extent to which they use these facilities or join in with the wide range of other activities and social opportunities provided by the service.

There was a manager in post for the service who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run. The registered manager was supported by two assistant managers and a team leader in the day-to-day operation of the service. They were also supported by a senior representative of the provider, known as the ‘general manager’, based at offices in close proximity to the service.

During our inspection some relatives of people who use the service expressed significant levels of concern, disappointment and frustration about the way in which care and support was currently provided. In their view the service had, over a period of time, moved away from its original ethos and founding principles.

Some relatives felt that these change had a detrimental effect on the levels of care and support their family members received. A number of these concerns had already been raised with and addressed by the relevant local authority. People’s relatives and other interested parties have had a number of opportunities, over a long period of time and in different forums to discuss the changes made to the service, how it has evolved and how it currently operates.

The relatives of other people who use the service, together with social care professionals who provided us with feedback, were very positive about the service, staff who provided support and the overall quality of care people received.

Although people were supported to take their medicines safely by trained staff, medicines were not always managed in a safe and proper way. This was because the processes, systems and checks used to manage medicines were not as safe or effective as they could have been in all cases.

People told us that staff helped them stay safe, both in their homes and when out and about in the local community. Staff received training about how to safeguard people from abuse and were knowledgeable about the potential risks and how to report concerns. Robust recruitment practices were followed and there were sufficient numbers of suitable staff available to meet people’s care and support needs at all times.

Plans and guidance were in place to help staff deal with unforeseen events and emergencies in a safe and effective way. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.

People who received support, most relatives and social care professionals were positive about the skills, experience and abilities of staff employed at the service. Staff received training and refresher updates relevant to their roles. They had regular meetings with managers to discuss and review their personal development and performance.

People were encouraged and helped to maintain good health and were supported to access health and social care professionals when necessary. They were also encouraged and supported to eat a healthy balanced diet that met their individual needs.

Staff obtained people’s agreement and consent to the care and support they provided. They supported people in a kind and caring way that promoted their dignity. Staff had developed positive relationships with the people they supported and were clearly very knowledgeable about their needs and personal circumstances.

People who received support, and some of their relatives where appropriate, were involved in the planning and reviews of the care provided. The confidentiality of information held about people’s medical and personal histories was securely maintained at the service.

People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences and routines. People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at home and in the local community.

People who received a service and some of their relatives told us that the registered and general manager and staff listened to them and responded positively to any concerns they had. People were encouraged to raise any concerns they had and knew how to make a complaint if the need arose.

We found that people who used the service were supported to live independently in a small number of properties located within a mile of the office base. Some of the people lived in group homes and others lived in flats or houses suited to their individual needs. We found that peoples' choices, preferences and wellbeing were at the forefront of everything that was in place at Camphill. For example, many of the people who used the service had indicated that they would like to 'work', and we were told about the various 'jobs' that people had been assigned to do. There were activities and social events every day which people could participate in, if they wished. People we spoke with were very positive about the 'community' and the support they received from the staff at Camphill.