Cambian Whinfell Shap Road

People’s experience of using this service:

The care service had been developed and designed in line with values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Staff were highly skilled in supporting people to lead meaningful lives of their choosing.

Since the last inspection people’s life opportunities and quality of life had greatly improved. This was because of the service’s commitment in ensuring each person had an individualised support plan that had a focus on creative ways of communicating with them. People were now fully engaged and empowered in setting their own goals and aspirations.

People told us that staff focused on them having as many opportunities as possible for them to gain new skills and become more independent. Relatives told us that the staff team were “phenomenal” and “Absolutely fantastic” in their understanding of supporting autistic people. One relative said that the input had been life changing for their relative and they were "over the moon" with the progress made. They said, “For the first time ever [name] is now making decisions and is in control of his life.”

The service used nationally recognised best practice to devise their own solutions to support autistic people. Some people, with the use of technology and staff trained in understanding the support needs of autistic people, had begun to communicate their wishes for the first time. This meant that people were more in control as they had been given ways to express their views to influence how they wanted staff to support them.

The use of technology and a host of communication aids had become a key feature of the service. The registered manager was highly trained and skilled in this area and had shared these skills and knowledge with the staff team, who had fully embraced these new ideas and solutions.

People were therefore helped to exercise control and choice over their lives being supported to consent to care and to make decisions. The principles of the Mental Capacity Act (MCA) 2005 were very well understood by the staff team which meant people’s rights were protected.

People were given creative ways and tools to manage their own behaviours with staff being very clear on the approach to take with people. People told us that they liked the fact they could now manage behaviours that they had previously found difficult. One person told us, “I feel a lot happier now and can let staff know how I’m feeling.” Another person said, “I’m much better now with my feelings and can work them out for myself.”

People were well supported to have a very active part in the local community and were encouraged to make friendships outside of the home. With enabling support from staff, they were engaged in work placements, college courses, volunteer work, fund raising and regularly took part in sporting and community events.

Keeping people safe had a high profile in the service. A proactive approach gave people as much responsibility as possible for keeping themselves safe from harm, and this included from potential abuse. Numerous strategies, communication methods and aids were used to help people understand about abuse, that included bullying and on reducing risks while out in the community. For example, a story comic strip had been created with people to help prevent bullying.

Supporting people to be in control was carried over to all areas of people’s lives including healthcare and healthy lifestyle choices, such as with planning healthy menus. Medicines were safely managed and robust checks were in place to identify and take actions when shortfalls were identified.

Well-developed systems were in place for monitoring quality and safety, and people in the home were supported to play an active role. Where shortfalls or areas for further improvements were identified these were acted upon and used to promote good practice.

Staff were given opportunities for learning, development and reflective practice both individually and as a team, which influenced how the home was developed. Staff were motivated and proud of the success and improvements they had made to people’s quality of life.

The registered manager demonstrated a strong and supportive leadership style, seeking feedback to further improve the care and support provided. Staff said they were listened to, were encouraged to try out new ideas and this led to a very rewarding environment to work in.

Relatives, health professionals and social care professionals involved with the home spoke highly of the service, staff and the management team.

More information is in the full report and can be found at www.cqc.org.uk

Rating at last inspection: At the last inspection the service was rated good (June 2016). The service had improved to Outstanding in Caring and Responsive.

Why we inspected: This inspection was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Cambian Whinfell Shap Road provides accommodation and personal care for four males who have autism and complex needs. The home primarily provides accommodation to people over the age of 18. The property is a spacious, residential house in keeping with neighbouring properties. The home is in a residential area of Kendal in south Cumbria. People who live in the home all have their own bedrooms and there are suitable shared facilities including toilets and bathrooms, sitting rooms, a kitchen and dining areas.

There was a registered manager employed in the home. 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.

People who could speak with us told us that they felt safe in the home and said the staff were nice and good at their jobs.

The focus of the service was on promoting people’s rights and independence. People followed activities that they enjoyed and were given opportunities to gain new skills and to increase their independence.

Support was planned and provided to take account of each person’s needs, interests and preferences. People received personalised care that took account of their abilities as well as their needs.

There were enough staff to support people. The staff treated people in a kind and caring way and knew people well. They knew how people communicated their wishes and gave people choices in a way they could understand.

The staff were trained and supported to ensure they had the skills and knowledge to support individuals and to protect their safety and rights.

Hazards to people’s safety had been identified and people were protected from abuse and avoidable harm.

The registered manager set high standards and was knowledgeable about how to support people who had complex needs. They understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People’s rights were protected because there were no restrictions on their liberty unless an appropriate authorisation was in place.

The registered manager and registered provider had good systems in place to oversee the quality of the service. People were supported to express their views and were included in how the service was provided.

Is the service safe?

We saw that assessments of people's capacity were used to protect them. This ensured that where appropriate people acted or advocated on behalf of people using the service. This meant that people received care and support consistent with and in accordance to their wishes.

We saw records for accidents and incidents that had been dealt with appropriately and any actions to prevent reoccurrence had been identified. We saw that where necessary risk assessments had been reviewed taking into account the incidents.

Is the service effective?

The records we saw documented consultations of best interest decisions made by the appropriate people involved in the care and support of the people using the service. We saw policies and procedures promoting the rights of people using the service to exercise choice in their daily lives.

There were a variety of methods being used to communicate with people. This ensured safe and appropriate personalised care and support was given. Care plans also included pictorial information. This was to assist people to communicate their thoughts and feelings about what they wanted. This helped staff to understand how to respond to peoples individual likes and dislikes. Staff we spoke with had an understanding of people's needs.

Is the service caring ?

We saw that the care was monitored through regular reviews and changes were made where necessary. Staff we spoke with told us they worked closely with families so they felt involved and could make contributions of their own.

Not all people living at Cambian Whinfell Shap Road had the capacity to give consent for their treatment and support. The home recognised this and there was evidence seen in care plans, that parents and advocates were consulted and had agreed with the level of support being provided.

Is the service well-led?

The provider employs a team of people to evaluate and promote the quality of their services. Relatives and advocates of those living in the home were regularly involved in consultation about the service provision and its quality. We saw that regular reviews were held. This meant that people and or their representatives could make suggestions or comment about the environment they lived in.

We saw that where necessary risk assessments had been reviewed taking into account any incidents. We were told that the information was reported centrally to the provider and this is then looked at during quality monitoring visits by other senior managers to the home.

Is the service responsive?

For some people recruited by the previous provider there were no records of checks of people's physical or mental well-being. However at the time of our visit the registered manager made arrangements for everyone employed by the service to have these checks completed.

We saw that audits and quality monitoring checks had been completed on a regular basis. We saw from records of incidents and audits of medications that processes and systems had been amended to prevent reoccurrence of problems identified. We saw that these actions had been implemented following a recent audit of medications