About the service: Camowen is a residential care home for people living with a variety of care needs, including people living with dementia. It is registered to provide personal and nursing care for up to 20 older people. At the time of our inspection, 18 people were living at the home.

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

People’s experience of using this service:

¿ Actions in relation to the control and management of infection were insufficient to mitigate the risk of infection.

¿ One person had sustained a series of falls, but there was no evidence to show a referral had been made to the falls team. This was followed-up at the time of inspection. The associated risk assessment had not been updated as needed.

¿ Consent to care and treatment had not always been gained in line with the requirements of the Mental Capacity Act 2005. One person was subject to Deprivation of Liberty Safeguards, but the authorisation for this from the local authority had lapsed and there was no evidence to show this had been reapplied for.

¿ A range of audits had been implemented to monitor and measure the quality of care and the service overall. However, these had not been effective overall in that they had not identified the issues we found at inspection. This is an area in need of improvement.

¿ People said they felt safe living at the home and spoke positively about the staff who supported them. One person said, “No-one is ever angry or impatient, you cannot fault them”. People were protected from the risk of potential abuse or harm and staff had been trained in safeguarding. People’s risks were identified and assessed as needed. Staffing levels were sufficient to meet people’s needs and new staff were recruited safely. Medicines were managed safely.

¿ We observed people were comfortable in their surroundings and felt safe and happy. People were relaxed and willing to have a conversation with us. Throughout our inspection, we observed positive interactions between people and staff. People were treated with dignity and respect and involved in all aspects of their care. One person said, “Carers are very good and friendly, they will stop and have a chat”. Staff had been trained in a variety of areas and were skilled and experienced in supporting people. They had regular supervisions and annual appraisals.

¿ People were complimentary about the food on offer and told us they had a choice of what they would like to eat. One person said, “I like to go down to the dining room and I enjoy talking to my friends”. People had access to a range of healthcare professionals and services. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

¿ People received personalised care that was tailored to meet their individual needs, preferences and choices. Care plans were detailed in the information and guidance provided to staff. Staff encouraged people in decisions relating to their care and in care planning. Complaints were logged and managed appropriately. People could stay at the home until the end of their lives if this was their wish and their needs could be met.

¿ People and staff were involved in developing the service and their views were listened to and acted upon. Staff felt the managers were approachable and there was an ‘open-door’ policy. Staff enjoyed working at the home.

Rating at the last inspection: Good. The last inspection report was published on 20 August 2016.

The overall rating has changed to Requires Improvement.

Why we inspected: This was a planned, comprehensive inspection. The inspection took place in line with CQC scheduling guidelines for adult social care services.

Enforcement: Action we have told the provider to take is included at the end of the report.

Follow up: We will review the service in l

The inspection took place on 12 and 15 July 2016 and was unannounced.

Camowen is a care home situated close to the town centre of Worthing and is registered to provide accommodation and care for up to 20 older people with a variety of healthcare needs. At the time of our inspection, 20 people were living at the home. Camowen is a large detached older-style property surrounded by accessible and well-tended gardens. All rooms have en-suite facilities comprising a washbasin and toilet, except for one room which accommodates a person cared for in bed. All rooms are of single occupancy. Communal areas include a main lounge in the conservatory, dining room and two small lounges, one upstairs and one downstairs.

A registered manager was in post. 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.

The service was well led by a registered manager who was highly respected by, and supportive of, all the staff at Camowen. Their pro-active and enthusiastic approach and leadership skills had resulted in a well-managed home that delivered high quality, effective care. People, relatives and staff all spoke highly of the home and the service provided. People were asked for their feedback and all responses rated the home as either outstanding or good. A range of audits continually monitored and reviewed the care provided and the service was committed to delivering improvements. People and staff felt they were listened to and that their comments would be taken seriously and acted upon. Feedback obtained by the home and posted on various websites consistently described the service in glowing terms.

People told us they felt safe living at the home and staff had been trained to recognise the signs of potential abuse, knowing what action to take if they suspected abuse was taking place. People’s risks were identified, assessed and managed appropriately. Accidents and incidents were acted upon promptly, reported appropriately and care plans reviewed as needed. Staffing levels had been assessed based on people’s care and support needs and there were sufficient numbers of staff on duty. New staff were recruited following a robust process and checks undertaken to ensure their suitability to work in care. People’s medicines were managed so they received them safely. The home was clean, tidy and free from offensive odours.

New staff studied for the Care Certificate, a universally recognised vocational qualification. Training was provided on a rolling programme and staff had completed and updated training in a range of essential areas. Staff were encouraged to study for additional qualifications or undertake further training. Staff received regular supervision meetings with their managers and annual appraisals had been completed. Mini training sessions were organised at team meetings to update staff knowledge and skills. People had sufficient to eat and drink and were encouraged to maintain a healthy diet. They had day-to-day choices from home cooked food and special diets were catered for. People had access to a range of healthcare professionals and support.

People were looked after by kind and caring staff who were dedicated to their work; some staff supported people at the home even when they were not due to come into work. People were involved in all aspects of their care and supported to express their views. They were treated with dignity and respect and had the privacy they needed.

Care plans provided comprehensive, detailed information about people to staff and how they wished to be cared for. Information was personalised and captured people’s likes, dislikes and preferences, as well as their day-to-day care needs. A range of act

People told us that they felt they were well cared for and the staff members understood the needs of people well. One person living at the service told us "the staff always ask me before they do anything, I always get a choice".

We reviewed the training records and found staff received appropriate training for their roles. The training provided staff with the knowledge and skills to deliver care that was safe and appropriate for people living in their own home.

We found people had personalised care plans and risk assessments. We found for every identified risk there was a plan in place to address the risk.

We found the provider had a system in place to monitor the quality of the service they

provided.

We spoke with five people who lived at Camowen and one relative. People told us they were happy living there and were satisfied with the care they received. People described the service as "Very good," "Very nice" and "Very caring." One person said, "I don't think you could get a better one [care home]." Another person said "I'm very well looked after." People said that staff were kind to them and supported them in the way they preferred. People told us that their consent to care and treatment was obtained and their care needs were discussed with them. We found the provider obtained people's consent verbally and in writing to protect people's rights.

We found that people's care was planned and delivered in line with their needs and preferences. Staff understood people's needs and how people liked to be supported. People's care needs were regularly documented and reviewed which meant that records were accurate and fit for purpose.

We found that people were protected from the risks of abuse and neglect. Staff had received training in safeguarding vulnerable adults and had background checks done to ensure they were of good character. Potential risks to people were assessed and staff understood how to avoid or minimise these risks. People told us they felt safe living at Camowen.

We found that there were appropriate recruitment procedures in place to ensure staff were fit for their roles. The provider had systems in place to monitor their own quality.

We spoke with four people who live at Camowen and one relative. They told us the staff had treated them with respect and that the care they received was good.

We spoke with three members of care staff who were on duty. They demonstrated they knew about the level of care that each person required. They also told us they were well supported by the manager and well trained so that they were able to provide good quality care.