Camphill Communities East Anglia is a supported living service for up to 28 people who have a learning disability and or autism. The service is referred to as Thornage Hall by people, relatives, staff and the provider. We have also referred to the service as Thornage Hall in our report. Thornage Hall provides supported living across four houses located on the Thornage Hall estate and one house in Thornage village in Norfolk.

Thornage Hall is a member of the association of Camphill Communities who have a vision of an environmentally sustainable world where everyone can live, learn and work together in a meaningful way regardless of ability or disability. Thornage Hall estate has a biodynamic farm which provides food for people living there and for retail to the local area. A range of agricultural, crafting, computing and artistic ventures help people develop meaningful skills within a working environment.

At the time of this inspection there was not a registered manager 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. In the absence of a registered manager the providers representative during our visit was the head of personal care services. The new manager (who was also the chief executive) was due to commence employment on 13 August 2018.

At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service had been developed and designed in line with the 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 lived as ordinary a life as any citizen.

There was mixed feedback about staffing primarily due to the challenges of recruitment and the high use of agency staff. Staff were committed to still delivering a quality service to people and were busy however feedback and our observation showed there were sufficient staff to meet people’s needs in a timely manner. We have recommended the provider continue to closely monitor staffing levels. Staff were recruited safely.

People continued to receive a service that was caring. Staff knew people's needs well and were responsive and supportive. Staff treated people with dignity and respect. Staff continued to seek and gain people's views. The service worked within the principles of the Mental Capacity Assessment 2005 (MCA) and staff sought people's consent before entering their home and supporting them.

Medicines continued to be stored and administered safely, and people received their medicines as prescribed. Audits were carried out of medicines to ensure they were managed in line with good practice guidelines. Infection control practice was good and helped to reduce the risks associated with poor cleanliness systems.

People and relatives were complimentary about the service and the support provided. There was information available if people or their relatives wanted to complain. People who used the service and the relatives told us the service was well led. Staff were aware of their roles and responsibilities and most felt well supported. Effective quality monitoring systems were in operation.

Further information is in the detailed findings below

This inspection took place on 8 December 2015 and was unannounced.

The service location of Camphill Communities East Anglia is generally known as Thornage Hall and is referred to as such throughout this report. The service provides personal care and support for adults with learning disabilities.

People supported by the service live in one of four houses on the Thornage Hall estate or a house in the nearby village of Thornage itself. Thornage Hall is a Camphill Community. Camphill Communities were established as intentional communities whose ethos is to recognise the uniqueness of all individuals and seeks to respect, value and enhance the strengths and potential of everyone. Thornage Hall estate has a biodynamic farm which provides food for people living there and for retail to the local area. A range of agricultural, crafting, computing and artistic ventures help people develop meaningful skills within a working environment. People living at Thornage Hall are also supported to develop and pursue interests outside of their immediate community.

There was a registered manager in post who was also the director of operations at the service. 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 safe. Medicines were managed and administered in a safe manner. Staff understood how to safeguard people and knew what action to take if they had any concerns.

The service had sufficient staff to meet people’s needs, but at the time of our inspection needed to use agency staff to do so. Appropriate checks had been made to ensure that the agency staff were suitable to work with people at Thornage Hall, as well as checks being made on staff directly employed by the service. The service managers had high standards and only recruited staff of a calibre they were satisfied with.

Staff received suitable training and support from the provider. This included training on communication methods used by people. The service had recognised that as people became older their needs would change and had sourced relevant training in order to provide people with effective care.

Up until recently consent had not been an issue for the service as people were able to make decisions about their own care and support. However, due to the changing needs of some people the service needed to implement the requirements of the Mental Capacity Act 2005 and procedures were in place to do this.

People were supported to maintain a varied diet and their health needs were well catered for.

Staff were respectful and caring and encouraged people to be as independent as possible. The service was responsive to people’s needs. Care plans were detailed, person-centred and up to date and people received prompt attention when they needed it. Associated risk assessments were in place.

The service was well managed with appropriate measures in place to monitor the quality of the service provided. The staff group worked well together and supported each other. People understood the complaints system.

At the time of our inspection 25 people lived at this location in five houses. A ‘house co-ordinator’ also lived in each house ensuring that a member of staff could be easily contacted by each person throughout the 24 hour period. The location included a variety of workplaces such as an organic farm and market garden and a weaving room. Most of the people who used the service worked in one of these areas. One person we spoke with told us that they enjoyed walking to and from their work each day “…even if the weather is bad.” Another told us "I'm a good weaver."

Each house had its own communal kitchen. We saw people and staff working together to prepare and serve lunch. The food was freshly cooked, well-presented and nutritious and included vegetables grown in the market garden.

People we spoke with told us that they enjoyed living and working at Camphill Communities East Anglia and that they felt safe. Each of the care records we looked at contained a form titled ‘What do I do if I’m not happy?’ This told people in easy-to-read terms what to do if they were worried about something.

We spoke with three members of staff about their training and support. Each one told us that they had received their required mandatory training and had been given supervision and appraisal according to the provider’s policy. The provider used a range of methods to assess and monitor the quality of service provision and took action when improvements were required.

We spoke with a group of five people while having coffee with them as they discussed their plans for the Christmas period. We also spoke with one person in private and spoke to several members of staff.

We saw people helping with household chores such as vacuuming and dusting and others who were baking and helping prepare meals.

We looked through people's support plans, checked how medicines were stored and administered. We spoke with staff and checked their employment records. We also asked people if they had any concerns about the service they received.

People told us "I would not go anywhere else to live." "I like my key worker, we get along very well." "People here are very good to me."

We observed how well staff supported people by encouraging them to make their own decisions and how comfortable people appeared be within their surroundings.

We received nothing but positive comments telling us how involved everyone was, how they meet up to make decisions about their lives either on a one to one basis or as a group and how kind and supportive the staff and volunteers were.

A number of people told us they were now more independent with their personal care, with some gentle prompting. We were told ”I can now shower without help but staff remind me to have one” and “I feel more grown up now as I can do more for myself”.

We observed open, happy and smiling faces from people who were relaxed and able to speak out about their thoughts. We saw comments discussed in detail and actions taken or planned to improve or alleviate concerns raised.