City and South Cambridgeshire Learning Disability Partnership

Updated 9 January 2023

Cambridgeshire Learning Disability Partnership (LDP) has been registered with the Care Quality Commission since November 2016, provides regulated activities for treatment of disease, disorder or injury and had never been inspected. The Cambridgeshire Learning Disability Partnership brings together specialist health and social care services for people with a learning disability.

The LDP is responsible for commissioning and providing these services on behalf of Cambridgeshire and Peterborough Integrated Care Board and Cambridgeshire County Council as part of a Section 75 Agreement. Social Care staff are employed by the County Council, and health staff are employed by Cambridgeshire and Peterborough Foundation Trust. There is a Formal Management Agreement between both organisations for the Integrated service and all staff are part of the LDP.

The LDP directly provides access to specialist nurses, psychiatrists, psychologists, therapists, allied health professionals, Social Workers and Social Care staff through its integrated community teams, which cover the county from four locations:

• Huntingdon
• East Cambridgeshire
• Fenland
• South Cambridgeshire and City

Cambridgeshire Learning Disability Partnership has not been inspected by the Care Quality Commission.

This report relates to our inspection of City and South Cambridgeshire Learning Disability Partnership. Reports for the other three learning disability partnerships services are available on the website. The LDP in house provider services directly provide daytime support, respite care and some supported living accommodation in various locations across Cambridgeshire. The in-house services referred to are registered with the CQC individually and separately from the community teams referred to in this inspection The majority of daytime support, respite care, domiciliary care and supported living accommodation were commissioned by the LDP from a wide range of independent and voluntary sector care providers, acting in partnership with the LDP to deliver high-quality care options for people with a learning disability.

What people who use the service say

We spoke with three people using the service and reviewed comments and feedback from surveys, speak out forums and local partnership board.

We saw evidence that staff used a variety of communication tools to engage with people and their supporters and carers.

One person told us their named worker supported them when they are contemplating suicide, and advice and guidance helped and redirected him. The person felt strongly the staff member had saved their life.

Two people told us they had the mobile phone numbers of named workers to contact. When they had messaged or telephoned, staff responded quickly. They felt well supported and staff understood their needs. They could ask for a meeting and this would be arranged quickly.

One person said the psychiatrist helped reassure them and feel better about their health condition. The psychiatrist visited them at home and were easy to talk with.

Updated 9 January 2023

• There was no risk assessment of the providers premises, and no fixed alarm points in any of the interview rooms.
• Staff did not routinely hold staff alarms to keep them safe.
• At the time of inspection, the service had high vacancy rates.
• Staff did not complete risk assessments for three people.
• Staff did not receive regular supervision and appraisals.
• Managers did not receive sufficient up to date information to have oversight of specific performance areas.
• We observed a planned session with one person that was not carried out by staff in a respectful and supportive way.
• The service did not meet the target time of 18 weeks for seeing people from referral to assessment and assessment to treatment. The South team referral to assessment waiting time was 45 weeks. In the City team referral to assessment waiting time was 21 weeks
• The information management system was burdensome to front line staff. Staff used a mix of electronic systems, with improvements due to take place from August 2022.

However:

• People were protected from abuse.
• People received kind and compassionate care from most staff who protected and respected their privacy and dignity and understood each person’s individual needs. People had their communication needs met and information was shared in a way that could be understood.
• People were involved in managing their own risks whenever possible. Staff developed positive behaviour support plans with people who used the service so that they were aware of any risks they posed to themselves, others or their environment.
• People made choices and took part in activities which were part of their planned care and support. Staff supported them to achieve their goals.
• We observed a multidisciplinary meeting where staff demonstrated strong links with adult social care services and others to meet people’s social care, housing, employment and education needs.
• People and those close to them were active partners in their care. Staff empowered people who use the service to have a voice and to realise their potential. They showed determination and creativity to overcome obstacles to delivering care.
• People were empowered to feedback on their care and support. We saw examples where staff had encouraged feedback using an easy read “we welcome your feedback” form. We also saw an easy read version of “our learning disability vision, making a better future together” that had been co-produced and set out agreed next steps for enabling people to live happy, safe and healthy lives, and to have the same life opportunities as anyone else.
• Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff supported people through recognised models of care and treatment for people with a learning disability or autistic people. Leadership was good, and governance processes helped the service to keep people safe, protect their human rights and provide good care, support and treatment.
• Staff worked with social care providers to ensure care was line with best practice and national guidance. For example, quality standard 101, behaviour that challenges National Institute for Heath and Care Excellence (NICE).

Updated 9 January 2023

• There was no risk assessment of the providers premises, and no fixed alarm points in any of the interview rooms.
• Staff did not routinely hold staff alarms to keep them safe.
• At the time of inspection, the service had high vacancy rates.
• Staff did not complete risk assessments for three people.
• Staff did not receive regular supervision and appraisals.
• We observed a planned session with one person that was not carried out by staff in a respectful and supportive way.
• The service did not meet the target time of 18 weeks for seeing people from referral to assessment and assessment to treatment. The South team referral to assessment waiting time was 45 weeks. In the City team referral to assessment waiting time was 21 weeks
• The information management system was burdensome to front line staff. Staff used a mix of electronic systems, with improvements due to take place from August 2022.

However:

• People were protected from abuse.
• People received kind and compassionate care from most staff who protected and respected their privacy and dignity and understood each person’s individual needs. People had their communication needs met and information was shared in a way that could be understood.
• People were involved in managing their own risks whenever possible. Staff developed positive behaviour support plans with people who used the service so that they were aware of any risks they posed to themselves, others or their environment.
• People made choices and took part in activities which were part of their planned care and support. Staff supported them to achieve their goals.
• We observed a multidisciplinary meeting where staff demonstrated strong links with adult social care services and others to meet people’s social care, housing, employment and education needs.
• People and those close to them were active partners in their care. Staff empowered people who use the service to have a voice and to realise their potential. They showed determination and creativity to overcome obstacles to delivering care.
• People were empowered to feedback on their care and support. We saw examples where staff had encouraged feedback using an easy read “we welcome your feedback” form. We also saw an easy read version of “our learning disability vision, making a better future together” that had been co-produced and set out agreed next steps for enabling people to live happy, safe and healthy lives, and to have the same life opportunities as anyone else.
• Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff supported people through recognised models of care and treatment for people with a learning disability or autistic people. Leadership was good, and governance processes helped the service to keep people safe, protect their human rights and provide good care, support and treatment.
• Staff worked with social care providers to ensure care was line with best practice and national guidance. For example, quality standard 101, behaviour that challenges National Institute for Heath and Care Excellence (NICE).