Archived: The Old School House

The Old School House is a residential care home registered to provide personal care to up to ten people with a learning disability. At the time of the inspection there were three people living at the home.

Registering the Right Support has values which include choice, promotion of independence and inclusion. This is to ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home was not fully meeting the principles of this policy.

The Old School House is currently in a period of transition. The home is being sold and people, placing authorities and staff have been given a date for its final closure if a sale is not achieved.

People’s experience of using this service and what we found

The priority for the home managers and staff is currently to keep people safe while planned changes take place. People received safe and effective care and support to meet their individual needs. People were protected from harm as risks were known although some safeguards were not the least restrictive despite keeping people safe. Staff were confident to recognise and report abuse.

People received their medicines as prescribed and there were procedures in place to ensure the process was carried out safely.

People were supported by a staff team who had the knowledge and skills to meet their needs effectively. There were enough staff employed to ensure flexible support. Staff were well supported.

People’s needs had been assessed and documented in care plans. Staff were confident they could meet people’s individually assessed needs and relatives were equally as confident in staff's skills and abilities.

People’s care was responsive to their changing needs. Staff worked in partnership with health and social care professionals to ensure consistency and ensure people received appropriate and safe support. People were supported to access healthcare, and other agencies, when required and effective joint working had a positive impact on people who used the service.

People received appropriate support to eat and drink and their nutritional needs were met.

Staff were caring and respectful, promoting people’s privacy, dignity and independence.

People knew how to raise a concern and felt listened to.

Activities were currently not being developed although people still had opportunities to enjoy social events, especially in the lead up to Christmas time.

Interim management arrangements ensured stability at a time of great change. The provider had been open and transparent about changes and had taken appropriate action when things had gone wrong and when people had been put at risk of harm.

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

Rating at last inspection

The last rating for this service was requires improvement. (Report published March 2019. At this inspection the service is now good.

Why we inspected

This was a planned inspection brought forward following safeguarding concerns raised to the local authority. At the time of the inspection these concerns were being addressed.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme or until the home closes. If we receive any concerning information we may inspect sooner.

Registering the Right Support has values which include choice, promotion of independence and inclusion. This is to ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home was not fully meeting the principles of this policy.

People’s experience of using this service:

People did not consistently receive safe care. Peoples risk assessments were not always followed and risks associated to the environment had not been mitigated.

People were not consistently receiving responsive care and support.

The systems in place to monitor the quality of care were not always effective and actions were not consistently driving improvements.

People felt safe and they were protected from the risk of abuse. There were sufficient safely recruited staff. Staff were trained and able to support people’s needs.

People were treated with kindness by staff who knew them well. People’s privacy and dignity was respected and their independence was encouraged. People could choose for themselves.

People were listened to and had their views sought about the care they received. There was a positive culture and learning and partnership working were encouraged.

The service met the characteristics of Requires Improvement in most areas. We have made recommendations about assessment and care planning and understanding current guidance.

We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment and governance. Details of action we have asked the provider to take can be found at the end of this report.

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

Rating at last inspection: At the last inspection the service was rated Good (report published 22 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we found the service had deteriorated to Requires Improvement.

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.

The Old School House provides accommodation and personal care for up to 10 adults with a learning disability. At the time of our inspection 9 people were living at the service.

At the last inspection we found further improvements were required to increase staff understanding of how to keep people safe and quality assurance processes required further development. During this inspection we found improvements had been made. At the last inspection we found staff lacked understanding of the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLs). During this inspection we found the provider had made improvements.

There was 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.

People felt safe. There were sufficient numbers of staff to respond to people’s needs and support people safely. People were supported by staff who had been recruited safely and had the skills and knowledge to meet people’s care and support needs. People were supported by staff who knew how to recognise and report potential abuse. Risks to the health, safety and well-being of people were identified and managed. Staff had a good understanding of how care and support should be provided in order to keep people safe. People’s medicines were stored and managed safely and people received their medicines as prescribed.

People’s nutritional and hydration needs were met and people were involved in the planning and preparation of meals. People were given choices of food and drink and specialist diets were catered for. People had good access to a range of healthcare professionals when required.

People and their relatives felt they were supported by staff who were friendly and caring. People’s individual needs were understood and met by staff and people and their relatives were involved in making decisions about how their care and support was provided. Staff supported people in a way that maintained their privacy and dignity and promoted their independence. People were supported to maintain relationships that were important to them.

People felt involved in the assessment, planning and review of their care. Staff had a good understanding of people’s, personal needs and preferences. People were encouraged and supported to follow their individual interests and take part in activities they enjoyed. People and their relatives knew how to complain and expressed confidence that concerns would be dealt with efficiently by the registered manager.

People, relatives and staff were encouraged to give feedback and felt involved in the development of the service. The registered manager had effective systems in place to monitor the quality and consistency of the care provided and was committed to driving continuous improvement.

The people told us about their trips to the shops and fishing. All the people seemed happy and relaxed and keen to show us their home.

The staff we saw supporting people with their activities understood what each person wanted. Everyone seemed very comfortable in each other's company. The arrival of the registered manager was eagerly greeted by the people who seemed very pleased to see her and the facilities manager when they joined us in the dining room.

We asked people if we could have a look around the building and go into their bedrooms. We were shown around by the registered manager and joined by a senior care worker. The building had been extended to provide new bedrooms with bathrooms, a new lounge area and administration office. The new facilities were very well designed and furnished to a high standard. We were shown round the older accommodation and told about the plans in hand to modernise and upgrade the rooms.

We saw all the occupied bedrooms, which were furnished and decorated to suit the individual needs of each person. All the bedroom doors had alarms connected to the monitor board for night time support.

The lounge areas were very spacious and well furnished. The kitchen had recently been refitted to a high standard and all the bathroom and toilet areas had up to date facilities and were well maintained.

We spoke to two of the four staff members on duty. They told us that they felt very well supported by the management and their colleagues. They were listened to and consulted before decisions were made. They had access to any training they needed to support them to do their work and that their current training was up to date. They told us about the work they undertook to support the people to have active and full lives. They told us how they supported the people to see their families. They knew how to report any concerns regarding safeguarding issues and would not hesitate to report any concerns. They both said the staffing levels were good and they could provide the support the people needed.

People who received a service enjoyed a range of leisure and social activities, both at home and in the local community.

People's likes, dislikes, preferences and goals were considered in relation to the care and support they received. People were involved and consulted in how their care was delivered. Independent living skills were promoted.

Staff met people's care and support needs in ways that they preferred. We saw that detailed records gave staff the information that they required to do this. People's health needs were closely monitored. Assessments of risk supported practice.

People were supported by a knowledgeable and well trained staff team who knew their care and support needs well. Staff said that they felt well supported. Most staff had worked at the home for a number of years enabling them to provide consistent care and support.

The environment was well maintained. We saw changes had been made to the home in order to keep people safe. We asked the manager to check that these changes were not restricting others living at the home.

We saw that the home had a complaints procedure in place. We were told that there had been no recent complaints.