Archived: Pier View House

Updated 26 April 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by one inspector over two days.

Service and service type:

Pier View House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Pier View House accommodates up to four young people with ranging complex needs and learning disabilities, which includes autistic spectrum disorder (ASD) and needs resulting from behavioural, emotional and social difficulties (BESD). The home currently provides up to 52 weeks per year accommodation, care and support to learners who access the main college campus to meet their specialist educational needs.

A registered manager was not 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 and associated Regulations about how the service is run. Day to day management of the service was carried out by an acting manager, who was in the process of applying to register with the CQC

Notice of inspection:

This planned comprehensive inspection took place on 26 and 27 February 2019. Due to the nature and size of the service, the inspection was announced and the provider was given 72 hours’ notice that the inspection would take place.

What we did:

Before the inspection we reviewed the information we had received about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We also considered information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we gathered information from:

• Two learners using the service

• Observations of interactions between learners and supporting staff

• The manager and senior leadership team including the chief executive officer

• The provider’s nominated individual and head of care

• The maintenance, estates and ground manager

• The provider’s health and safety advisor

• The provider’s nursing team leader

• Seven members of care staff, including waking night staff

• Human resources and recruitment staff

• Records of accidents, incidents and complaints

• Audits and quality assurance reports

• Business contingency plans

• Four people’s care records

After the inspection we gathered information from:

• Four relatives

Updated 26 April 2019

About the service:

Pier View House is an on-site residential unit that provides accommodation and care for up to four people who attend St Johns College. St Johns is a special educational needs (SEN) school and specialist college that provides education, care and medical therapy to young people aged 7 to 25, who have a wide range of complex learning disabilities, including autism and related autistic spectrum conditions (ASC). The provider refers to people using the service as learners, which they will be referred to throughout the report. At the time of inspection Pier View House provided care and support to four learners, for up to 52 weeks per year. Pier View was compliant with the values underpinned in Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. Learners had access to local amenities, facilitates and services such as healthcare and were supported to access these regularly.

People’s experience of using this service:

• Learners were consistently supported and empowered to make day to day decisions. Where appropriate learner’s consent was sought and their ability to be involved in decision making was recorded in care planning, however records did not always detail the decision-making steps taken when acting in individuals ‘Best Interest’. The manager took immediate steps to address this and implemented a detailed recording tool to support learners and staff. We have recommended that the provider review relevant legislation to improve recording and evidence of best practice guidance.

• Learners were supported to receive their medicines safety with support from appropriately trained staff for the role.

• Risks to learners and the environment were effectively managed though robust assessments and people were appropriately protected from the risk of abuse and avoidable harm.

• We received overwhelmingly positive feedback and relatives consistently told us their loved ones received exceptionally high quality, compassionate and outstanding care at Pier View House. This also included exceptional communication and genuine partnership working with learners and people that were important to them.

• The manager and support staff were extremely passionate and highly motivated in promoting positive outcomes for people and maximising learner’s independence at every opportunity. Learners at Pier View House were valued and treated as individuals and staff had a comprehensive understanding of their needs.

• The manager was committed to ensuring information was shared with learners in an accessible format including care plans, signage and developing meaningful communication tools. Engagement was at the heart of service delivery and integral to the manager and staff’s core values.

• Learners were supported to receive highly personalised care to meet their needs and care records were person-centred to reflect people’s likes, dislikes and preferences. Learners were regularly consulted and information was updated to reflect their achievements and development.

• Learner’s rights and freedoms were upheld and staff treated people with dignity and respect. The provider took a proactive approach to inclusivity and staff received additional training to promote antidiscrimination.

• Where learners required additional support to manage anxious, distressed and heightened behaviour, we saw robust care planning and proactive support offered.

• Learner’s had access to a wide range of activities to meet their interests, which were flexible to meet their individual needs. Learner’s had easy access to the local community and facilities and were supported to attend a range of events.

• The provider ensured the delivery of high quality care through robust quality assurance processes and there was good communication between the organisation.

• The service met the characteristics of Good across the safe, effective, responsive and well-led domain and consistently demonstrated Outstanding characteristics in caring. More information can be found to evidence this in the full report.

Rating at last inspection:

This service was previously rated as Outstanding at the last comprehensive inspection. This report was published on 30 August 2016.

Why we inspected:

This was a planned inspection based on the previous inspection rating.

Follow Up:

There is no required follow up to this inspection. However, we will continue to monitor the service and will inspect the service again based on the information we receive.

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