Archived: Borradaile House

Borradaile is a residential home providing accommodation and care to eight young adults who attend St John's School and College. Borradaile is based in Brighton on the college campus. There were eight young men living at the home at the time of the inspection. The young men living at the home are referred to as learners by the provider and within this report. Learners can live at the home for their three years at the college, 38 weeks a year, during term time.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were protected from the risk of harm. Risks to people were assessed and reduced and staff supported people to take positive risks to improve their independence. Medicines were managed safely, and the home was clean and hygienic.

People were supported to eat a balanced diet and had access to health professionals as required. Staff received training specifically related to people’s needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received support from a staff team who were kind and caring. A relative told us, “The staff are kind and caring, they look after him and support him to do the things he likes." People’s choices were listened to and supported, and their views were sought by staff. People’s independence was promoted, and they were given opportunity to develop their skills. People’s privacy and dignity was respected.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were involved in the planning of their care and support. Their care plans were individualised and reflective of their needs and preferences. People had access to a range of activities and the home had strong links with the local community.

The home was well managed. Staff spoke highly of the management and support they received. One member of staff told us, “The senior staff are outstanding and have given me good guidance and direction.” There were quality assurance and monitoring systems in place to support the people to receive high quality care. People and staff were engaged in the running of the home.

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 good (The report was published on 26 July 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Borradaile House is a residential unit providing accommodation and care to young adults who attend St John’s School and College. St. John’s 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, such as autism and related autistic spectrum conditions (ASC) and young people who have special needs resulting from behavioural, emotional and social difficulties (BESD). Borradaile House is based next to the college campus and is a 38 weeks a year service, meaning that people can live at the service only during term time. At the time of our inspection, there were eight people living at the service all of whom were male. Six learners live within the main house, with another two living in a self-contained flat below. The provider has five separate residential locations in the Brighton and Hove area. This report relates to Borradaile House. The provider refers to people using the service as learners, which they will be referred to in this report.

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 and associated Regulations about how the service is run.

Learners living at Borradaile House were supported with exceptional care, dedication and understanding. Transitions for learners to and from their care setting at college was bespoke and planned thoroughly. For learners with very complex physical or emotional needs a great deal of planning and preparation was involved. By liaising and co-ordinating with relatives, other professionals and authorities, staff and the environment were prepared to reflect each individual learner’s preferences and routines. When changes were needed these were done as quickly as possible, such as recognising group living wasn’t right for one learner, leading to a flat being developed for this learner to have their own space. Staff worked closely and co-operatively through partnership working to make sure learners had access to ongoing support, to remain at college if they wished and to make sure when they moved on the appropriate arrangements had been made for them.

Learner’s experience of their care and support was overwhelmingly positive. They were involved in the planning and reviewing of their care records and were able to direct their care, and were assisted innovatively to learn how to manage their anxieties and emotions. They discussed and shaped the activities they wished to take part in and were listened to. They took part in socially inclusive activities in their local communities and well as at the college. Learners had work experience and work placement opportunities as well as working in college departments. Learners benefitted from new and creative methods of communication and staff worked proactively to help learners to make choices and decisions about their care and lifestyle. Learners were supported to be as independent as possible, taking responsibility for their medicines, and learning new skills.

Outstanding training resources equipped staff with the skills, knowledge and understanding to meet the challenges of supporting learners with diverse and complex needs. They said the learners were “at the centre” of everything they did. Staff were supported to develop individually, to voice concerns which they were confident would be listened to. Bespoke training had been developed to ensure that learners remained safe and had their health and wellbeing protected at all times. Staff were passionate, committed and motivated to make sure the learners journey through college was a positive experience.

Learners were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One learner told us, “I like living here”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

Learners were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and staff knew what to do.

Learners were encouraged and supported to eat and drink well. There was a varied daily choice of meals and learners were able to give feedback and have choice in what they ate and drank. A relative told us, “It’s been amazing what they have done with [my relative] and what he eats. He was so fussy and had such limited eating habits. They have got him eating things that we wouldn’t have believed possible. We’d have ended up wearing it if we’d served it to him”. Special dietary requirements were met, and weight was monitored, with permission. Health care was accessible for learners and appointments were made for regular check-ups as needed.

Learners were encouraged to express their views and had completed surveys. Feedback received showed they were satisfied overall, and felt staff were friendly and helpful. Learners and their relatives also said they felt listened to and any concerns or issues they raised were addressed.

Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where managers were always available to discuss suggestions and address problems or concerns. One member of staff told us, “St John’s is incredibly supportive and understanding around staff”. The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.

The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us 'Yes I like everything literally, the staff are great'. Another person who used the service told us 'I do like it here. The staff are nice'. Staff we spoke with referred to people who used the service as 'learners' and had a good understanding of their support needs. One member of staff we spoke with told us 'The care here is very good. We have a good rapport with the learner's and they seem fine and happy here'.

Staff we spoke with said that they had undertaken training for safeguarding vulnerable adults and children. We saw robust systems and accessible information in place in respect to safeguarding.

We spoke with three care workers during our inspection and were told that they felt valued and supported, and that their training needs had been met. We also saw that the service had quality assurance systems in place to monitor the quality of the service provided, and to gain the views of the people who used the service.