The Old School House

Updated 19 November 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Old School House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection

During the inspection

We spent time observing people in communal areas who were unable to communicate with us. We spoke with one person and nine staff including five support staff, the deputy manager, the registered manager and a compliance officer. We also telephoned two relatives, who had agreed for us to contact them and three health professionals.

We reviewed the care records of three people and medication records. We looked at one staff file in relation to recruitment and records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 19 November 2019

About the service

The Old School House is a residential care home providing personal and nursing care to younger adults with autism, learning disability and sensory impairment.

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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 18 people. 18 people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. Staff were discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People benefitted from a well-led service, which placed people at the heart of everything they did. The registered manager was passionate and inspired staff to provide quality person-centred care delivering good outcomes for people. People were valued and loved for who they were.

The service continuously strived to ensure people were part of the community they lived in. 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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. Feedback from health professionals and family was consistent, praising the service for its individualised care and enabling support to people. People looked well cared for and relaxed.

People were treated as individuals and were valued and respected. Staff ensured people’s privacy and dignity was protected and knew people very well, they were intuitive to people’s methods of communication.

People were cared for safely and could be assured that staff had been checked for their suitability to work with them. People’s medicines were administered safely, and people could rely on them being given at the times they needed them.

There were effective systems in place to manage the quality of the service and drive improvements. People’s feedback was sought and acted upon. Staff were valued and proud they worked at The Old School House.

Staff were well motivated and managed. People could be assured they were cared for by staff who had the training, skills and knowledge to provide effective and safe care.

People, families and staff were confident if they had a complaint they would be listened to and action taken to address the issue. The registered manager was open and honest, encouraging and welcoming ideas to develop and improve the service.

People's support focused on them having as many opportunities as possible for them to gain new skills and experiences and be as independent as possible.

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 (published 5 April 2017).

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.