15 January 2022
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was completed by three inspectors and a pharmacist. Two inspectors and a pharmacist visited the service and the other inspector made telephone calls to relatives to gather their feedback about the service.
Service and service type
Hereward College is registered as a college. It provides accommodation for people who require
nursing or personal care during academic term times.
The service had a manager registered with the Care Quality Commission. 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
We gave the service 24 hours’ notice of the inspection. This was to allow staff to inform people living at the service we would be visiting and to arrange for them to speak with us.
What we did before the inspection
Prior to the inspection we reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as safeguarding concerns. The provider completed a provider information return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection-
We spoke with two people who used the service and two relatives about their experience of the care provided. We spoke with nine members of staff including the representatives of the provider, registered manager and care workers which the provider called Independent Living Support workers.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to their recruitment. A variety of records relating to the management of the service, including quality checks and training records were reviewed.
After the inspection –
We continued to seek clarification from the provider to validate evidence found.
15 January 2022
About the service
Hereward College is a specialist college which provides residential accommodation and personal and nursing care for up to 40 younger adults with learning disabilities or autism spectrum disorder. At the time of our inspection 11 people lived at the service during term time. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
Due to COVID-19 restrictions the service stopped operating in March 2020 and began to provide residential care again in September 2021.
People’s experience of using this service and what we found
The provider had systems in place to assess and monitor the quality of the service but we found these were not robust and had not identified areas that required improvement. We found medicines were not always stored safely at the correct temperature. Appropriate procedures were not followed for a person who received their medicines covertly. Covert medicine is when medicine is given to a person without their knowledge.
People were protected by the provider's recruitment procedures. The provider made appropriate
Pre-employment checks to ensure only suitable staff were employed. Staff understood their
responsibilities in terms of safeguarding people from abuse and knew how to report concerns if they suspected abuse.
People's care and support needs were assessed before they moved into the home. Care plans detailed how care workers should support people to meet those needs. Staff had received training and support relevant to people's needs. People were supported to maintain a balanced diet. 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 were supported in a clean and hygienic environment. Staff were aware of processes to reduce the risk of cross infection.
People told us that staff were kind, caring and respectful. We observed positive interactions between people and staff. People's privacy and dignity were maintained, and staff were aware of the importance of supporting people to develop their independence.
People received care that was personalised to their needs and preferences. Staff understood how to support people in a way that respected their equality and diversity and took into account any religious or cultural requirements. Information was provided to people in a format they could understand. People were supported to maintain contact with people who were important to them, and were supported to follow their hobbies and interests.
The provider and registered manager worked in partnership with health and social care professionals to plan and deliver care which met people’s needs. The provider sought feedback about the service from people, their relatives, staff, and health and social care professionals. They used this information to help drive improvement of the service. People and relatives were aware of how to raise concerns. No complaints had been received at the time of our inspection. Staff enjoyed working at the service and felt supported by the registered manager.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Care was person centred to promote dignity and human rights. People were involved in all aspects of their care and were supported make choices relating to the care they received. People were supported to gain independence in ways which were important to them, such as accessing public transport or learning cooking skills. The behaviours of leaders and care staff ensured people using services lead more confident, inclusive and empowered lives.
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 23 October 2019)
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified a breach in relation to good governance of the service.
Please see the action we have told the provider to take at the end of this report.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.