Hereward College

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.

Enforcement

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.

Follow up

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.

Hereward College is a care service within a further education college which provides support for 12 people during term time. These are young people with complex physical needs, learning disabilities and autism. The service can accommodate up to 40 people. This is a large building in the grounds of the college. A respite service is also offered to people over a shorter period of 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

Outcomes for people using the service was positive. Staff were very caring in their approach and had good relationships with people. Promoting independence was a key part of the service and people were encouraged to improve their daily life skills to develop further.

There were enough staff to ensure people were safe. Where risks associated with people's health and wellbeing had been identified, plans were in place to manage those risks while ensuring people could remain independent.

Staff understood their responsibility to safeguard people from harm and knew how to report concerns. Robust systems were in place to ensure any potential safeguarding concerns were prevented at the earliest opportunity.

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; systems supported this practice.

People received care which was responsive to their individual needs. Staff took the time to get to know people and had a good understanding of how to support them well.

Care records provided staff with information in relation to people’s backgrounds, interests and individual health needs.

Staff encouraged people to maintain a balanced diet and respected their individual choices. The provider and staff team worked with external healthcare professionals to ensure people's health and wellbeing was maintained.

A registered manager was in post. Positive feedback was received in relation to the management of the service. People and staff were actively involved in, and had opportunities to feedback about, the running of the service including the re-design of the facilities at Hereward College.

Quality checks were carried out to monitor the service, and these identified where improvements could be made.

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

Rating at last inspection

The service was rated as Good (published 9 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hereward College is a further education college for students with disabilities and additional needs. They provide specialist facilities for both day and residential students with physical disabilities and learning difficulties. They also provide respite care breaks for 16 to 25 year olds. At the time of our visit, 23 students were using the residential accommodation.

The residential unit had a registered manager. 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.

Staff told us the management team were open and transparent. The management team were open with us about their recent Ofsted inspection and the actions they had already taken to put things right. However during our visit, we saw information about an incident which had been dealt with by the college, which we believed should have been reported to the safeguarding authorities.

There were enough staff on duty during the 24 hour period to maintain student safety. Students understood the college's safeguarding procedure and felt confident in reporting any concerns to staff.

Students enjoyed living in the residential unit. They told us staff were caring and fun to be with. Students enjoyed learning to be more independent and developing life skills they could use in the future. They liked the activities they participated in both within and outside of the campus grounds. Students enjoyed the meals they planned, and helped to prepare and cook.

Students told us they felt safe at Hereward College. Student safety was maintained through recruitment practice which minimised the risks of employing unsuitable staff; secure premises and procedures which reduced the risks of uninvited visitors accessing the flats; and through good risk assessments of students health and social care needs.

The college nursing team provided students with good support to meet their healthcare needs. If students needed to visit or be seen by other healthcare professionals such as the GP, these were arranged. The nursing team supported staff with training to help them understand some of the complex needs of students who lived on campus.

Student received their medicines as prescribed. This was either with support from staff, or through self administration. The nursing team oversaw medicine management to ensure medicines were administered safely. Students health and social care needs were also supported by occupational therapists, psychologists and speech and language therapists.

Residential staff enjoyed their work, and most had worked at the college for a long time. They had received training to meet the needs of students who lived on campus, and were provided with management support to undertake their roles effectively. They knew how to safeguard students and who to report any safeguarding concerns to.

Staff cared for the students at the college, and supported them in ways that respected their privacy and dignity. They understood the importance of seeking student consent before undertaking any task, and worked within the principles of the Mental Capacity Act.

Students knew who were the team leaders and the registered manager. They felt able to talk to them if they had any concerns about life at the college. There were regular opportunities for students to voice their opinions about college life, and students told us staff acted promptly if they raised any points. Students were fully involved in planning their care and support needs, and care plans provided detailed information from the person's perspective of how they wished to be supported.

Hereward College is a further education college for students with disabilities and additional needs. They provide specialist facilities for both day and residential students with complex disabilities and learning difficulties. They also provide respite care breaks for 16 to 25 year olds. At the time of our visit, 27 students were using the residential accommodation.

The college has a registered manager responsible for the residential accommodation. 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.

Since our last inspection in 2013, there have been two safeguarding concerns raised. One in relation to a person who received respite support at the college, and another in relation to a student who previously lived at the college. Prior to these incidents the college had started an external review of its policies and procedures to ensure the safety of students and people who received respite care. As a consequence of investigations by the local authority, the college extended the remit of the review to learn lessons from these.

Staff understood their responsibility to safeguard students from harm. Staff were available at the times students needed them and had received training so that students care and support needs were met. Where risks associated with people’s health and wellbeing had been identified, there were plans to manage those risks.

Staff understood the importance of supporting student's independence and providing choice. They understood the principles of the Mental Capacity Act, and management were aware of Deprivation of Liberty safeguards. At the time of our visit, no student living on site was considered to lack capacity to make their own decisions. Students told us they were supported to be independent, and were able to engage in hobbies and activities that interested them.

Students were supported to menu plan and encouraged to cook their own meals where possible. Students ate in their own flats and also used college facilities for meals. Since our last visit, the college has worked to improve the understanding of both staff and students in relation to healthy eating.

Students were referred to external healthcare professionals to ensure their health and wellbeing was maintained, as well as being referred to healthcare staff based on campus. These included a nursing team, psychologists, occupational therapists, and speech and language therapists. Medicines were managed so that people received their medication as prescribed.

There were processes to monitor the quality and safety of the service provided and to understand the experiences of students who lived on site. Arrangements were in place so that actions were taken following concerns raised, for the benefit of students who lived in the accommodation.

"I'm really enjoying it - it's a good college. The support from the staff is brilliant."

"The accommodation is really good. It gives you a sense of independence and having your own space...nothing is too much for anyone."

"The staff are absolutely fab - you can have a laugh but at the same time they know there is a job to do."

We looked at the nutrition provided to students. We were satisfied students received nutrition and hydration to meet their needs. Students were also given good support to develop independent cooking skills.

We looked at the equipment used to support the care and well being of students in their stay at Hereward College. We saw there were good systems in place to ensure equipment was safe and well maintained.

We talked with staff about the support they received from the college to help them work effectively with student care. Staff told us they felt well supported to undertake their roles.

We looked at cleanliness and infection prevention measures. We saw the accommodation was clean and tidy. There were good systems in place to prevent the spread of infection.

We looked at the complaints procedure. We saw the complaints procedure was accessible. The college had taken the small number of complaints it had received seriously. Students told us they felt able to inform staff if they had concerns.

We observed students being treated with dignity and respect. We were told by one student 'the staff ask us for our opinions'yes I think they do listen to what I say'.

We saw good care planning and assessment records to ensure the safety and well being of students.

We noted staff had received training to help them identify and understand what to do if they were concerned a student was being abused (safeguarding adults). Students told us they felt safe at the college.

We saw sufficient staff on duty to meet the care and nursing needs of students. Staff had been well trained to understand the individual needs of students. One student told us 'we have consistent staff, they have different titles, some are care support, some are mentors, and there are also nurses'staff work in the same flats so we get to know them pretty well'.

We saw records which demonstrated good recruitment practices ensuring people who worked in the college were safe to work with students.

The college had good systems in place to assess and monitor the quality of residential provision and care support provided to students living on campus.