Archived: College House

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people’s needs were not always met.

The provider was in breach of legal regulation in relation to person-centred care and safe care and treatment.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care plans lacked evidence of people’s involvement and were not regularly reviewed or updated to reflect changing needs. We found people’s care plans did not include information about their preferences, emotional or mental health needs.

Relatives confirmed gaps in communication and planning: “(Person’s name) loves going out, but she only goes shopping once a week now and rarely sees Mum.” This showed the provider was not proactive in enabling choice and control.

This contributed to the breach of regulation in relation to person centred care.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

One person’s local authority plan was not fully integrated into their care records, and mental capacity assessments were missing where restrictions applied. Staff relied on verbal handovers, but the last written handover was dated over a month before our visit, increasing the risk of missed information and poor outcomes for people.

Relatives told us, “We didn’t know (Person’s name) had been admitted to hospital until after she came home.” This demonstrated poor continuity and communication.

Professionals told us referrals were made, but records lacked clarity on follow-up actions.

The provider did not always provide clear and accessible information. Guidance for staff was not easy to find, and care plans were not available in accessible formats.

The registered manager told us they were aware of the Accessible Information Standard (AIS), and they would provide care plans in different formats if required. Since 2016, all organisations that provide publicly funded adult social care are legally required to follow the AIS. The AIS tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication.

Relatives said communication about health events and hospital admissions was poor, although they said staff were approachable when concerns were raised. This lack of timely and clear communication meant people and families were not fully involved in decisions about care.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

The provider did not consistently involve people and their families in decisions about care. Surveys had not been sent since December 2024, and there was little evidence of feedback being acted on. We spoke with the registered manager about this, who informed us they had sent out other surveys since this, however, despite requests the registered manager provided no evidence of this when requested.

People told us they felt able to speak to staff and were generally happy, but relatives wanted more regular updates and involvement in planning.

The provider did not always make sure people could access the care, support and treatment they needed when they needed it.

The provider did not always ensure equitable access to opportunities. People could access healthcare appointments, but outings and social activities were limited due to staffing shortages. One person was funded by the local authority for six hours of community access per week, however they did not receive this support due to inadequate planning and staffing levels.

Relatives told us, “She used to go on holiday, but now she rarely goes out.” Staff confirmed low staffing levels meant some people could not go out as planned. This reduced people’s ability to maintain relationships and participate in activities they enjoyed.

Frameworks such as Right care, Right Culture and Right support were not always being implemented. This guidance aims to enhance the quality of care for autistic people and people with a learning disability, ensuring they receive appropriate support. Failing to follow this framework can result in a significant reduction in quality of life for people.

The home environment was accessible, and adjustments such as ground-floor rooms were in place.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The provider did not always promote equality in experiences and outcomes. While some people told us they were happy, records showed inconsistent support for individual goals and preferences. There was no evidence of audits or plans to monitor equality and diversity, and care plans lacked detail about cultural or personal needs.

We spoke to the registered manager about people’s specific learning disabilities to ensure their care and support was tailored to the person’s needs, the registered manager was not aware of people’s specific learning disabilities and people’s care plans lacked detailed information. This meant people’s care and treatment was not always designed with a view to achieving people’s preferences and ensuring their needs are met.

Staff told us they “treat everyone the same”, but this approach does not ensure personalised care.

This contributed to the breach of regulation in relation to person centred care.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider did not have effective plans for people’s future needs. People’s care records did not always include details about what was important to them at that stage of their life, such as specific wishes relating to funeral arrangements, people’s decisions on who they would want present and what mattered to them personally.

One person’s end of life care needs were not being met, the registered manager and provider failed to identify this shortfall. This put the person at risk of pain and discomfort.

One person’s care plan stated goals like, “Go to the zoo” and, “See Mum more”, but there was no evidence these were achieved or worked towards. Staff said they relied on knowing people well, but this was not supported by documentation, leaving a risk preferences could be overlooked.

This contributed to the breach of regulation in relation to person centred care and safe care and treatment.