We carried out a review of the data available to us about Royal College Manchester on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Royal College Manchester, you can give feedback on this service.
Royal College Manchester is part of the Seashell Trust. The service provides accommodation and support to up to 40 young adults with profound and multiple learning difficulties. Most people using the service are supported to attend the on-site college or school but the service also provides short breaks for young adults. The accommodation is provided by ten, four-bedroom, purpose built homes. Each home was adapted to meet the needs of the people living there.
People were receiving accommodation and personal care as a single package under one contractual agreement. CQC regulates both premises and the care provided, and both were looked at during this inspection.
People’s experience of using this service:
People received personalised care that suited their needs. People and relatives we spoke with told us they felt well supported and were happy. We observed people being treated as individuals and supported accordingly.
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.
People were treated as individuals and encouraged to develop life skills and be a part of the wider community.
People’s needs were assessed well in advance of them moving to the college to allow staff to identify other people who they may get on with and place them in houses together.
Staff were skilled in communicating with non-verbal people. Staff knew the people they were supporting well and understood their communication needs. This allowed staff to understand the person’s choices and mood.
Homes were adapted to suit the needs of people and, where appropriate, technology was used to allow people to control their own environment.
People were supported to be active and participate in activities both on-site and in the local community. Where appropriate the service tried to find people work placements to develop their life skills further.
The service met the characteristics of good in all areas and is therefore rated as good overall. More information is in the full report which is on the CQC website www.cqc.org.uk
Rating at last inspection:
At the last inspection the service was rated good (published 4 August 2016).
Why we inspected:
This was a planned inspection based on the rating of the service at the last inspection.
Follow up:
We will continue to monitor the service through information we receive and future inspections.
Royal College Manchester is an independent specialist residential and day college. The educational aspects of the college are regulated by OFSTED. It is the accommodation, care and support provided on site for people who require nursing or personal care which is regulated by the Care Quality Commission.
At the time of our inspection the service was registered to provide personal care for 40 people with severe and complex difficulties. These included a number of people who used the service with autistic spectrum disorder and multisensory impairment; all had communication needs and many presented with challenging behaviour.
The college is part of the Seashell Trust and is located on a large secure site in Cheadle, Manchester, which it shares with Royal School Manchester. It is referred to as ‘Seashells’. When we inspected there were 24 people in residential placements with 16 people registered with the short break unit. This unit supports people for a few hours per day and/ or longer stays.
There was a registered manager in place. 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. The registered manager was present throughout the inspection.
At the time of our inspection the service was nearing completion of a large and extensive programme of rebuilding. The older accommodation had been decommissioned and all residential people who used the service were in the process of transferring to new purpose built housing houses, each house accommodating up to four people. Each person had their own bedroom with en-suite facilities, and access to a communal lounge and kitchen/dining area. All the houses had been designed in a way to meet the complex needs of the people who live in them and had been planned to ensure the safety and security of people and to minimise the risk of accidental injury. The majority of residential people who used the service had moved and settled into their new homes, and it was anticipated that the last group, along with the short break unit, would be moving within the month following our inspection.
The people who used the service had complex needs and communication difficulties which meant that we were unable to speak to anyone who used the service; we contacted their relatives who told us that they were very happy with the care their relative received. One parent told us “[The] care whilst at Seashell Trust has always been to the highest of standards. Support has been excellent throughout the past three years.”
We saw that suitable arrangements were in place to help safeguard people from abuse, there was a safeguarding policy in place and all members of staff were aware of the whistle-blowing procedure.
Infection control measures were in place and when we looked around the houses we saw that all areas were well lit, clean and warm.
Equipment and services within the home were serviced and maintained in accordance with the manufacturers' instructions.
The service had a fire risk assessment and we saw that an evacuation plan had been drawn up for each person dependent on their needs for support in the event of an emergency.
People were cared for by sufficient numbers of suitably trained staff. We saw staff received the training and support required to meet people’s needs well. Staff spoke highly of their training and said this prepared them well for their role.
The staff we spoke with had an in- depth knowledge and understanding of the needs of the people they were looking after. We saw that staff provided respectful, kindly and caring attention to people who used the service.
All staff had been trained in medicines management and there were appropriate arrangements were in place for monitoring and administering medicines, but we found that the system for ordering medicines and liaising with general practitioners (GPs) was bureaucratic and cumbersome, and could lead to delays in responding to changes in medicines. This has been recognised as a concern by the registered manager and plans to streamline the system were currently being implemented
People’s needs were assessed and care and support was planned and delivered in line with their individual care needs and preferences. People had detailed, individualised support plans in place which described all aspects of their support needs.
People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. Staff were vigilant to needs; people were offered choice in how they were supported and were involved in day to day decisions about their care.
Staff were trained in the principles of the Mental Capacity Act (2005), and could describe how people were supported to make decisions to enhance their capacity and where people did not have the capacity; decisions had to be made in their best interests.
Although specific dietary needs were taken into consideration, we saw that meals were prepared in the individual houses, and the quality of food would be dependent on the skills and knowledge of the individual care workers preparing the food. We found that provision of food across the separate houses was inconsistent and did not always promote a healthy balanced diet. This has been acknowledged by the service and at the time of our inspection work had begun to review the quality and nutritional value of meals.
All residents had their own activity plan with a timetable of activities drawn up by the key worker in partnership with the residential student. The service had a wide range of resources for use by the residential people who used the service, including a fully equipped gym, swimming pool and ‘Gamelan’ Room equipped with a range of timpani and wind instruments to provide sensory and aural stimulation. Each house had a separate activity room; some had been adapted into sensory rooms, others provided safe areas or study areas to allow for the needs of the residential people who used the service
The service had clear aims and objectives, and to help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided and there were systems in place for receiving, handling and responding appropriately to complaints.
As the people who lived and attended college at Royal College Manchester had limited communication skills we contacted four family members. However we were able to speak with two students through an interpreter. The interpreter was the manager of the children's services provided by Royal College Manchester.
People told us that they were pleased with the care their family member received. Comments we received were; 'I have always found mangers and staff approachable, they had 'SKYPE' installed so that we could see each other so that we could 'talk' to each other'. 'The staff have the skills to care for X, I cannot fault the personal care'. 'I have no complaints; all have been excellent, fantastic communication and kept informed all along the way'.
The staff we spoke with were happy working at Royal College Manchester and said that they were well supported and that there was plenty of training offered.
We looked at support plans for three students and found them to be detailed and personal to the individual being looked after. There were appropriate assessments and care plans which were updated and reviewed as necessary.
We looked at the arrangements that the provider had in place for ensuring that people were protected from abuse and found them to be robust and effectively implemented. We looked at the arrangements for managing people's behaviour including the use of restraint and found it to be appropriate and effective.
Staff told us they were satisfied with the levels of training, education and support they received and many were extremely complimentary of the college.
We looked at the buildings and found them safe, suitable and noted that appropriate maintenance arrangements were in place.