We carried out a review of the data available to us about Old School House 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 Old School House, you can give feedback on this service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Good
People were kept safe from abuse and harm. Staff had received safeguarding training and understood how to raise safeguarding concerns. Individual risk assessments gave staff with the information to reduce and manage risks to people wherever possible. Care plans were personalised with the details and information that staff needed to provide person centred support.
Staff were recruited safely, they were supervised and appraised by the registered manager. Staff felt supported to carry out their roles and there were sufficient numbers of staff to meet people’s needs.
Staff were trained and competent to ensure that medicines were stored and administered safely. The provider carried out regular audits to ensure that medicines were monitored correctly. The service worked proactively with local GPs and a range of professionals, to make sure people received the support they needed.
Staff knew people well and supported them with kindness and compassion. People were comfortable and relaxed, and there was a mutual sense of respect, dignity and equality.
Consent was obtained from people before any care or support was provided and this was recorded and kept under review. The provider and registered manager worked in line with the principles of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS).
People understood how to complain. There was a complaints policy and forms in an accessible format. Staff understood the need to learn from complaints and respond to them as part of good care practice.
The service was well-led with a positive, empowering, person-centred culture that supported people to be independent. Quality was monitored and improvements made as required.
Further information is in the detailed findings below.
Old School House provides accommodation and personal care for up to eight people with a learning disability who may have an autism spectrum disorder. The service accommodates people whose wish is to maybe live more independently and staff work with people to achieve this aim. At the time of the inspection there were eight people living at Old School House and no vacancies. The service is a detached brick built house. It is set in a quiet lane just on the outskirts of New Romney town, but within walking distance to the high street. Each person has a single room, with two situated on the ground floor. In addition there are two bathrooms, a shower/bathroom, two separate toilets, large kitchen/diner, smaller training kitchen, lounge with doors to the garden and smaller upstairs lounge/diner. There is an enclosed garden with a paved seating area, lawn and raised beds and parking area at the back of the house. There is additional parking in the lane.
Rating at last inspection
At the last inspection, the service was rated Good and Requires Improvement in the 'Safe' domain.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 26 April 2016. A breach of legal requirements was found relating to managing risks associated with people’s care and support. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12 of the Health and Social Care Act Regulated Activities Regulations 2014, Safe care and treatment. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Old School House on our website at www.cqc.org.uk
Why the service is rated Good.
People told us they felt safe living at Old School House and staff were on hand to help them when they needed support. One person said, “This is a brilliant house”.
People received their medicines safely and when they should. There were systems in place to ensure medicines were managed safely.
Risks associated with people’s care and support were assessed and staff took steps to keep people safe whilst enabling their independence.
Staff knew how to recognise and respond to abuse. They had received training on how to keep people safe.
People benefited from living in an environment that was spacious and homely and equipment was regularly serviced.
Any accidents and incidents were recorded and appropriate action taken to reduce the risk of further occurrences.
People were protected by safe recruitment procedures. People had their needs met by sufficient numbers of staff and staff rotas were based on people’s needs and chosen activities.
Old School House provides accommodation and personal care for up to eight people with a learning disability who may have an autism spectrum disorder. The service accommodates people whose wish is to maybe live more independently and staff work with people to achieve this aim. At the time of the inspection there were eight people living at Old School House and no vacancies. The service is a detached brick built house. It is set in a quiet lane just on the outskirts of New Romney town, but within walking distance to the high street. Each person has a single room, with two situated on the ground floor. In addition there are two bathrooms, a shower/bathroom, two separate toilets, large kitchen/diner, smaller training kitchen, lounge with doors to the garden and smaller upstairs lounge/diner. There is an enclosed garden with a paved seating area, lawn and raised beds and parking area at the back of the house. There is additional parking in the lane.
The service is run by 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.
People were not fully protected by the risks associated with their care and support. Most risks had been assessed, but not all and some guidance required further detail, in order to keep people safe.
People received their medicines safely and when they should. People were involved in the planning of their care and support. Care plans contained information about people’s wishes and preferences. They detailed people’s skills in relation to tasks and what support they required from staff, in order that their independence was maintained. People had regular reviews of their care and support where they were able to discuss any concerns or aspirations.
People were supported to make their own decisions and choices and these were respected by staff. Staff had received training in the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood this process.
People were protected by safe recruitment procedures. New staff underwent an induction programme, which included shadowing experienced staff, until staff were competent to work on their own. Staff received training relevant to their role. Staff had opportunities for regular one to one meetings and team meetings, to enable them to carry out their duties effectively. All staff had gained qualifications in health and social care or had signed up to obtain these. People had their needs met by sufficient numbers of staff. Staff rotas were based on people’s needs, health appointments and activities.
People were relaxed in staff’s company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. Staff were kind and caring in their approach and often used banter and good humour. The staff team was small and had built up relationships with people and were familiar with their life stories and preferences.
People had a varied and healthy diet and were involved in planning the menus, shopping, preparation and cooking of their meals. Some people cooked their own meals at times. People were involved or responsible for household tasks and some accessed the local community independently. People had a varied programme of interactive and leisure activities that they had chosen and regularly accessed the community.
People were supported to maintain good health and attend appointments and check-ups. Appropriate referrals were made to health professionals when required. People did not have any concerns, but felt comfortable in raising issues. Their feedback was gained both informally and formally. Audits and checks were undertaken to ensure the service was effective. The registered manager had an open door policy and they took action to address any concerns or issues straightaway to help ensure the service ran smoothly.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.
We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records. If you would like to see the evidence supporting our summary please read the full report.
Is the service safe?
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one. Policies and procedures had been developed by the registered provider to provide guidance for staff on how to safeguard the care and welfare of the people using the service. This included guidance on the Mental Capacity Act 2005 and (DoLs).
We looked at the safety of the premises and found that it was suitable to meet the needs of the people living at the service. We found that special adaptations had been put in place to support people to remain independent.
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.
Is the service effective?
Feedback received from people using the service was positive and confirmed people were happy with the standard of care provided. Comments included: "I like it here; I get to go into the community'. Likewise, in relation to meals, one person reported: "The food is great I get to choose and help cook and sometimes we have takeaway'.
All of the people living in the home had an individual support plan which set out their support needs. People told us they had been fully involved in the assessment of their health and care needs and had contributed to developing their care plan.
Is the service caring?
On the day of our visit the general atmosphere in the home was calm and relaxed. The people living at the service were observed to be comfortable and relaxed in their home environment and were able to follow their own plans and preferred routines. Staff were attentive to the diverse needs of the people living in the property and were noted to communicate and engage with the people they supported in a respectful, dignified and caring manner.
Staff were aware of people's preferences, interests, aspirations and diverse needs. Our observations of the care provided, discussions with people, and records we looked at told us that individual wishes for care and support were taken into account and respected.
One person who lived at the service told us 'I have lived here a long time, the staff really help me'.
Is the service responsive?
People told us they were able to participate in a range of activities both in the home and in the local community. The activities included ones that people could enjoy as a group, and others that met their individual interests.
People told us they were regularly involved in reviewing their plans of care; and their choices were listened to. We saw evidence in care plans that people had identified their own goals. One person had stated they wished to go swimming and we noted that this plan had been put in place. One person told us that they had wanted to go on holiday. We saw evidence and talked with staff and this confirmed that the person who lived at the service had gone to Butlin's on holiday.
Is the service well- led?
People's personal care records, and other records kept in the home, were accurate and complete. The service worked well with other agencies and services to make sure people received their care in a joined up way. We noted this when we viewed people's annual reviews and noted that outside agencies had been involved in the person's review process.
The service has a quality assurance system, we were told that identified shortfalls were addressed promptly.
Staff told us that the home had received an award for good care practices and we were shown the trophy that was awarded to the home.
People told us they were able to make their own decisions and choices regarding their day to day care and support. Some people were able to and had signed their care plan. People also gave their consent to care and support by talking through their choices each day with staff.
People told us they were satisfied with the care and support they received. One person said, 'I like living here, we do nice things'. Another person said, 'They're good at looking after people here'. A relative told us, 'It's very good; I don't think I could fault it. I would give it 99 out of 100'. People knew about their care plan or confirmed staff had talked about the care and support they required. People said they had review meetings where they discussed their aspirations and any concerns.
People told us they got their medication when they should. One person said that they managed their own medication.
People said they felt there was enough staff on duty to meet their needs. They told us staff supported them when they needed help.
People did not have any complaints, but felt confident if they did these would be 'sorted out' by the staff.
People told us they were able to make decisions and choices in their day to day lives. They said their privacy was respected.
People told us they were satisfied with the care and support they received. One person said, 'I do like it here'. Another person said, 'It's good here, I can see my friends'. People knew about their care plan or confirmed staff had talked about the care and support they required. People said they felt safe living at Old School House and would talk to staff if they had any concerns.
People felt staff had the right skills and experience to meet their needs. They said they liked the staff and felt they helped them when they needed help.
People said they were given opportunities to express their views and give feedback on the service provided.