School House

School House is a care home for people who may have a learning disability or autism. The service was registered for up to 3 people; 2 people lived there at the time of our inspection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support:

People and their relatives told us they felt safe and supported. Risks were assessed and managed to ensure people could safely participate in activities that they enjoyed.

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 able to receive visitors without restrictions in line with best practice guidance.

Right Care:

People were safeguarded from abuse and avoidable harm. There were sufficient numbers of suitable staff and the provider operated safe recruitment processes. Staff supported people in line with their individual preferences and agreed care plans.

People were supported to receive their medicines safely and were protected from the risk of infection as staff followed safe infection prevention and control practices.

Right Culture:

There was a positive and open culture at the service and systems were in place to provide person-centred care. People and staff were involved in the running of the service and the provider worked in partnership with others to achieve good outcomes for people.

The quality of care was monitored and lessons were learned when things had gone wrong.

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 21 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We completed a focused inspection to review safe and well-led only.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for School House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

School House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered to accommodate up to three people with learning disabilities and autism. At the time of the inspection there were two people living at the 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.

A registered manager was in post. 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 and staff team strived to ensure people could play an active role in the community and to lead full and active lives. People were fully involved in the design and review of their care.

People were supported by a staff team who understood how to protect them from abuse. Care staff managed risks to people in a positive way. Processes were in place to keep people safe in the event of an emergency such as a fire. People were protected from harm while their independence was maximised. People were supported by sufficient numbers of staff who had been recruited safely.

People received their medicines safely and as prescribed. People were protected by effective infection control procedures.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were encouraged to eat more healthily. People were encouraged to be involved in monitoring and maintaining their day to day health.

Staff supported people in a way that was kind and caring. People’s privacy was respected and their dignity was promoted and upheld. People were encouraged to be as independent as possible and were supported to maintain important relationships.

Care staff had been equipped with the skills they required to support people effectively. Processes were in place to respond to any issues or complaints. The registered manager had developed an open and transparent culture within the service where people were respected and everyone was free to share their views. People were fully involved in the development of the service.

A range of quality assurance and governance systems were in place and these were being developed to make further improvements. The provider engaged with the wider community and other organisations in order to drive improvements to the lives of those being supported.

Further information is in the detailed findings below.

School House is registered to provide accommodation and personal care for up to three people who may have a learning disability. There was one person living in the home on the day of the inspection and had lived there for three weeks prior to our inspection. The home had been vacant for more than 12 months prior to the inspection.

There was no registered manager in post at the time of this inspection. 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. A new manager had been appointed and the provider informed us they would be registering with the Commission in the near future. Since our inspection the new manager has registered with the Care Quality Commission so there is now a registered manager in post.

The person told us they felt safe. Staff knew how to protect the person from the risk of abuse. Risks to the person’s safety were managed. There were sufficient numbers of staff to meet the person’s needs. There was a system in place to manage the person’s medicines safely.

When a person’s liberty had been deprived the provider had sought authorisation to do so. When a person lacked capacity decisions about their care were made in their best interests in line with the Mental Capacity Act 2005. The person told us staff supported them well. The person told us they had choices about their food and nutrition. If the person required further support with their health needs a system was in place to allow this.

The person told us and us saw staff were kind and caring. Good relationships had developed between staff and the person living in the home. Staff supported the person to remain as independent as possible and the person was encouraged to maintain relationships that were important to them. The person was supported by staff who respected their privacy and dignity.

Staff knew the care needs of the person. The person felt involved in their care and was able to make choices which staff respected. The person was able to spend time doing leisure activities of their choice which they enjoyed. The person was comfortable in reporting any concerns to staff should they need to.

Staff told us they were involved in the running of the home and they felt supported by the provider. A quality assurance system was in place.

In this report the name of the last registered managers appear. They were not in post and not managing the regulatory activities at this service at the time of this inspection. Their names appear because they were still registered managers on our register at the time of the inspection. After the inspection the provider sent us notifications to cancel the previous managers registrations.

At the time of our inspection two people lived at the home. The service was registered to provide support to people with learning disabilities and/or autism.

Previously, we completed an inspection in November 2013, where we found the provider was not meeting requirements for outcome 10: Safety and suitability of premises.

After the last inspection, the provider sent us an action plan. This told us the action the provider would take to make the necessary improvements and by what date.

At this inspection we checked whether required improvements had been made since the last inspection. We also completed a combined scheduled inspection and looked at other essential standards of care.

We found that the provider had made the necessary improvements with respect to the safety and suitability of the premises. There was one outstanding action. The provider told us that remaining carpets would be replaced by July 2014.

Below is a summary of what we found. The summary is based on our observations during the inspection. We spoke with the two people who used the service and two members of staff. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

The two people we spoke with told us they felt safe. They told us that care staff met their care and support needs and they felt safe when staff supported them in their home.

We found that policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) were in place. This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do so. At the time of our inspection no applications had needed to be made.

We saw that risk management plans were up-to-date and staff said they received updates when people's needs changed. This was intended to ensure that people were not put at unnecessary risk. Staff were able to tell us about risk management plans for people who used the service. Policies and procedures were in place to make sure staff had information they needed so that unsafe practice was identified and people were protected.

Is the service effective?

We found that people had an individual care plan which set out their care needs. Assessments included people's health needs and detailed information on their support needs to include promoting their independence. Both people told us they were working towards moving into their own flats. They were clear of their goals and what they needed to do to achieve them. We saw this information was clearly documented in their support plans. This was intended to ensure that people's individual care needs were met.

People had access to a range of health care professionals. We saw information on health appointments people had attended in the community.

Is the service caring?

We asked people who used the service for their opinions about the staff that supported them. One person told us: 'I am happy with the staff. I can talk to them. I feel relaxed' and another person told us: 'I like staff they are nice'. We observed that staff had positive and warm relationships with people who used the service.

Both people said their preferences, interests and diverse needs were being met. We found this information was recorded and care and support had been provided in accordance with their wishes.

People we spoke with told us that they felt their privacy and dignity were always respected by care staff. One person told us: 'Staff always knock before they come into my room. I can talk to them [staff]. I feel relaxed'.

Is the service responsive?

We saw that people attended weekly house meetings to talk about things they wanted to do and talk about house related issues. We saw examples of where people's comments had been addressed by staff. For example changes were made to menus in line with people's preferences. One person decided they didn't want to go swimming and staff supported them to find alternative healthy activities to take part in.

People took part in regular reviews about their care and support needs. This was documented in the care records we looked at. We saw that staff were well informed about changes to people's support needs.

Is the service well-led?

We found that the service had a quality assurance system in place to ensure the quality of the service continuously improved.

The manager told us they received good support from their management team and had no concerns about the operational running of the home. Staff told us they felt supported by the manager and had effective working relationships with their team.

At the time of the inspection we were informed that the service did not have a registered manager in post. In this report the name of two registered managers appear who were not in post and not managing the regulatory activities at this location at the time of the inspection. Their names appear because they were still Registered Managers on our register. We have spoken with the provider and written to them separately about this.

We spoke with both people who used the service during the inspection, they told us, "I love it here. They (staff) have helped me a lot" and, "I want to move soon to live on my own".

Medication was well managed and both people who used the service were supported to gain independence in this important area.

During the inspection we noted that there were some areas of the home that needed to be repaired, cleaned or replaced to ensure that people were protected from the risk of harm.

The service provided one to one staffing levels throughout the waking day from 7am-10pm and a sleeping in night staff. Staffing levels were sufficient to meet people's needs.

Complaints were appropriately managed and recorded.

Staff are supported through training and supervision by the manager of the service. There is a good system in place for assessing the quality of provision. This is obtained through seeking the views of the people who use the service.