National Star College - Ullenwood

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s health, care, wellbeing and communication needs were thoroughly assessed and reviewed to achieve positive outcomes. Staff worked closely with people, relatives and professionals to understand individual needs and aspirations. Comprehensive assessments informed personalised support, with people at the centre of decision-making. During a multidisciplinary review, we saw how staff, professionals and family members had worked together to develop a detailed plan that reflected a person’s goals and future ambitions. Staff provided ongoing reassurance that support would progress at a pace suitable for people so they would remain fully involved in decisions affecting their life. We saw the positive impact this had on the person and their self-esteem.

People and relatives consistently described support that reflected their individual communication and support needs. One relative explained how staff had significantly improved their family member’s communication and emotional wellbeing through personalised approaches. They told us, “[My relative has] come on leaps and bounds since coming here. [Their] communication in general has come on leaps and bounds. Now [they] can manage [their] feelings, and everything is not so immediate, and we understand so much more.”

Assessments focused on people’s strengths and there was a trauma-informed approach to understanding people’s needs. A residential manager told us, “The wrap around work [for a person we support] has been brilliant. [Sadly, they were] really distressed in [their] last setting. We realised that they needed a trauma informed approach [and we worked as part of a multi-disciplinary to comprehensively assess and meet their needs]. [The person] has now made a strong friendship with [another person], whereas [they] used to run away from people.”

Staff demonstrated a strong understanding of people’s preferred methods of communication, including the use of AAC devices and personalised communication systems. An AAC device (Augmentative and Alternative Communication device) is a tool designed to help individuals communicate when speech alone is insufficient. Observations showed staff adapting support to enable people to express their views and participate fully in student life.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-

People received support from staff who had the skills, knowledge and training to meet their needs safely and effectively. People and relatives told us staff knew how to support them and provided consistent care. One relative said, “[Staff] do a brilliant job. I feel in their debt. They have gone above and beyond.”

The service used recognised communication and behavioural support approaches to improve people’s outcomes. Staff described the use of Positive Behaviour Support (PBS) training and personalised communication methods, including communication and AAC technology. People had access to specialist professionals including nurses, physiotherapists, epilepsy specialists, and GPs. Staff responded promptly and appropriately to changes in people’s wellbeing and communicated effectively with healthcare professionals where required.

People experienced care that promoted independence, confidence and achievement. Staff celebrated successes and supported people to develop skills for employment and future living arrangements.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The provider worked with staff, teams and partner organisations to coordinate people’s care and support. Staff communicated effectively with one another, relatives and external professionals to help ensure continuity of care. Multidisciplinary meetings were held regularly to review progress and plan support, involving people and those important to them wherever possible. These multidisciplinary teams were based around people, and a range of communication channels were set up for each person so information sharing was timely and effective. We saw how this joined up working impacted positively on people’s care and their outcomes. One multidisciplinary team had transformed the persons healthcare to accommodate their religious and spiritual beliefs. Through effective joined up working with the person and their family, they had adapted their approach and practice to meticulously ensure they delivered personalised care. The residential manager said, “[Through a team approach] we are embracing her healthcare.”

Another person who received nutrition via a Percutaneous Endoscopic Gastrostomy (PEG) tube had been supported by a multidisciplinary team to improve their quality of life and social inclusion. A PEG tube is a specialised feeding tube inserted directly into the stomach to enable the administration of liquid nutrition and fluids. The person shared with staff they were missing out on social experiences with their family due to their feeding requirements. In response, the multidisciplinary team worked collaboratively to identify ways to help them feel more included. With support from the Speech and Language Therapy team, the person was able to trial and successfully incorporate a stabilised edible foam into their daily life. This innovative approach provided a range of taste experiences while remaining safe for the individual. As a result, they were able to participate more fully in family meals and social events, helping them to feel more involved and included in shared experiences.

Relatives described positive working relationships with staff and managers, and told us people benefited from coordinated support from a range of professionals. Staff actively advocated for people and worked with relevant organisations to achieve positive outcomes. One relative told us, “We get feedback from the college through [our relatives] personal diary. We also get emails on a daily basis. We can judge [our relatives] happiness. [Our relative] has a large group of keyworkers [and professionals]. It's a nucleus. They all get to know [our relative]. They are all kind and caring. They show genuine concern for [our relatives] welfare.”

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider had a good working relationship with the local GP who was on site weekly to complete planned and as required consultations. They had adapted how care was delivered to mirror how care was provided in the community. This helped to prepare people for when they left college and encouraged independence and autonomy around their healthcare. Relatives spoke positively about health outcomes achieved through the service. One relative explained specialist staff had helped secure access to healthcare appointments that may otherwise not have been available. People told us they could access healthcare support when needed and were encouraged to develop skills that would support them into adulthood and future independence.

The provider supported people to maintain and improve their health and wellbeing. People had timely access to healthcare services and specialist support when required. We spoke to one nurse who told us they had relocated their office inside a residence so they could be more available for people who needed them. They told us, “[Being present is also effective] for prevention. We can be proactively involved in seeing people’s health and lifestyles, meals [nutrition and hydration first hand]. Students are so involved in their healthcare."

Staff worked proactively with healthcare professionals to monitor people’s health needs and respond to changes in their wellbeing. For example, the provider engaged with secondary care colleagues to develop and improve the pathway for people accessing hospital. The joined-up working, centred around hospital passports, helped to reduce health inequalities and raise awareness about the reasonable adjustments people needed to access healthcare equitably. For example, some people with specific health needs found it difficult to wait at hospital outpatient appointments due to the nature of the environment. Staff worked with the hospital liaison nurses and organised, where appropriate, for healthcare professionals, such as epilepsy specialist nurses and the enteral feeding team, to visit people in their own environment where they felt more comfortable. This demonstrated a strong commitment to improving people’s healthcare outcomes.

Hospital admissions and discharged were managed comprehensively to ensure that people’s care needs were consistently met. An admissions assessment was completed for all planned and unplanned admissions to promote excellent communication channels between staff and secondary/ primary care. This enabled people to be supported in accordance with their changing needs and maximise their treatment plans to ensure they were effective and individualised. Discharge meetings were held to ensure staff remained competent and knowledgeable where people’s needs had changed. For example, we saw how one person was supported during a planned hospital admission for major surgery with minimal disruption to their routine and continuity of care maintained throughout. Demonstrating a strong commitment to person-centred support and effective healthcare outcomes, staff travelled over 150 miles to the hospital to provide consistent support for the duration of the person's stay.

People were supported to make healthy lifestyle choices and take part in activities that promoted physical and emotional wellbeing. The service provided opportunities for exercise, recreation, learning and community participation, including sports activities, outdoor pursuits and educational experiences. Observations showed people actively participating in sports, dance, theatre sessions and social events, supported by staff who encouraged independence and confidence. A residence manager shared examples of how health was promoted and encouraged and told us people had recently completed a 500-mile challenge, “[Where necessary, people] could contribute via the conversion chart with using their walkers, swimming etc. The challenge supported healthy lifestyles and encouraged activity. We had a visual chart on the board so people [could track progress]. We also encourage staff to get their blood pressure checked with [people and promote a real] culture around health.” We saw another example in a residence where the nurse actively rotated different topics and subjects on the health information board to share information for specific conditions at specific times of the year.

The provider monitored all people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Staff effectively monitored people’s experiences and outcomes and used this information to continually improve the support they provided. Staff regularly reviewed people’s progress, celebrated achievements and adapted support where necessary. During multidisciplinary reviews, evidence showed a strong focus on understanding outcomes, recognising successes and planning future goals. For example, the provider understood and clearly documented the expectations people had about the care they received and what positive outcomes looked like for them. One person with complex healthcare needs, had a very clear goal relating to a significant family event. Staff were working with the person and occupational health colleagues and showed a commitment to helping the person realise their goal. Another person’s health had been monitored and managed closely to achieve the best possible outcome during a period of ill health. A residential manager told us, “Despite significant surgery, [the person] missed very little of their life as a college student [as their tutors all came to them instead].” This meant the person did not need to take a prolonged period of time away from their education and could continue their ongoing learning and development.

There was a robust approach to monitoring the effectiveness of people’s care, treatment and support, and action was taken to continuously improve it. Clinical monitoring tools were used to monitor people’s health and identify any deviations from their baseline health at the earliest possible opportunity. Staff had developed a good working relationship with the rapid response team to support people who were unwell to prevent hospital admissions and remain in familiar surroundings where they felt most comfortable. A relative told us, “They meet health needs that we just couldn't manage at home.”

The provider recognised the need to liaise with external healthcare professionals in a way which met people’s needs, preferences and expectations. Staff had advocated for some people, who found it difficult to wait for outpatient appointments at their local hospital. They had engaged with the hospital liaison nurse and, as a result, people had been visited at college by the relevant healthcare professional such as epilepsy nurse, enteral feeding team etc. This meant people’s clinical care was monitored and improved in an environment where they felt relaxed and comfortable. Nursing staff spoke eloquently about how they monitored and improved people’s healthcare outcomes, whilst ensuring they were actively engaging in college life. One nurse told us, “We want people to have the life of a young adult. We want to provide the same level of [clinical] care as a nursing home but not feel like an older people home. We want this to be a place for young people [to be safe and healthy whilst achieving the things that matter most to them].” We also saw how healthcare professionals including a GP and physiotherapist supported student trips abroad so people could maximise their opportunities and potential, whilst ensuring their healthcare needs remained monitored and addressed.

People and relatives were given opportunities to provide feedback through surveys, meetings and ongoing discussions with staff. People described being involved in surveys and reviews, while relatives told us managers listened and responded when concerns were raised.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s ability to consent was consistently well documented, with clear records demonstrating people were appropriately informed and had agreed to the care and support provided. Staff understood the significance of providing a clear narrative to ensure people could give informed consent to daily choices and decisions.  

Staff completed training and followed an up-to-date policy relating to capacity and consent. Staff recognised the importance of seeking consent before providing care and demonstrated a person-centred approach. Staff adapted their communication methods to help people express their wishes and preferences in a way that was meaningful to them. Observations showed staff taking time to listen, explain options and support people to participate in discussions about their care. People confirmed they were involved in discussions about their support and care plans. One person told us, “[Staff] listen to what I have to say and take time if I’m unsure.”

We heard how one person had been followed by a well-known broadcaster as part of ongoing coverage of the challenges faced by young adults with disabilities. A mental capacity assessment was undertaken with the person to understand if they were able to make the decision to participate in the project themselves. The provider told us, “Undertaking the mental capacity assessment ensured that [the persons] autonomy was respected while also protecting him from potential harm or exploitation. It provided assurance that any consent given was informed, meaningful and valid in accordance with the Mental Capacity Act.”

The assessment determined the person was able to understand and communicate the purpose of the film and felt proud about taking part in it. The approach taken ensured the person’s rights were respected, and support was delivered in line with the principles of capacity, choice, dignity and independence.