Background to this inspection
Updated
6 December 2019
The inspection
We carried out our inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. Our inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection was completed by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Education & Life Skills - Warford is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because people are often out and we wanted to be sure there would be people at the service to speak with us.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and commissioners of the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service. The majority of other people could not give us their views so we observed them being supported by staff. We observed staff supporting people to eat and administering medication. We spoke to the registered manager, two house managers, two senior support staff, four support staff and a group of nine support staff before a team meeting. The Expert by Experience also spoke to nine people's relatives over the phone in order to gain their views.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including staff training, audit documentation, meeting minutes, policies and procedures were reviewed.
Updated
6 December 2019
About the service
Education & Life Skills - Warford is a residential care home that was providing personal care and accommodation for 18 people in two adapted ‘houses’ at the time of the inspection. The service specialises in supporting younger adults who have a learning disability or are autistic. Most of the people using the service were also students at the provider’s school and specialist college on the same site.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
People’s experience of using this service and what we found
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement. As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 supported by a team of safely recruited, trained and experienced staff. People's received their medicines when they needed them, and their healthcare needs were met. People also benefitted from having access to support from a range of healthcare professionals and therapists who worked on site.
People were supported to access and participate in a range of activities, sports and pastimes they enjoyed. People were supported to meet people, socialise and try new things.
People were relaxed in the company of staff and each other. Relatives felt staff had a good understanding of their loved one's needs and how to communicate with them effectively.
People received the support they needed to eat a balanced diet that met their needs and preferences. Mealtimes were flexible and varied according to individual needs and commitments.
People’s needs had been assessed and planned for before they moved into the service. This helped to ensure that people received planned and co-ordinated person-centred support.
The registered manager and house managers had a good understanding of their roles and responsibilities and of people’s needs. There were systems in place to assess the quality of the service people received and bring about improvements. Relatives and staff felt the service was managed well.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: Good (published 7 April 2017)
Why we inspected:
This was a planned inspection based on the previous rating.
We will continue to monitor the information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.