Archived: Framfield House

Framfield House is a residential unit providing accommodation and care to young adults who attend St John's School and College. St. John's is a special educational needs (SEN) school and specialist college that

provides education, care and medical therapy to young people aged 7 to 25, Who have a wide range of complex learning disabilities. Such as autism and related autistic spectrum conditions (ASC) and those who have special needs resulting from behavioural, emotional and social difficulties (BESD). Framfield House is based in Seaford, approximately 13 miles from the college campus and is a 38 weeks a year service, meaning that people can live at the service only during term time. The service is registered for a maximum of nine people. At the time of our inspection, there were nine young adults living at the service.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Nine people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service:

Information regarding people’s DoLS, MCA and Lasting Powers of Attorney (LPoA) was not always clear in their care documentation to ensure staff were aware of specifics, including who was legally entitled to make decisions on a person’s behalf. Information did not include who had been involved in conversations when decisions had been made. However, the impact for people was low as staff knew people well. 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.

The registered manager had created an open and positive culture. Staff felt well supported and the home had a warm and welcoming atmosphere. People were fully involved in the service and had opportunities to give feedback. Staff were well motivated, proud to work at the service, and morale was very high. Systems were in place to monitor the service and drive improvement. One relative told us, “I wish [person] could live here permanently. Its calm, welcoming, homely, clean and spacious. Framfield is well-led and a home from home.”

Systems supported people to stay safe and reduce the risks to them, ensuring they were cared for in a person-centred way. People and relatives told us they felt the home was a safe place to be and felt comfortable to raise concerns with staff. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.

Staff were trained in administering medicines. People were protected by the prevention and control of infection and we observed staff wearing gloves and aprons when supporting people. There was enough staff to support people safely and the registered manager had safe recruitment procedures and processes in place.

Staff knew people extremely well and tailored their support accordingly. Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to live as independently as possible and told us that their needs were met. Activities took place on a daily basis and people were encouraged to participate if they wanted to.

People and relatives told us that staff treated them with kindness and we observed friendly interactions throughout the day. People were supported to ensure their health needs were responded to and health needs were reviewed on a regular basis. People had their privacy and dignity protected.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Outstanding (report published on 24 July 2017).

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care.

Follow up: We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated Good.

Framfield House is a residential unit providing accommodation and care to young adults who attend St John’s School and College. St. John’s is a special educational needs (SEN) school and specialist college that provides education, care and medical therapy to young learners aged 7 to 25, who have a wide range of complex learning disabilities, such as autism and related autistic spectrum conditions (ASC) and young learners who have special needs resulting from behavioural, emotional and social difficulties (BESD). Framfield House is based in Seaford, approximately 13 miles from the college campus and is a 38 weeks a year service, meaning that learners can live at the service only during term time. The service is registered for a maximum of nine people. At the time of our inspection, there were seven young adult learners living at the service all of whom were male. The provider refers to people using the service as learners, which they will be referred to in this report.

There was a registered manager 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 and associated Regulations about how the service is run.

The service had positive culture that was exceptionally person-centred, open, inclusive and empowering. Staff went the extra mile to share information with learners and provide explanations in a way that empowered them to make informed decisions and become more independent

Staff had a common aim and purpose to achieve outstanding outcomes for learners. They excelled at providing consistency which had a positive impact on learners’ wellbeing, reduced their anxiety levels and provided stability.

Learners living at Framfield House were supported with exceptional care, dedication and understanding. Transitions for learners to and from their care setting at college were bespoke and planned thoroughly. For learners with complex physical or emotional needs a great deal of planning and preparation was involved. When changes were needed these were done as quickly as possible, such as recognising the living arrangements were not right for one learner, leading to an entire floor of the service being dedicated for this learner to have their own space.

Learners mattered and the care was exceptionally personalised. Each person had a trusted member of staff, known as a keyworker, who took a lead role in each person's care and wellbeing. They continuously looked for ways to ensure learners had positive experiences and led fulfilling lives. Staff knew about learner's lives, their interests and talents and encouraged them to become more independent and try new things. Staff worked closely and co-operatively through partnership working to make sure learners had access to ongoing support, to remain at college if they wished and to make sure when they moved on, the appropriate arrangements had been made for them.

Learner’s experience of their care and support was overwhelmingly positive. They were involved in the planning and reviewing of their care records and were able to direct their care, and were assisted innovatively to learn how to manage their anxieties and emotions. They discussed and shaped the activities they wished to take part in and were listened to. They took part in socially inclusive activities in their local communities and well as at the college. Learners had work experience and work placement opportunities as well as working in college departments. Information was shared and explanations given to learners to help them form their own opinions and make their own choices and decisions.

Staff were enthusiastic and happy in their work. They felt supported within their roles and held the management team in high regard, describing a management approach, where managers were always available to discuss suggestions and address problems or concerns. There was a strong emphasis on team work and communication sharing. The registered manager and staff had a ‘can do’ attitude and were solution focussed.

Staff were aware of their role in safeguarding learners from abuse and had received appropriate training. We saw risk assessments had been devised to help minimise and monitor risk, while encouraging learners to be as independent as possible. Staff were very aware of the particular risks associated with each person’s individual needs and behaviour.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

Recruitment practices were robust and new staff received and induction to the service which included shadowing experienced staff before working unsupervised. Staff received the training and support they needed to undertake their role.

The registered manager was aware of their legal responsibilities and kept up to date with good practice. They had also formed links with the local community. Accident and incidents had been recorded and monitored to identify trends and themes. Systems of audit were in place and where improvements had been identified, action had been taken to rectify this.