Collegiate House

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.

This is the first assessment for this newly registered service. This key question has been rated 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 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, well-being and communication needs with them. People's needs, preferences and aspirations were comprehensively assessed and regularly reviewed to ensure support remained personalised and responsive to people’s changing needs. People were actively involved in reviews of their care and support, with family members and those important to them included where appropriate. A relative said, “There is a care app, which I can access on a daily basis. There are no issues, I am happy where [name] is living.” Regular reviews were also undertaken by social work professionals, helping to ensure a coordinated approach to meeting people's needs.

Care records were consistently updated by staff and reflected people's current needs, preferences, wishes and goals. A staff member told us, “We provide great person-centred care. We always involve people in their care. We are always tweaking the support plans; all staff follow this. The residents enjoy living here. The staff team is very good, we have a small team, everyone gets on and we always have resident’s best interests at heart and forefront.” Care plans contained detailed and holistic information about people's life histories, cultural and religious needs, personal interests, strengths and the outcomes that were important to them. This enabled staff to develop a thorough understanding of each person and provide highly individualised support. Staff continuously assessed people's well-being and changing needs through daily interactions. For example, staff recognised each day when 1 person preferred to remain at home and spend time completing jigsaw puzzles rather than undertaking an activity or community outing. Staff respected and responded to these choices, demonstrating a flexible approach that promoted this person's independence, autonomy and well-being.

People's individual goals were clearly linked to their care plans, enabling staff to effectively monitor progress, record achievements and continually support people to work towards their aspirations and desired outcomes. Staff demonstrated a commitment to listening and responding to feedback. For example, a staff information board was identified as causing anxiety for some people during shift changes. The provider acted promptly to remove the board, which resulted in a reduction in people's anxieties and improved their experience of transitions throughout the day.

Staff completed detailed daily records which provided a clear and accurate account of people's care, support and well-being. Records contained relevant information about changes in needs, outcomes achieved and actions taken, ensuring continuity of care and supporting effective decision-making.

The provider always 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. They worked to develop evidence-based good practice and standards. People received annual learning disability health checks, helping to identify and address health needs at an early stage and promote positive health outcomes. Staff had developed strong and effective working relationships with healthcare professionals. Staff worked closely with the local GP, who visited the service regularly to review people's health and well-being and ensure any emerging concerns were responded to promptly. This collaborative approach supported people to access timely and appropriate healthcare interventions.

Staff demonstrated a proactive approach to managing people's health needs and sought specialist advice when required. For example, they worked closely with neurology specialists to establish whether a person had experienced an epileptic seizure. This intervention was particularly important as the person had remained seizure-free for many years and the outcome of the assessment could have influenced future treatment and medication decisions. Staff's vigilance and partnership working ensured decisions about the person's care were informed by specialist expertise and the most up-to-date clinical information.

Care plans contained detailed and comprehensive information, including guidance and recommendations from health and social care professionals. Staff incorporated this advice into people's everyday support to promote positive outcomes. For example, specialist input from positive behaviour support professionals was embedded within care planning, enabling staff to provide consistent and person-centred support. In another example, staff followed advice from healthcare professionals relating to a person's physical health, which contributed to improved outcomes through targeted orthopaedic support and successful weight management.

Staff received specialist training to ensure they delivered care in line with recognised best practice. This included British Institute of Learning Disabilities (BILD)-accredited Positive Behaviour Support (PBS) training, which is aligned with the Restraint Reduction Network's principles, which aims to reduce restrictive practices for people. As a result, staff understood how to proactively support people in ways that promoted their rights, independence and quality of life, while reducing the likelihood of restrictive practices being used. The service's commitment to evidence-based approaches helped people achieve better outcomes and receive support that was both effective and person-centred.

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. There was a strong culture of teamwork throughout the service, all staff consistently told us morale was high and they worked exceptionally well together to deliver person-centred care. Staff shared information effectively and demonstrated a shared commitment to ensuring people remained at the centre of planning and decision-making about their care and support. This coordinated approach promoted consistency and helped people achieve positive outcomes.

Partnership working was a notable strength of the service. Without exception, professionals told us staff worked collaboratively with them, valued their expertise and consistently acted upon their advice and recommendations. This helped to ensure people received coordinated care that reflected best practice and was responsive to their individual needs. A professional told us, “Decisions made over care were done so through a Multi-Disciplinary Team (MDT) discussion type approach. Decisions made have been implemented effectively and reviewed appropriately, again through the use of MDT discussion. When concerns have required review, management have reached out to invite the views of other professionals.” Communication between staff, healthcare professionals and other services was effective and focused on achieving the best possible outcomes for people. As a result, people experienced joined-up care that was responsive, holistic and centred around their individual needs, goals and aspirations.

Staff supported people to access a range of specialist services and worked proactively with professionals to improve outcomes. For example, one person had recently begun working with a speech and language therapist. The person told us this support had increased both their confidence and their ability to communicate effectively. Staff and professionals worked together to ensure recommendations were embedded into the person's daily support, maximising the benefits of the intervention. Effective multi-disciplinary working had also supported people's emotional well-being. Staff worked closely with one person's psychiatrist and provided practical and emotional support to enable them to attend appointments and engage with treatment. The person spoke positively about the impact this had on their well-being and told staff, “My head feels lighter when I have been.” This demonstrated how coordinated working between staff and healthcare professionals helped people achieve meaningful improvements in their quality of life and overall well-being.

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. Staff were committed to supporting people to achieve and maintain good health and wellbeing. People's health needs were understood in detail and support was tailored to their individual circumstances, preferences and goals. Staff adopted a proactive approach to promoting healthy lifestyles and worked creatively to overcome barriers people experienced in accessing healthcare services. For example, staff provided extensive and personalised support to 1 person who found attending health appointments challenging. Through the use of individualised goals, social stories and regular progress reviews, staff supported the person to develop confidence and understanding around healthcare interventions. As a result, the person significantly improved their engagement with health screening appointments, including attending a recent dental check-up, ensuring important health monitoring and preventative healthcare needs were met.

People were encouraged and supported to make healthy lifestyle choices. Healthy eating formed part of everyday support, with people having access to fresh fruit and vegetables and being involved in discussions about nutrition and wellbeing. Staff introduced innovative initiatives, such as 'fake-aways', which provided healthier alternatives to takeaway meals whilst maintaining the enjoyable social experience and activity people valued. This demonstrated the service's commitment to promoting healthier choices in ways that were meaningful and sustainable for people.

Staff actively supported people to engage in physical activity and pursue interests that promoted their physical and emotional wellbeing. People regularly attended activities including the gym, swimming, football and hydrotherapy sessions. These opportunities helped people remain active, improve fitness levels and enhance their overall wellbeing. Positive health outcomes were achieved through this tailored support. For example, 1 person successfully achieved a weight-loss goal they had identified within their annual objectives, resulting in improvements to their physical health and overall wellbeing. Staff recognised and celebrated these achievements, helping people remain motivated to pursue healthier lifestyles.

Oral healthcare was promoted effectively. People received oral health assessments and were supported to attend regular dental appointments. Staff implemented guidance consistently and encouraged good oral hygiene practices as part of daily support. Reviews demonstrated one person's oral health had significantly improved as a result of staff encouragement, regular assessment and ongoing engagement with dental services.

Staff demonstrated a strong understanding of the relationship between physical and mental well-being and responded proactively to identified health concerns. For example, 1 person used a specialist breathing device during the night. Staff identified a link between reduced sleep, low mood and the person's emotional well-being through careful monitoring and review. Working with the person and health professionals, different breathing masks were trialled to improve comfort and effectiveness. Staff also encouraged the person to continue using the device when low sleep levels had been identified. As a result, the person experienced noticeable improvement in their day-to-day mood and well-being.

Staff’s holistic and person-centred approach empowered people to take an active role in managing their health, resulting in measurable improvements to both physical and emotional well-being.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. The provider had highly effective systems in place to monitor, review, and improve outcomes for people. There was a strong focus on ensuring people were supported to achieve goals that were meaningful to them and reflected their individual aspirations, interests, and preferences. People's progress was regularly reviewed through detailed and person-centred ‘my progress reviews’, which clearly recorded achievements, identified new opportunities, and ensured support remained focused on improving quality of life.

People were actively involved in setting and reviewing their goals, with input from those who knew them well, including family members, key workers, and the wider staff team where appropriate. Reviews were personalised, celebratory in nature, and evidenced through photographs and written records which captured people's progress and achievements over time. A relative said, “We attend all reviews and we work towards goals. One goal we are working on is for [name] to come home to visit us here. Staff are working with us, as we are all aware this may be tricky. I advocate for [name] regularly."

Records demonstrated that people were making positive and sustained progress towards their goals. For example, one person had developed greater independence by effectively communicating their choices and increasing their involvement in domestic tasks. Another person had achieved significant improvements in their health and well-being through weight loss, supported by staff encouragement and personalised support. A further person had successfully accessed a holiday for the first time in several years, achieving an outcome that had previously been considered unmanageable due to their support needs.

Staff consistently recognised and celebrated progress, however small, and used regular reviews to identify how support could be adapted to help people achieve even greater independence, inclusion, and quality of life.

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment. People's rights to make decisions about their care and treatment were consistently respected and promoted. Wherever possible, people had provided consent to their care and support, and records clearly reflected their involvement in decisions affecting their lives. Staff demonstrated a strong commitment to ensuring people remained at the centre of decision-making and were supported to exercise choice and control.

The service worked in accordance with the principles of the Mental Capacity Act (MCA). Where people lacked capacity to make specific decisions, robust decision-specific mental capacity assessments and best interest decisions had been completed. These processes involved relevant people, including family members, professionals and staff who knew the person well, helping to ensure decisions reflected people's wishes, preferences, values and rights.

Staff demonstrated a clear understanding of consent and people's right to refuse care and support. They recognised consent as an ongoing process rather than a one-off event and understood the importance of respecting people's decisions. One staff member told us, “We encourage people, such as with activities, but no one does what they don’t want to, it is their choice and we are led by them.” This reflected the service's person-centred culture and commitment to promoting independence and autonomy.

Staff took proactive and creative steps to maximise people's ability to make informed decisions. Where decisions were more complex, such as agreeing to healthcare treatment or attending medical appointments, staff dedicated additional time to ensuring people understood the options available to them. They used a range of accessible communication tools, including photographs, social stories and step-by-step explanations, tailored to people's individual communication needs and preferences. This helped people understand information, consider potential outcomes and participate meaningfully in decisions about their care and treatment. As a result, people were supported in the least restrictive way, their rights were upheld, and decisions about their care and treatment were made in a manner that promoted dignity, independence and positive outcomes. A person told us, “The staff don't tell me to get changed, they would say things like ‘do you think you should change them dirty clothes’, they give me the chance to think and make my own choices.” And a professional told us, “Capacity assessments were evidenced as person-centred taking into consideration the person’s difficulties to communicate their needs."