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Archived: RNIB Pears Centre for Specialist Learning Requires improvement

The provider of this service changed - see old profile

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Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 December 2016

The inspection took place on 14 November 2016 and was unannounced. We informed the registered manager we would return for a second day on 15 November 2016. At our last inspection of this service in November 2013, we found the provider met the requirements of the regulations.

The Royal National Institute of Blind People (RNIB) is a registered charity that offers a range of services to people living with sight loss. RNIB Pears Centre for Specialist Learning; 5 Pears Court provides specialist accommodation, nursing and personal care for up to six children and young adults living with complex health and medical needs who require long term ventilation and / or other complex health requirements.

Five Pears Court is one bungalow of a group of specialist built bungalows at Pears Centre providing care for children and young people up to the age of twenty years. Between the ages of eighteen and twenty years of age, young people are supported to transition to adult services. Five children and young people lived at 5 Pears Court on the day of our inspection visit.

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 2008 and associated regulations about how the service is run.

Staff put children at the centre of the service and gave person centred care and support appropriate to children and young people’s ages. Staff received training in core care practices and specialist clinical training in managing children’s complex health care needs. The provider’s aim was to have a nurse on every shift, but challenges in recruitment had meant some shifts were not covered by a nurse at the home. Further nurse recruitment was taking place, but while this was happening detailed contingency plans were in place to ensure children and young people’s complex care needs continued to be met, including on-call nurse cover. Care staff were trained at level three with advanced care skills which included supporting children and young people on long term ventilation, changing tracheotomy tubes and undertaking oral and nasal suction when needed.

Most risks were assessed and actions were taken to minimise identified risks of harm or injury to people. Risks to children and young people’s skin had been assessed but action had not always been taken to implement care plans when people’s skin became sore or damaged. Where skin was sore or damaged, risks of further skin damage or deterioration had not always been assessed. Children and young people had their prescribed medicines available to them and staff supported people in administering these safely. Staff received training in the safe handling, administering and recording of people’s medicines.

Children and young people had been involved in planning their care as far as possible. Staff were very knowledgeable about children’s and young people’s needs and were able to effectively support these. Additional training took place to update and refresh staff skills and knowledge. Staff said children and young people’s care plans provided them with the detailed information they needed to support people safely and effectively. Children and young people’s nutritional and hydration needs were met and the guidance of dieticians was followed. Staff worked closely with healthcare and other professional therapists involved in children and young people’s day to day healthcare and support.

The registered manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act (2005) and worked within the principles of this. Management had an understanding of the Deprivation of Liberty Safeguards (DoLS).

Staff were kind, respectful and compassionate toward children and young people. Young people were listened to and their v

Inspection areas

Safe

Requires improvement

Updated 14 December 2016

The service was not consistently safe.

Staff understood their responsibilities to protect children and young people from the risk of abuse and most understood their responsibilities to report any concerns.

Children and young people felt safe living at the home and risks of harm, injury and deterioration in health had been assessed.

Risks to children�s� and young people�s skin had been assessed but action had not always been taken to implement care plans when young people�s skin became sore or damaged.

Staff were suitably skilled and trained to meet children�s and young people�s complex health care needs. Shifts were planned to safely and effectively meet children�s and young people�s needs and a contingency plan was in place when shifts were not always covered by a qualified nurse. Further recruitment was planned for. Children and young people were supported with their prescribed medicines from trained staff.

Effective

Good

Updated 14 December 2016

The service was effective.

Staff were trained and knew children and young people well so that they could effectively meet their individual needs. Staff understood their responsibilities in relation to the Mental Capacity Act 2005 and gained consent from people before supporting them and undertaking tasks. The managers understood and worked within the remit of the Deprivation of Liberty Safeguards.

Children�s and young people�s nutritional and hydration needs were met and the guidance of dieticians was followed. Staff referred children and young people to healthcare professionals when needed and worked closely with healthcare and other professional therapists involved in children and young people�s healthcare and support. The home was purpose-built to meet the individual needs of the children and young people living there.

Caring

Good

Updated 14 December 2016

The service was caring.

Young people told us that staff were kind and caring. Relatives described staff as friendly and welcoming. Staff respected children and young people as individuals and maintained their privacy and dignity. Young people were listened to and their views were acted on.

Responsive

Good

Updated 14 December 2016

The service was responsive.

Children and young people were involved in planning their care and support as far as possible. Care plans were detailed, personalised and contained information to enable staff to work with children and young people to maintain their wellbeing. Staff knew children and young people well and how to meet their care needs. Staff encouraged and supported children and young people with their activities and learning to achieve their potential. Young people knew how to raise a concern or complaint if they needed to.

Well-led

Requires improvement

Updated 14 December 2016

The service was not consistently well led.

The home had a positive culture and staff were supported in their job role to be person centred, inclusive and empowering toward children and young people who lived there. Children and young people were not actively encouraged to share their views and give feedback on the quality of the service. The provider had some systems to monitor the quality of the service provided, but these had not always been effective in identifying where improvement was needed.