Archived: Pier View House

Pier View House is an on-site residential unit that provides accommodation and care for up to four people who attend St Johns College. St Johns 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, including autism and related autistic spectrum conditions (ASC). The provider refers to people using the service as learners, which they will be referred to throughout the report. At the time of inspection Pier View House provided care and support to four learners, for up to 52 weeks per year. Pier View was compliant with the values underpinned in Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. Learners had access to local amenities, facilitates and services such as healthcare and were supported to access these regularly.

People’s experience of using this service:

• Learners were consistently supported and empowered to make day to day decisions. Where appropriate learner’s consent was sought and their ability to be involved in decision making was recorded in care planning, however records did not always detail the decision-making steps taken when acting in individuals ‘Best Interest’. The manager took immediate steps to address this and implemented a detailed recording tool to support learners and staff. We have recommended that the provider review relevant legislation to improve recording and evidence of best practice guidance.

• Learners were supported to receive their medicines safety with support from appropriately trained staff for the role.

• Risks to learners and the environment were effectively managed though robust assessments and people were appropriately protected from the risk of abuse and avoidable harm.

• We received overwhelmingly positive feedback and relatives consistently told us their loved ones received exceptionally high quality, compassionate and outstanding care at Pier View House. This also included exceptional communication and genuine partnership working with learners and people that were important to them.

• The manager and support staff were extremely passionate and highly motivated in promoting positive outcomes for people and maximising learner’s independence at every opportunity. Learners at Pier View House were valued and treated as individuals and staff had a comprehensive understanding of their needs.

• The manager was committed to ensuring information was shared with learners in an accessible format including care plans, signage and developing meaningful communication tools. Engagement was at the heart of service delivery and integral to the manager and staff’s core values.

• Learners were supported to receive highly personalised care to meet their needs and care records were person-centred to reflect people’s likes, dislikes and preferences. Learners were regularly consulted and information was updated to reflect their achievements and development.

• Learner’s rights and freedoms were upheld and staff treated people with dignity and respect. The provider took a proactive approach to inclusivity and staff received additional training to promote antidiscrimination.

• Where learners required additional support to manage anxious, distressed and heightened behaviour, we saw robust care planning and proactive support offered.

• Learner’s had access to a wide range of activities to meet their interests, which were flexible to meet their individual needs. Learner’s had easy access to the local community and facilities and were supported to attend a range of events.

• The provider ensured the delivery of high quality care through robust quality assurance processes and there was good communication between the organisation.

• The service met the characteristics of Good across the safe, effective, responsive and well-led domain and consistently demonstrated Outstanding characteristics in caring. More information can be found to evidence this in the full report.

Rating at last inspection:

This service was previously rated as Outstanding at the last comprehensive inspection. This report was published on 30 August 2016.

Why we inspected:

This was a planned inspection based on the previous inspection rating.

Follow Up:

There is no required follow up to this inspection. However, we will continue to monitor the service and will inspect the service again based on the information we receive.

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

Pier View House is a residential unit providing accommodation and care to four 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 young people who have special needs resulting from behavioural, emotional and social difficulties (BESD). Pier View House is based on the college campus and is a 38 weeks a year service, meaning that people can live at the service only during term time. The provider has five separate residential locations in the Brighton and Hove area. This report relates to Pier View House, and at the time of our inspection, there were four women living at the service. 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 registered manager had oversight of the running of the service but had delegated the day to day operation of the service to a manager.

Learners living at Pier View House were supported with exceptional care, dedication and understanding. Transitions for learners to and from their care setting at college was bespoke and planned thoroughly. For learners with very complex emotional needs a great deal of planning and preparation was involved. By liaising and co-ordinating with relatives, other professionals and authorities, staff and the environment were prepared for each individual learner’s preferences and routines. Staff worked closely and co-operatively through partnership working to make sure learners had access to ongoing support and to make sure when they moved on, the appropriate arrangements had been made for them. A relative told us “It’s all very well thought out, individualised and focused on the young person. It’s not just about the fact they have a space, it’s about making sure it’s right for the young person, that’s what makes it special”.

Leaners were involved in the planning and reviewing of their care and discussed and shaped the activities they wished to take part in. One learner told us “I have a plan, we always have a plan, and (staff member’s name) is supporting me. We’re doing gardening this afternoon”. They were assisted innovatively to learn how to manage their anxieties and emotions. In relation to a therapy session a learner commented “It helps me forget about things, helps me relax, feel less stressed”. A relative told us “They approach her needs and differences in a way which is helping her to progress; it is just amazingly different what they do here”.

Learner’s experiences of their care and support was overwhelmingly positive. A learner told us “I love it here. My keyworker is awesome. We get on really well. Everything she’s into are the things I like”. A relative commented “People who know her well say to me (learner’s name) looks so different, so well, they’ve got the sparkle back in her eyes. They’ve got their confidence back. The difference they have made to (learners name) is enormous”.

Staff worked proactively to help them to make choices and decisions about their care and lifestyle and supported them to be as independent as possible, and learning new skills. Learners took part in socially inclusive activities in their local communities and well as at the college.

The service was exceptionally well led. Staff were enthusiastic and happy in their work. They felt supported within their roles and held the management and senior management team in high regard, describing an ‘open door’ management approach, where managers were always available to discuss suggestions and address problems or concerns. A member of staff said, “It’s a great place to work, everything about it is person centred and supportive”.

Team work was effective. Staff had a common aim and purpose to achieve positive outcomes for leaners. They excelled at providing consistency which had a positive impact on learner’s wellbeing, reduced their anxiety levels and provided stability.

Training resources equipped staff with the skills, knowledge and understanding to meet the challenges of supporting learners with diverse and complex needs. They said the learners were “at the centre” of everything they did. Staff were supported to develop individually, to voice concerns which they were confident would be listened to. Bespoke training had been developed to ensure that learners remained safe and had their health and wellbeing protected at all times. Staff were passionate, committed and motivated to make sure the learners journey through college was a positive experience.

Learners were encouraged and supported to eat and drink well. There was a varied daily choice of meals and learners were able to give feedback and have choice in what they ate and drank. A relative told us “They’re eating well and look so much healthier than they did before. That’s increased their confidence as well”. Health care was accessible for learners who were encouraged to make their own appointments.

Learners were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One learner told us, “I feel safe definitely. I can talk to the staff anytime if I’m feeling stressed out or worried about something”. A relative told us “I think she’s absolutely safe. I don’t have to worry at all”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place.

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.

Learners were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and staff knew what to do.

The provider had robust systems in place to assess the quality of the services provided and identify areas for improvement.