Archived: Ruskin Mill College

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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The vision of Ruskin Mill was to promote a service wherein ‘each individual has the potential to shape their own future through experiencing meaningful relationships with the universe, earth and people.’ The service’s values were based around inclusive learning, mutual respect and, treating individuals with dignity and respect.

All staff and senior management demonstrated this clear vision and a highly positive person-centred culture was seen throughout. Staff had set high standards for themselves and this promoted an exceptionally positive culture which challenged disability perceptions, improved the confidence of people and had very positive impacts on the lives of the people using the service. Throughout the inspection, we found people and staff were motivated and passionate about equality and empowering people to live the lives they want.

Young people and their shared lives carers spoke overwhelmingly of the positive support, guidance and healthcare interventions people had received. They were full of praise for the staff in terms of their kindness and compassion. People were 'very happy' with the service they received. We received positive comments about their views and experiences. Young people told us they felt safe because of the staff and viewed the staff as experts in their knowledge and skills when supporting people with complex needs.

Young people were supported by staff who had received exceptional training and support to carry out their role. The provider had considered and implemented creative methods for staff to truly understand the experiences of young people when they were staying at Ruskin Mill College. Young 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.

The service’s focus on challenging expectations and misconceptions had led to excellent outcomes for young people. Staff told us how the ethos of the service was that disabilities should never be considered a barrier to opportunities for people. Throughout our inspection we heard comments from young people about their future aspirations and the support staff gave them to achieve these. These included “The staff have been great and have made me realise all the things I can do’’, “I am so much more independent than when I first arrived”, ‘‘The support I get is excellent’’, and “I am very excited about starting my new job.”

The service excelled in understanding the needs of young people and supporting them to gain skills which would lead to employment opportunities Staff worked hard to make sure, that where it was possible, people had opportunities to lead as full a life as possible. They made sure learning opportunities were tailored to meet people's individual needs, preferences and abilities. Staff made sure young people had opportunities to enjoy themselves. People's suggestions and ideas were sought and valued when it came to planning the direction of the service.

The registered manager and extended leadership team offered exceptional leadership and had a clear vision about the direction of the service. They were highly committed to improving young people's lives and ensuring they had the best care they could receive. They expected the same high standards from the staff who were also committed to these shared values. The management team were very much part of the overall care team at Ruskin Mill. They were very involved in people's care, visible and approachable. Staff working at the service clearly understood their role and worked hard to promote a homely atmosphere.

There was a robust quality assurance system in place to ensure people received the best possible service. Young people were empowered to take an active part in assessing the quality and performance of the service. The registered manager and provider worked closely with partner agencies and services to promote best practice within the service and make a positive impact to young people’s lives. The service was constantly striving to innovate to ensure they were providing the best possible care to the people they were supporting. The registered manager had developed a strong leadership team within the service to ensure the high standards implemented were sustained in their absence.

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.

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.

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

Rating at last inspection

The last rating for this service was good (published 24 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the time of our inspection eight people were living at three addresses registered to provide accommodation and personal care. These were called 'team homes'. The college provided staff to support people at these addresses. Twenty people were using the Shared Lives scheme under the regulated activity of personal care. Students live with Shared Lives carers in their home. Ruskin Mill recruits, trains and monitors Shared Lives carers who are paid a fee to provide care and support to students.

People using the Shared Lives scheme and living in team homes all attended the college. The Care Quality Commission (CQC) regulates and inspects the accommodation and personal care provided by Ruskin Mill. The educational provision at the college is regulated and inspected by the Office for Standards in Education (OFSTED ).

Most of the young people used the service in term time only. However, if required, by individual arrangement they were able to stay at their 'team home' or Shared Lives carer when the college shut at the end of term.

We carried out an unannounced focused inspection of this service because we had received some information of concern and we wanted to investigate this. We have only looked at the areas of safe and well-led as the concerns were within these areas.

This report only covers our findings in relation to these specific areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Ruskin Mill College’ on our website at www.cqc.org.uk. Our findings at this inspection have not changed the current rating of ‘good’ for the key questions of Safe and Well-led or the overall ‘good’ service rating.

There was a registered manager in post at the service. 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.

There was a robust safeguarding process in place at Ruskin Mill College. Staff had received safeguarding training and were able to describe the various types of abuse. There were clear processes in place for staff and people using the service to report concerns. Where concerns had been raised they were reported to the appropriate agencies and the concerns had been addressed appropriately.

The service had implemented thorough checks to ensure the staff who were employed were suitable and safe for the role. Staff had received a thorough induction when they first started working at the service to ensure they were appropriately skilled to support the people using the service.

The registered manager and senior leadership team offered strong leadership which was evident throughout the inspection. Staff we spoke with told us they felt confident in the skills of the management team and felt well supported by management. The vision and values of the service were clear and coherent. Staff of all levels had a good understanding of the visions and values. There was a positive, open and transparent culture within the service. The staff and management took accountability of their own practice to ensure the service provided to people was person centred and safe. Staff told us they were encouraged to question and challenge regardless of their job role and this had promoted a positive culture within the service. Staff told us this had resulted in positive staff morale across the organisation.

At the time of our inspection eight people were living at three addresses registered to provide accommodation and personal care. These were called ‘team homes’. The college provided staff to support people at these addresses. Twenty people were using the shared lives scheme under the regulated activity of personal care. This is an arrangement where individuals and families in the local community (shared lives providers) provide accommodation and support for students.

People using the shared lives scheme and living in team homes all attended the college. The Care Quality Commission (CQC) regulates and inspects the accommodation and personal care. The educational provision at the college is regulated and inspected by the Office for Standards in Education (OFSTED).

Most of the young people used the service in term time only. However, if required, by individual arrangement they were able to stay at their ‘team home’ or shared lives provider when the college shut at the end of terms.

This inspection was unannounced and took place on 8 and 9 December 2016.

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.

Ruskin Mill as a specialist residential college had a clear and distinct vision and set of values. Staff consistently reinforced the aim of ensuring the young people received a co-ordinated service that aimed to meet their physical, psychological, educational, social and spiritual needs in a holistic manner. This meant learning plans and activities provided at college were continued when people were at home or using their local communities. People and staff spoke enthusiastically about their learning, achievements and striving to gain greater independence.

People benefitted from receiving a service that kept them safe. The registered manager, staff and shared lives providers understood their role and responsibilities to keep people safe from harm. People were supported to take risks, promote their independence and follow their interests. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff and shared lives providers before they started work with people to assess their suitability. Medicines were well managed and people received their medicines as prescribed.

The service people received was effective in meeting their needs. Staff received regular supervision and the training needed to meet people’s needs. Shared lives providers also received training and were able to access support from the provider when needed. The service complied with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. The accommodation we saw was personalised and met people’s needs.

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff and shared lives providers treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that were easy to understand. People were supported to maintain relationships with family and friends during term times. Some relatives said communication between the provider’s senior staff and them was not always good.

The care and support people received was built around their individual needs, whilst giving opportunities to develop skills in living alongside others. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

The service was well led. The registered manager and senior staff provided good leadership and management. Sophisticated systems were in place to ensure the vision and values of the service were understood and implemented. The quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.

As part of this inspection we spoke with 14 students and five care staff. We also reviewed records relating to the management of the service which included, seven care plans, daily care records and staff training records. Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

Information from incident reports was used to review the effectiveness of risk assessments and personal plans. Changes were made as needed to keep students safe whilst protecting their freedom.

Emergency arrangements were in place to support students unhappy with their residential placement. Student concerns about bullying or the behaviour of others were being effectively addressed.

Is the service effective?

Specific training staff needed to support new students had been provided before students started at the college. Training staff needed to support returning students had not yet been provided.

Is the service caring?

Students told us support had improved over the last six months. They felt positive about their remaining time at the college. Students were happy to be supported by small groups of consistent staff that they liked. Staff and shared lives providers interacted with students in a respectful and appropriate way. Students were relaxed in their residential placements.

Is the service responsive?

Students told us they had been actively involved in developing their personal plans. They were happy with the resulting plans and staff were confident the content was accurate. The needs of students were well documented but how they should be supported was still being developed as term had only recently started.

Is the service well-led?

At the time of our inspection the provider did not have a registered manager in post. They had recently begun the application process with us to address this.

Record keeping quality checks were being undertaken and problems highlighted by the checks had been addressed. Staff now felt well supported to produce the personal plans. Staff told us senior staff were responsive to requests for training and support.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found '

Is the service safe?

Students told us that they felt safe in their residential home. One student said 'I feel safe, it's much improved'. Students had access to support services if they felt they needed to talk with someone about anti-social behaviour or other concerns.

There was a more robust system in place to identify, monitor and prevent incidents from occurring and minimising potential risks. The student records we looked at clearly demonstrated that incidents of self-harm, absconding and threatening behaviour had reduced significantly.

The provider had set up a new student and safety well-being team. This team met on a weekly basis to track, review and analyse all student occurrences, accidents and safeguarding incidents. Students' safety was promoted because the service obtained advice and support from specialists such as, psychology and the mental health team in order to meet their needs effectively.

All staff had attended safeguarding training and enhanced training around managing more challenging behaviours was being rolled out.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care settings. While no applications have been submitted, appropriate policies and procedures were in place. Relevant staff had received training in the Mental Capacity Act and the application of DoLS.

Is the service effective?

Student's needs were assessed and they told us that they were involved in planning their care. Students we spoke with told us 'they do things the way I want' and 'I am involved in making decisions about what I do'. We saw from care records that students were involved in making decisions about their care and that their wishes were respected by staff.

Since our previous inspection the provider had made many positive changes to their record keeping and had implemented a new system of care planning and risk assessments. However, as the changes made to the care plans were recent, the provider had not had the opportunity to fully embed these. As a result we found that not all students had adequate and detailed care plans and risk assessments in place. The provider could not be assured that all students' needs were clearly identified and that they received the support they required. We asked the provider to address these concerns.

Is the service caring?

Students told us that they liked the staff who supported them and got on well with them. We observed that staff were respectful, caring and when asking questions, gave students time to respond at their own pace.

Staff demonstrated through conversation with us that they knew the likes, dislikes and preferences of the students they supported. They told us that the new care plans and risk assessments which were now in place were a big improvement. They told us they had worked with students to update their individual care plans.

Is the service responsive?

Student's care had been reviewed regularly and weekly meetings were taking place with students regarding their welfare. Weekly meetings were held in the team homes to discuss student's well-being and to highlight and address any areas of concern.

There had been changes made to the reporting of occurrences [incidents] and we saw that these were followed up within the timescales set by the provider. In addition, there were more robust systems in place to ensure that information about incidents were shared amongst staff. Appropriate action was taken to ensure students and others were safe and received appropriate support.

Is the service well-led?

Students were asked for their views about the service to help ensure their views contributed towards improvements and further development of the service.

The service had quality assurance systems in place so that the quality of service provision could be monitored and shortfalls could be identified.

Staff reported that communication between the residential provision and the college had improved. Since our previous inspection in December 2013, there had been changes to the lead roles within the residential setting. Staff we spoke with were clear on their roles and responsibilities and there were defined reporting lines so all staff knew who to report to.

In this report the names of Richard Luck and Julian Pyzer appear as the registered managers. At the time of the inspection both of these people had left the provider's employment and were not in any way managing the regulatory activities at this location. There names appear on the report because they were still registered on the CQC register at the time of the inspection.

We spoke with the registered manager, a senior residential manager and head of academic administration of Transform Residential limited and the principal of the Ruskin Mill College. We also spoke with 12 care staff ranging from support workers to shared lives providers. Care staff told us they really enjoyed their work. Some care staff said they would appreciate more training especially around behaviours which challenged. We found that not all care staff had received appropriate training to support them in their role.

In some residential team homes, the high number of different members of care staff who cared for individual students was detrimental to their welfare as they needed consistency in the staff who supported them. We looked at safeguarding and found that incidents were reported as required, however, multiple incidents were not tracked and analysed to help prevent further incidents. Record keeping, was not of an adequate standard which ensured that care staff had appropriate information to support people and all risks were managed effectively. The provider did not have an effective system of quality assurance in place.

We looked documentation maintained by the provider about the people who were supported. We also looked at the recruitment and selection records of the staff that were employed to support people in team homes and also their shared lives carers.

We found people were involved in their care and they were encouraged to maintain their independence. People were treated with dignity and respect. People's care was planned and delivered according to the assessments completed and were reviewed regularly. Appropriate risks were considered to ensure people stayed safe.

We also found that the provider recruited, checked and approved shared lives carers and their own employed staff to provide care and support to vulnerable adults. The services were provided in the shared lives carers own home and in team homes that were staffed by the provider.

The provider, staff and shared lives carers had robust policies and procedures for safeguarding vulnerable adults, and people who used the service knew how to complain.

Shared lives carers and employed staff told us that they felt well supported. The people that used the service, shared lives carers and staff said that there were systems in place for them to voice their own views and opinions and to receive feedback about this.