We carried out a review of the data available to us about Grammar School House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Grammar School House, you can give feedback on this service.
Grammar School House is a residential care home providing personal care and support for up to 12 adults with learning disabilities and / or autistic spectrum. At the time of inspection 10 people, aged between 40 and 62 were living in the service.
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.
The service was an adapted historic school house, bigger than most domestic style properties, but with ongoing refurbishment, lack of ‘care home signage,’ ensures the premises is noted on its historic value, not as a care home. Its location in the village, within close walking distance of the local shops and facilities is supportive of people being part of / involved in the local community.
People’s experience of using this service:
Relatives were complementary about the service and would recommend it to others. One relative told us, “Staff know the clients so well, know what people need…whole place has such a nice family feel.” Another said, “I just feel so lucky, care is second to none.”
People were supported by management and staff who were highly motivated, kind and compassionate.
Staff supported people to keep safe and acted when necessary to prevent any harm or discrimination. People were supported to receive their medicines as prescribed.
People were supported to eat healthy. Staff had built up good relationships with health professionals to ensure people’s learning disability and healthcare needs were met and supported.
Staff received the right training and guidance to enable them to effectively support people. People’s complex needs were well planned for.
The service had built up good links with the local community and supported people to access a range of activities to take part in if they wished. Visitors praised the welcoming atmosphere of the service.
Staff knew people well and understood people’s communication needs, preferred routines, likes and dislikes and what mattered to them.
Care plans were person centred and showed people and family members who played a significant in people’s lives had been consulted. Staff were responsive in identifying and reviewing changes to support good physical and mental health.
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 provider had systems in place to check on the safety and quality of the service people received and act on the information to drive continuous improvement.
Rating at last inspection:
Requires Improvement. The date the last report was published was 11 June 2018.
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Follow up:
We will continue to monitor this service and plan to re-inspect this service within the published timeframe for services rated as Good.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Grammar School House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Grammar School House provides care and support for up to 12 adults who have a learning disability and or autistic spectrum. There were ten people living in the service when we inspected. The service is located in the village of Earls Colne near Colchester in an old Grammar School building. The building has been adapted into two units, one called, ‘the House’ and the other ‘the annex.’
The service had a registered manager who had been appointed and registered since the last inspection. 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.
At the last inspection in September 2015 we rated the service good. At this inspection we found that some improvements were needed and have rated the service as requires improvement.
Risk assessments were in place which set out how risks should be mitigated and staff were clear about the steps they needed to take to reduce the likelihood of harm. We have recommended that the service reviews its policy on the use of mobile telephones to ensure that staff are clear about when they should be used. Regular checks were undertaken on the environment however the registered provider had not identified all the risks such as the use of door locks which could not be overridden in an emergency.
The numbers of staff on duty were sufficient however we could not see from the records that people always received their assessed hours and have recommended that more complete records are maintained to evidence this. Checks were undertaken on staff suitability for the role prior to them commencing employment.
Staff knew how to protect people from abuse and we saw that the service had responded to concerns which had been raised in an appropriate and open way. We have however recommended that they review their processes with regard to the use of advocates for individuals who are subject to a safeguarding alert. People received their medicines as prescribed but we have recommended that how people are given their medicines is reviewed to ensure that people’s dignity is protected.
Staff confirmed that they had access to regular training and were well supported.
People’s health needs were monitored and people had access to specialist and routine health and social care professionals in respect of their needs. We saw that some people had had specific health conditions that required close monitoring and active management. Records showed that staff communicated closely with professional and relatives regarding the individual’s wellbeing.
People got enough to eat and their nutritional needs were assessed was monitored. We have recommended that those individuals whose fluid intake was being monitored have their fluid records totalled to ensure that sufficient fluids are taken. There were plans in place to support people who were at risk of choking but these were not followed on the day of the inspection. The registered manager agreed to follow this up with the SALT team and organised more training for staff.
People and relatives we spoke with told us that they were happy with the support provided. It was clear from the interactions we observed that the staff and the people living in the service were comfortable with each other. Staff interactions were person centred and they demonstrated that they knew people well. Care plans contained good information about the person, their likes and dislikes and how they liked support to be provided.
People were supported to pursue hobbies and interests that they enjoyed. We have recommended that further efforts are made to identify people aspirations and goals and work undertaken towards achieving these.
There were clear systems in place to respond to complaints and address concerns.
The registered manager was passionate and committed to delivering a high quality person centred service. They provided clear leadership and were respected by the staff team who told us that they were well supported. There were systems in place to review quality however they had not identified all the areas we found at the inspection. People and their relative’s views were sought on the quality of the care.
The service was located in an old Victorian building but staff had made efforts to individualise the rooms and make the environment homely. The registered manager was aware of Registering the Right Support guidance and the provider had made efforts to reduce the impact of the environment by splitting the service into two units which worked to varying degrees. Notwithstanding this staff demonstrated a good awareness of the principle that a person with learning disabilities and autism can live as ordinary a life as any citizen.
Grammar House School provides specialist care and support for up to 12 adults who have a learning disability and/or autistic spectrum. There were 11 people living in the service when we inspected on 2 September 2015.
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.
There were procedures in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.
Staff understood how to minimise risks and provide people with safe care. Procedures and processes were in place to guide staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.
Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people’s needs. People were treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.
Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.
People received care that was personalised to them and met their needs and wishes. Staff listened to people and acted on what they said. The atmosphere in the service was friendly and welcoming.
Care and support was individual and based on the assessed needs of each person. People’s care records contained information about how they communicated and their ability to make decisions. Staff supported people to be independent and to meet their individual needs and aspirations. People were encouraged to pursue their hobbies and interests and participated in a variety of personalised meaningful activities.
People or their representatives were supported to make decisions about how they led their lives and wanted to be supported. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests. The service was up to date with changes regarding the Deprivation of Liberty Safeguards (DoLS).
People’s nutritional needs were being assessed and they were supported to eat and drink sufficiently. People were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.
There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities.
There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the service. Systems were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was used to make continual improvements to the service.
We saw that management of medicines and the maintenance of premises was safe and effective.
A person with whom we spoke indicated to us that they had been involved in what went into their care plan.
People with whom we spoke told us that they had filled in some forms about what they liked to eat and what they wanted the home to do better for them.