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Inspection carried out on 7 January 2020

During a routine inspection

About the service:

College View is a residential unit providing accommodation and care to young adults aged 19 to 25, who have a wide range of complex learning disabilities, such as autism and related autistic spectrum conditions

(ASC) and who have special needs resulting from behavioural, emotional and social difficulties (BESD). College View is based on the St. Johns School and College campus and is a 52 week a year service, meaning

that people can live at the service all year round. The service is registered to provide accommodation for up to 11 people and at the time of our inspection, there were six people living there.

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 and physical 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 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.

People’s experience of using this service:

Staff knew people extremely well and tailored their support accordingly. We observed strong relationships between staff and people due to the continuity of staffing and their approach. Systems supported people to stay safe and reduce the risks to them. Staff knew how to recognise signs of abuse and what action to take to keep people safe. There was enough staff to support people safely and the registered manager had safe recruitment procedures and processes in place.

Staff were trained in administering medicines. People were protected by the prevention and control of infection and we observed staff wearing gloves and aprons when supporting people.

People received high-quality person-centred care that exceeded their expectations. The management and staff team went above and beyond to ensure that people’s care and preferences met their expectations, with their wellbeing and independence being at the heart of the service. Activities were innovative and highly regarded by people and relatives. The service ensured people were involved in their community and empowered in the planning of activities to reduce social isolation and improve well-being. A relative told us, “They treat people with respect and make an effort to think of things which will enhance their life.”

People were supported to maintain their health and had support to access health care services when they needed to. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were fully involved in the service and had opportunities to give feedback. Feedback about the registered manager was very positive and staff felt very well supported. Staff were well motivated and very proud of the service, and morale was very high. Systems were in place to monitor the service and drive improvement.

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

Rating at last inspection: Requires Improvement (report published on 9 January 2019).

Why we inspected: This was a planned comprehen

Inspection carried out on 30 October 2018

During a routine inspection

This inspection site visit took place on 30 October and 1 November 2018, the inspection was announced 48 hours before the inspection.

College View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

College View is a residential unit providing accommodation and care to young adults aged 19 to 25, who have a wide range of complex learning disabilities, such as autism and related autistic spectrum conditions (ASC) and who have special needs resulting from behavioural, emotional and social difficulties (BESD). College View is based on the St. Johns School and College campus and is a 52 week a year service, meaning that people can live at the service all year round. The service is registered to provide accommodation for up to 11 people and at the time of our inspection, there were seven people living there. The provider refers to people using the service as learners, which they will be referred as in this report.

The learners who live at College View attend the provider’s specialist education college during weekdays between 9am and 4pm. While attending this, learners are supported by staff who work at the College. The learners living at College View require high levels of support with managing their behaviours that may challenge and had 2:1 or 1:1 support when they were not attending College and in their home.

College View had been built and registered before Registering the Right Support (RRS) had been published. These values and guidance includes advocating choice and promotion of independence and inclusion, so people using learning disability or autism services can live as ordinary a life as any other citizen. The provider did have a Statement of Purpose that reflected the values that underpin the RRS and other best practice guidance. However, the provider had not fully developed the service in response to the values that underpin RRS. We found that the service was geographically isolated and that the provider had not had clear oversight of their systems and staff training plans, to prevent and respond to crisis situations and safe use of restrictive interventions. Therefore, it is unlikely that a request to register College View today would be granted.

At the time of inspection there was no registered manager. However, a new manager had been appointed and was in the process of registering with the CQC. Since April 2018 there had been three changes in leadership and management. The most recent registered manager had left the organisation at the beginning of October 2018 and so had many of the senior support staff team. 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.

College View was last inspected in April 2016. At the last inspection we found that the service was Good overall with Outstanding elements of care in Responsive. This inspection was prompted following concerns we received about medication errors, which led to a safeguarding concern and the lack of staff to support learners safely. We also received information that staff had been restraining learners without appropriate training and restraining them unnecessarily. We were told there was a high turnover of staff leading to staff shortages, general poor management and support for staff. At this inspection we found the concerns were substantiated. Whilst the provider and new manager have acted to improve the delivery of care and support and developed action plans at the beginning of October 2018 to address these issues. These changes need to be embedded to demonstrate sustained improvement a

Inspection carried out on 19 April 2016

During a routine inspection

We inspected College View on 19, 20, 21 and 22 April 2016 and it was an announced inspection.

College View is a residential unit providing accommodation and care to 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). College View is based on the college campus and is a 52 weeks a year service, meaning that people can live at the service all year round, rather than only during term time. The provider has five separate residential locations in the Brighton and Hove area. This report relates to College View, and at the time of our inspection, there were eight people 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.

Learners living at College View 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 physical or 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 to reflect each individual learner’s preferences and routines. When changes were needed these were done as quickly as possible, such as recognising group living wasn’t right for one learner, leading to a flat being developed for this learner to have their own space. Staff worked closely and co-operatively through partnership working to make sure learners had access to ongoing support, to remain at college if they wished and to make sure when they moved on the appropriate arrangements had been made for them.

Learner’s experience of their care and support was overwhelmingly positive. They were involved in the planning and reviewing of their care records and were able to direct their care, and were assisted innovatively to learn how to manage their anxieties and emotions. They discussed and shaped the activities they wished to take part in and were listened to. They took part in socially inclusive activities in their local communities and well as at the college. Learners had work experience and work placement opportunities as well as working in college departments. Learners benefitted from new and creative methods of communication and staff worked proactively to help learners to make choices and decisions about their care and lifestyle. Learners were supported to be as independent as possible, taking responsibility for their medicines, and learning new skills.

Outstanding 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 happy and relaxed with staff. They said they felt safe and there were sufficient staff to su