This unannounced comprehensive inspection was conducted by one Care Quality Commission Inspector on 10 and 14 January 2019.
Robert House 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.
The Fortune Centre of Riding Therapy (FCRT) provides a three year residential Further Education Through Horsemastership Course for 16 to 25 year old people with learning disabilities. Students are provided with the opportunity to transition into adulthood in a supported environment. They learn and develop independence and life skills through the interaction with horses.
Robert House is one of three registered locations that make up the FCRT. Robert House offers residential accommodation and learning support for up to seven students between the ages of 16 to 25. Robert House accommodates third year students and at the time of our inspection seven students with learning disabilities were living there. The home consists of a main building with bedrooms with en suite bathrooms, an office, a kitchen, a dining area/conservatory and a lounge.
The service had been developed and designed in line with the values that underpin the registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained good overall.
The service did not have a registered manager in post. The previous registered manager had left the service at the end of December 2018, however the provider was in the process of employing a replacement registered manager who was due to commence their employment in February 2019. The provider had ensured there were appropriate staff in place to manage the service in the interim period. 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.
Students told us they felt safe at Robert House, they knew who to speak to if they had any concerns and told us names of staff members they could speak to if they were worried. Parents spoke very positively about the service provided at Robert House. Staff understood how to identify, prevent and report abuse and felt well supported in their roles. Staff received training to enable them to carry out their roles competently.
Students were supported by safely recruited staff and there were enough appropriately trained and experienced staff to support students in ways that suited them. Communication styles and methods were tailored to individual students and staff supported students to understand the choices available to them. Staff were knowledgeable about their role and spoke positively regarding the induction and training they received. Staff felt well supported by the management team and received regular supervision sessions and appraisals.
Students received personal care and support in an individualised way and their privacy was protected. Staff knew students well and were able to demonstrate a good understanding of how they wished their care to be provided. Students were treated with dignity and respect.
Medicines were handled appropriately and consistently, stored securely and managed and disposed of safely.
Student’s needs were rigorously assessed and care, support and guidance was planned and delivered to meet their needs. Records showed a detailed, robust, student specific assessment of need had been carried out to ensure risks to student’s health were managed effectively. Unique and creative support systems were in place to ensure students developed key life skills that had an extremely positive impact on their lives.
Students were consistently and innovatively supported to promote and maintain their independence. There was an emphasis on personalised, meaningful activities that were based on student’s interests and experiences. This led to students taking up paid employment positions and taking part and enjoying a wide range of activities over and above their own perceived expectations. The activities stretched their physical and mental abilities and promoted a high level of well-being and an outstanding sense of achievement for the students.
Students and their relatives were fully involved in assessing and planning the care and support they received. Students were referred to health care professionals as required.
Students and relatives knew how to make a complaint and felt confident they would be listened to if they needed to raise concerns or queries. There were weekly house meetings and an active student council that enabled students to voice their concerns or queries. This showed the service took students views seriously and were keen to maintain a continuous circle of improvement and listen to the students.
People told us they had confidence in the management team and felt the service was well led. Students and relatives spoke very positively about the management team and staff.
There was a process in place to ensure improvements were made regarding the safety and quality of the service provided.