St David's House, Exeter
St David's House in Exeter, Devon, was rated outstanding for being caring, effective, responsive and well-led following an inspection by the Care Quality Commission (CQC), on 14 & 20 November 2019.
The safe category received a score of Good.
The WESC Foundation provides specialist services for children, young people and adults with a visual impairment and other complex needs. WESC offers school and college education provision, supported internships and work experience in the community and through their own retail and horticulture enterprises. WESC vision and mission is to promote a society where visually impaired young people with additional needs are valued for their contribution and their rights and independence are promoted.
People living at St David's House had often, but not always, transitioned from their education provision with WESC towards a more independent adulthood, developing their skills and accessing opportunities in their community. They were able to continue to access all WESC specialist services, including healthcare and day centre.
CQC inspectors highlighted that staff gave many examples of how they supported people to make their own decisions. They observed residents to find out what they liked and didn't like, ensuring a wide range of repeated experiences so people could make decisions based on those experiences and change their ideas.
Information was incredibly detailed describing peoples' body language or words used to indicate consent or choice. For example, whether they enjoyed a bath or shower or wanted perfume on and how they showed this.
One person was able to show 'yes' and 'no' using I-Talk (by pressing coloured buttons). Staff ensured the person always had the I-Talk and communicated using yes and no questions. The person had become skillful with staff support and now joked using the I-Talk, sending staff for something then changing their mind halfway.
There was a happy, engaging and lively atmosphere in the home. Staff were vigilant about supporting people with visual impairment and always communicated using peoples' preferred methods, ensuring people knew what was happening around them.
People were relaxed in the company of staff and there was lots of smiling and laughter. This showed how good communication had supported the development of important relationships between people who used the service and staff. Staff knew what sort of environment people needed such as enjoying the lighted bubble tubes for relaxation, being quieter or enjoying loud music and singing. At the time of the inspection a staff member played the piano with a person who was clearly enjoying making music together.
Relatives said family members were exceptionally well cared for and were consistently positive about the staff team. One relative said, "We know much she loves WESC, she is so well looked after and treated. There's always something going on. We have great admiration for all the staff as you have to be something special to work with these special needs’ young adults. We would like to take this opportunity to thank them all."
Care plans reflected the principles and values of Registering the Right Support. Records referred to promoting people's independence, their diverse needs and inclusion within the local community. Each care plan had details about how people responded to choices, what phrases they may use to indicate yes and no or body language. This included how staff should speak with people to provide effective encouragement.
One relative said, "I am very, very impressed with the staff within St David's House that I have dealt with during my visits. They all are very friendly and have peoples' best interests in mind."
One person had wanted to attend another person's activity even though this may not have been suitable for them. Staff supported them to try the activity, so the person could make an informed choice not to attend further, which made the person more relaxed once they had been.
Another resident had become more accepting of sighted guides and no longer needed a handling belt or two staff for safe mobility. This had meant they could now participate in sailing trips.
Staff shared their positive experience of working at WESC, feeling privileged to work with the 'amazing' people they supported. Comments included, "There are so many good things I could write about the staff and the things they do for the people" and "We make sure people have a positive experience and achieve something every day. It makes them feel good about themselves."