Inspection on 07/12/05 for Beaumont College

This inspection was carried out on 7th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beaumont College 18/01/07

Beaumont College 01/10/05

Beaumont College 31/01/05

Beaumont College 03/07/04

Beaumont College 06/02/04

Beaumont College 06/02/04

Similar services:

Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Beaumont College Slyne Road Lancaster Lancashire LA2 6AP Lead Inspector Mrs Marie Cordingley Announced Inspection 7th December 2005 10:00 Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beaumont College Address Slyne Road Lancaster Lancashire LA2 6AP 01524 541400 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) SCOPE Care Home 77 Category(ies) of Physical disability (77) registration, with number of places Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st October 2005 Brief Description of the Service: Beaumont College is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 77 students. The college offers students a wide range of pre-vocational courses and individually tailored learning programmes, based on their own strengths and needs. Whilst education is a primary function of the college, residential care services are also provided to the majority of students who study there. As the educational standards within the college are inspected by OFSTED, inspectors from the Commission for Social Care Inspection assess standards which are associated with the residential care service provided at the college. The college is conveniently located in a residential area of Lancaster, close to a variety of facilities and amenities. Accommodation is provided over three floors and there is a passenger lift available for the use of students. In addition to the main building, further accommodation is provided for eight students, in a separate and smaller building situated in the grounds of the college. Due to its size and layout, this building offers accommodation which is more domestic in character. Due to a reduction in the number of students living at the college, a higher proportion of accommodation is now offered on a single room basis. Plans are underway to further increase the amount of single room accommodation available in the future. Support staff (some of whom are qualified to NVQ level 2 or above in care) are on duty at the college on a 24-hour basis. The registered provider of this service is SCOPE, a national, non profit making organisation whose headquarters are based in London. Due to the recent retirement of the Principle, the college is currently without a registered manager. The Commission are waiting for SCOPE to propose a new registered manager. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 5 Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three days on the 7th, 8th and 10th December 2005. There were 57 students living at the college the time of the inspection as well as a number of students who attend the college in the daytime only. Prior to the visit, students, their relatives and other professionals were sent questionnaires which asked their views on care standards at the college. The Commission received a good response to these questionnaires. Throughout the visit, inspectors consulted managers and a number of staff members. Students were also consulted and observed going about their daily routines. A tour of the building was undertaken and a variety of documents were examined. As part of the inspection, a case tracking exercise was undertaken. This involved the inspectors closely examining all aspects of care provided to selected students from the point of their admission to the college. What the service does well: Students at the college were sent questionnaires prior to the inspection. The Commission received 16 completed questionnaires which represented approximately one quarter of residential students. The results from the questionnaires were very positive and confirmed that the majority of students were satisfied with all aspects of their care. Out of 16 responses; • • • • • 15 students said they liked living at the college all the time. 15 students said that they always felt safe. 16 students said that staff always treated them well. 1 student said they liked living at the college some of the time. 1 student said that they sometimes felt safe. Other positive comments made on the questionnaires included; • • • • I have lots of friends. I am treated very well. It’ s fun and friendly. I love being more independent. DS0000010024.V258416.R01.S.doc Version 5.0 Page 7 Beaumont College • It’s nice and cosy. The inspector also received completed questionnaires from parents of students and other professionals involved in their care, such as visiting health care professionals. Again, the responses were very positive and all the parents who completed questionnaires were satisfied with all aspects of their son or daughter’s care. Visiting health care professionals all stated that the college met students’ needs well and that any health care advice they gave was always incorporated into students’ individual care plans. The inspectors consulted a number of students throughout the visit and received some very positive feedback. All the students who spoke to the inspectors were very happy with life at the college and spoke highly of support staff and managers. One student said ‘’This is the best place I have ever been, I never want to leave.’’ In observing students going about their daily routines it was apparent that they were relaxed and comfortable in their surroundings. In addition, the inspectors noted many examples of students sharing very positive interaction with support workers. It was apparent that students and support workers shared good relationships. Throughout the visit, the inspectors found evidence to confirm that students’ care is extremely well planned. As described later in this report, the assessment process is extremely thorough and carried out over several months prior to a student’s admission. Much care is taken to ensure that the college are fully aware of each student’s needs and what support they need to provide to meet these needs. In addition, the assessment process involves a lot of different professionals who all have their own areas of expertise, for example dieticians and speech therapists. All the information gathered during the assessment process is used to formulate a written support plan which outlines how staff will address each individual need. The inspectors viewed a number of support plans and found them to be of a very high standard. Support plans were extremely in-depth covering all aspects of a student’s daily life. In addition, it was apparent that each student’s plan was very much based on their individual strengths and needs and that their own goals and wishes had been taken into account during the development of their plan. The provision of meals is an area in which the college perform particularly well. It is later described in this report that students at Beaumont College benefit from an extremely high standard of catering. In particular, the college respond very well to those students who have special dietary needs and have also developed some very impressive systems for supplying special food such as pureed or soft meals. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 8 Evidence was found during this inspection to confirm that staff at the college benefit from a very high standard of training which is provided in abundance. In viewing records, it was found that on average, staff received 26 paid training days every year in areas pertinent to their roles such as adult protection and health and safety. In addition, it was also confirmed that over 50 of support staff at the college now hold National Vocational Qualifications in care at Level 2 or above. Students at Beaumont College benefit from the regular input of a variety of professionals who have expertise in different areas, for example, occupational therapists and behavioural specialists. In addition, the college has national and international links with agencies promoting good practice in areas such as positive approaches to behaviour management, continence care and epilepsy. Throughout the visit, the inspectors were impressed by the professional approach of the managers at the college and the level of commitment they demonstrated. There is a very well structured management team within the college which is made up of professionals with a variety of backgrounds. Throughout the inspection, the management team demonstrated that they had the skills and knowledge to exercise effective leadership. What has improved since the last inspection? During this visit it was confirmed that a number of areas identified for improvement at the previous inspection had been developed. A number of improvements had been made to the college’s medication procedures resulting in safer systems. Labelling of medication held within the college had been developed to include more accurate information. However, the inspector still noted some inaccuracies which needed to be addressed. The temperatures of fridges used for the storage of medication were being monitored on a daily basis and records confirmed that appropriate action had been taken when the temperatures had been found to be outside of recommended limits. It was found that the college had made some significant improvements in addressing environmental issues which had been raised by the Commission for some time. The Commission have raised concerns for several years about the fact that students only have access to one lift within the college. During this visit, it was confirmed that work was underway to provide a second lift and it was hoped this lift would be ready for use in early January 2006. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 9 A number of areas within the college had been fitted with overhead tracking devices. This means that students who require assistance to transfer can be moved more safely and in a more dignified manner. Some doorways had been widened to provide better access for students who use wheelchairs. SCOPE are planning to widen all remaining doorways by March 2008. Some of the students’ toilet and bathing facilities had been improved, providing a better standard and improved access. Some rise and fall sinks had been installed but there were still a number of areas that did not have these. Rise and fall sinks are necessary to ensure that students using various types of wheelchairs are able to access them. A rolling programme is in place at the college to ensure students’ bedrooms are well decorated and maintained. Since the last inspection, a number of bedrooms had been refurbished and new carpets fitted. In general, students’ bedrooms were found to be decorated to a good standard and all those viewed by the inspectors were personalised with students’ own possessions. In line with a requirement made following the last inspection, the issue of keyholding had been addressed in each student’s support plan. It was also confirmed that the standard assessment procedure now addresses each student’s requirements in relation to key holding and all students who want a key for their bedroom and are able to use one safely, will be provided with one. Following the last inspection of the college, a requirement was made that all students’ personal information be stored securely. It was confirmed during this visit that the college had arranged to have key code locks fitted to the room where information was stored, ensuring that only authorised people could access it. Whilst it was found during the last inspection that staffing levels at the college exceeded those recommended in previous Department of Health Guidance, the inspectors were advised that they were not adequate to enable the college to meet their individual contractual obligations to each student. Since then, staffing levels have been reviewed and as a result significantly increased. It was confirmed during this visit that these levels were now adequate to meet students’ individual contracted services. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 10 Records viewed during the visit confirmed that over 50 of support staff now hold National Vocational Qualifications in care at level 2 or above. This is a good achievement and means that the college are now meeting the national target for adult services. Following the last inspection, requirements were made in relation to the supervision of staff. The college have now reviewed their supervision policy and systems have been reviewed to ensure that all staff who provide supervision are given training to do so. In addition, staff were being provided with supervision on a more frequent basis in line with National Minimum Standards. What they could do better: It was recognised that further improvements could be made in the labelling of medication held within the college. On inspection of one student’s medication, it was evident that the labelling did not match the contents of the monitored dosage system, indicating that further improvements were required in the general labelling of the monitored dosage systems. It was also recognised that the administration of medication by specialised technique although generally witnessed by support staff, was not reflected in the records. A witnessing signature for the administration of these medications would ensure more robust procedures and safer systems are in place. A list of authorised staff signatories for medication administration was recommended at the last inspection for interpretation of the medication administration records, this had not been acted upon and remains a strong recommendation. The environmental issues that were raised in the previous inspection report are being addressed as an ongoing programme of improvement for the college. However, until this work is completed much of the college’s accommodation does not meet required standards. A number of areas within the college remain inaccessible to students. In particular, several kitchenette facilities within the separate living areas are totally inaccessible to students who use wheelchairs due to their size and layout. Many of the doors within the college are too narrow for students who use wheelchairs to access easily. This is being addressed as part of an ongoing programme. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 11 A programme of installing overhead tracking devices is now underway. When completed these facilities will be of great benefit to students as it will mean they can be assisted when transferring in a safer and more dignified manner. Measures which include the reduction in the number of residential students have been taken, so as to increase the amount of single rooms available. In addition, a thorough assessment is carried out of each prospective student’s needs in terms of being provided with a single or double room. The Commission have recommended for some time that all students who require a single room be provided with one. The college has a Statement of Purpose and Service User Guide in place which provide information about all aspects of the college’s management and daily life. However at the time of the visit, these were inaccurate due to the fact that they had not been updated to reflect recent changes in the management team. In addition, the provision of a Service User Guide in audio or video format would be of great benefit to prospective students and is an area that the college is exploring. Since the retirement of the Principle in August 2005, the college has been without a registered manager. This needs to be addressed as soon as possible and the Commission are waiting for an application from SCOPE for this purpose. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 12 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 13 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. The college gain a great deal of information about all prospective students in good time to plan their care effectively. Staff training is provided in accordance with the needs of students. EVIDENCE: A Statement of Purpose and Service User Guide are available but these need to be updated to reflect recent changes in the management team at the college. The Service User Guide is very informative and provides the prospective student with a lot of information about daily life at the college such as activities, mealtimes and arrangements for care planning. It has been recommended in previous inspections, that the SUG be made available in alternative formats such as audio or video for the benefit of those students who do not read. It was found during this inspection that prospective students benefit from an extremely thorough assessment process which involves a variety of professionals. The assessment process takes several months to complete and involves a number of face-to-face meetings with the prospective student and his or her representatives. The inspectors were impressed with the level of multi disciplinary input involved in each student’s assessment, which included that of occupational therapists, dieticians, behavioural specialists and nursing staff. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 14 In addition, it was confirmed that each student’s assessment is routinely examined to identify any training needs for staff. For example, if a prospective student had a specific condition, managers would ensure all staff were provided with training in that condition before the student was admitted to the college. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 15 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 The individual needs and choices of students are central to the support planning process. Students are assisted to take responsible, well managed risks to enhance their personal development. EVIDENCE: All students within the college have written individual support plans which are of an exceptionally high standard. The plans cover all aspects of a student’s care needs and clearly state the support staff should provide to meet these needs. In viewing the plans, it was apparent that they had been developed using a person centred approach. This means that the students’ own views and opinions had been taken into account as much as possible and there was a notable emphasis in promoting independence and increasing opportunities. All the plans seen by the inspectors had been regularly reviewed to ensure that any changes in a student’s needs were addressed. In addition, it was noted that students and their representatives had been involved in the review process at all stages. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 16 Any restrictions to a student’s freedom or choices were only in place where they were necessary to safeguard their wellbeing. Where such restrictions existed, these were clearly stated in the student’s support plan and had been agreed by all those involved with the student. Throughout the inspection, evidence was found that the college are highly committed to promoting independence and assisting students to make choices in their lives. This was apparent in students’ support plans, as was measures taken by the college to facilitate such aims. For example, access to independent advocacy services and assistance with communication aids. The inspectors found that there were established arrangements in place to ensure that students had the opportunity to participate in the daily running of the college. Such arrangements included the student council, which had been recommenced after several years and weekly meetings for students in their individual living areas. In addition, it was noted that students had been given the opportunity to be involved in a number of steering groups such as the newly formed Equality and Fairness Board. It was also pleasing to note that students had recently been involved in the recruitment of two senior managers at the college. However, a recommendation was made that more formal systems be implemented to involve students in quality assurance processes within the college. For example enabling students to participate in the recently established Quality Steering Group. As earlier stated, systems for storing students’ personal information have been much improved. Keycode pads are now used on the areas where information is stored so that only authorised people can access them. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 17 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Students at Beaumont College are enabled to choose from a wide range of fulfilling activities and are supported to develop and maintain relationships. The provision of meals at the college is of a particularly good standard. EVIDENCE: Students at Beaumont College are enrolled on a three year programme which is designed to support them through the transition into adult life and develop their independent living skills. Education is provided alongside residential support and both the keyworker and the college’s personal development tutors work with the student following the ten foundations for independent living. Good evidence was seen in students’ support plans of the progress they had made during their time at the college. In addition, evidence was seen of students developing skills in real and relevant situations, for example within the local community or their individual living areas. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 18 Much evidence was available to demonstrate that students were able to participate in a range of activities. Leisure timetables were seen in students’ support plans and photographic evidence of valued activities was available in personal files and displayed on the walls of the college. Students who were consulted expressed satisfaction with the social life at the college, many stating that this was the best part of living there. The college has a number of cars and minibuses available for outings and students are actively encouraged to use public transport. Several students were seen going out throughout the inspection to specific places or just for a walk. As part of each student’s individual support plan, a community access plan is completed. This plan identifies the support and aids required for the individual to access the community as well as including any necessary risk assessments. Students were observed to have free access to all areas of the college dependant on their abilities. Further work is being done to enable students to use assisted technology to unlock and open doors and to control more of their environment and therefore enjoy more independence. The college has a communications team and great advances are being made with assisted technology and communication aids. Observation of a mealtime and examination of menus and records confirmed that the catering team work hard to provide a varied, nutritious and appealing diet. There is an extensive choice of foods at each mealtime with a least six beverage choices available. It was noted that students were encouraged to sit where and with whom they like. One student was observed eating alone, but discussion with the student and a member of staff confirmed that this was her preference. Students are made aware of the food available in several ways. There is a written menu, a push button communicator which gives a verbal description and a sample meal out on display. The catering staff are evidently well informed of students’ likes, dislikes and other dietary needs and maintain good records of these. One student with very specific dietary requirements was very well catered for, with all staff showing a good awareness of foods that she should not eat and special preparation requirements for her meals. The student’s support plan contained good information with very specific guidance for staff with regards to all her eating and drinking needs such as required posture when eating. The inspectors consulted one student who had some cultural requirements in relation to his diet. He confirmed that he had been accommodated and was very happy with his menu plan. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 19 The college’s provision of pureed diets is excellent with pureed foods being reconstituted into moulds to represent the food in its original state. This makes the food more appealing and enables everyone to take part in a communal eating experience. The college’s award winning chef who developed this system, has been consulted by chefs from other large care providers on how they can provide similar pureed meals. The manager commented that they were pleased that the college had been able to spread this good practice across the area. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 20 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21. The college has excellent policies and procedures for the handling of medication. Independence is encouraged as far as possible and students that are capable of self-medicating are appropriately supported. Students’ personal medical needs are carefully assessed and detailed plans are put in place to ensure these needs are met. EVIDENCE: Through discussion with students and staff and in viewing students’ individual support plans, the inspectors were able to determine that students are fully involved in their own care planning. This was also apparent when viewing staff guidelines which stated students’ preferences in the way they were transferred for example. There were extremely comprehensive individual support plans in place for each student, which included professional assessment input from health care staff and other visiting professionals such as general practitioners. On inspection, it was evident that these were detailed, clear and instructive. Students were consulted as far as possible in the development of these plans. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 21 Records viewed confirmed that students received medical intervention when appropriate and regular GP contact was evident. A formal contract with the Primary Care Trust had been arranged that ensured all ‘nursing’ tasks were regularly monitored. This fully addressed the clinical governance issues raised at previous inspections. Discussions with the college nurse and inspection of the relevant records such as input from physiotherapists and dieticians, confirmed that there is an excellent network of professional care to meet the needs of students. In addition, it was pleasing to note that a number of visiting professionals such as a national continence specialist further enhance students care. Medication systems in the college were found to be extremely well managed and there were excellent auditing systems in place to ensure that the correct procedures were being followed at all times. Appropriate risk assessments were carried out and a robust risk management framework was found to be in place. Medication is kept in the students’ own bedrooms in secure dedicated safes. Support staff generally only administer to two or three students and a manager’s audit is carried out after every medication round to ensure all medicines have been administered and signed for. The administration of medication by specialised technique was clearly documented and care planned. However, it was again noted that no witnessing signature was evidenced on the administration documents. This is recommended to ensure no mishandling of these potentially abusable medicines can occur. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 22 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Students at Beaumont College are encouraged to raise complaints and any complaints that are raised are investigated quickly and effectively. There are robust systems in place to ensure that students are protected from all forms of abuse. EVIDENCE: SCOPE has a comprehensive complaints procedure entitled ‘Complaining isn’t Wrong – it’s a Right,’ which is included in the Service User Guide. The college has a very pro-active approach to complaints. A working group including students is currently devising a more accessible format of the complaints procedure. There is a notice board in the reception area giving audio guidance in respect of making complaints. Students have been involved in making a complaints video for SCOPE and one student has been involved in creating a harassment/bullying video. All complaints are recorded and logged with a complaint number, date received, complainant name, detail of complaint and the person responsible for dealing with it. An outcome of any investigation is recorded along with a final conclusion and any remedial action. The inspector viewed records of a complaint made by one student in relation to accessibility in one of the college’s toilet facilities. It was found that this complaint had been well managed and the college had responded both quickly and effectively improving access for all the students. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 23 The college have a number of measures in place to ensure that any incident or suspicion of abuse is promptly reported and investigated. The inspectors were impressed with the procedures which were very robust and comprehensive. A number of management staff at the college have undergone specialist training which enables them to undertake the role of DAPAs (designated adult protection advisors) or DCPAs (designated child protection advisors). Their role is to provide advice and support to any person who reports an incident of abuse and management rotas are organised to ensure that there are a number of these advisors on shift within the college at any one time. A risk and vulnerability statement is completed for each student which covers health risks and personal vulnerability in areas such as community access, feeding and nutrition, physio and movement and vulnerability to abuse. This information is then used to create a vulnerability register of students who are believed to be at high risk of abuse. This can be for a number of reasons, for instance, a student who has complex, behavioural needs or a student requiring a high level of support in relation to communication. A manager is appointed to each student who is placed on the vulnerability register. Part of the process is to ensure that managers who are appointed do not have any direct line management responsibility for the area that the student lives in, therefore ensuring that they can remain objective. The manager is then required to complete a report on a weekly basis, having spoken to the student, interviewed support staff and examined the student’s individual plan. A weekly meeting is then held with the management team to go through the reports and identify if there are any causes for concern. The concern incident reporting system is another pro-active way that the college protect students from abuse. Staff are encouraged to make formal reports of anything that gives them concern but doesn’t necessarily constitute an abuse situation. For example, if a student was denied a requested night out due to lack of staff this would be reported as a concern incident. There were measures in place to ensure that all concern incident reports were examined on a daily basis and any remedial action is recorded. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 24 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30. Much of the accommodation at the college does not meet the required standard. However, SCOPE are now demonstrating a commitment to addressing the identified areas and are making improvements. EVIDENCE: As earlier stated, the Commission for Social Care Inspection have been raising concerns about the environmental standards at Beaumont College for some time. The Commission have now been provided with a long term action plan which addresses all the identified areas. The college is a very spacious building providing a number of areas for students to access throughout the day. Smaller communal areas have now been provided on each living area within the college, which means students have more choice about where to spend their free time. The provision of a second lift is required to ensure that all areas of the college are easily accessible to all students. Work to provide this lift is now underway and the college are hoping it will be completed by the end of January 2006. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 25 A number of areas within the college have now been fitted with overhead tracking devices. This means that students who require assistance to transfer can be moved more safely and in a more dignified manner. However, more of this equipment is required. Some doorways have been widened to provide better access for students who use wheelchairs. SCOPE are planning to continue with this programme and it is planned that all doors will be widened by March 2008. Although the college is registered to accommodate 77 students, there were only 57 students living there at the time of the inspection. This reduction in numbers has resulted in an improvement in the number of single rooms available. It is however, recommended that all students who require a single room are provided with one. Some of the students’ toilet and bathing facilities have been improved, providing a better standard and improved access. Some rise and fall sinks have been installed but there are still a number of areas that do not have these. Rise and fall sinks are necessary to ensure that students using various types of wheelchairs are able to access them. Kitchenette facilities have been provided within each living area. However, some of these facilities are not accessible to students who use wheelchairs due to their size and layout. A rolling programme is in place to ensure students’ bedrooms are well maintained and nicely decorated. Since the last inspection, a number of bedrooms have been refurbished and new carpets fitted. In general, students’ bedrooms were found to be decorated to a good standard and all those viewed were personalised with students’ own possessions. Some students had been able to choose the colours of their bedroom walls and carpets. Keyholding is now addressed in each student’s support plan as part of the standard assessment procedure. This means that all students who want to have a key for their room and are able to use one, will be provided with one. Plans are currently in place to provide more appropriate types of keys such as those that a student could open with voice activation for instance. The introduction of such equipment would benefit the students immensely. The college is kept clean and hygienic and there are systems in place to prevent the spread of infection. On visiting the main laundry area however, the inspector noted that this was generally untidy and needed to have a basic all-through clean; window bottoms and shelves were very dusty and cluttered. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 26 Discussions with the laundry staff confirmed that the guidelines for Control of Substances Hazardous to Health (COSHH) are followed. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 27 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. Students at Beaumont College receive care from well trained and supported staff. Staffing levels are appropriate for the number and needs of students. The turnover of staff at the college is fairly low, providing students with continuity and stability. EVIDENCE: Staff consulted during the visit were able to express their commitment to their work, and their sense of fulfilment in enabling students to achieve their potential. They showed a good knowledge of the needs of the students, and how to care for those needs. Staff were seen with students throughout the day; giving privacy while a student was in a bathroom; asking permission of a student to enter their room; sitting and joining in with students chatting, while writing up notes; listening and guiding as they accompanied students to their destinations. Training records showed that 51.85 of staff are NVQ qualified, and the manager stated that the number registered to undertake further courses would take that figure up to 86 in the next 12 months. These courses range from Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 28 NVQ Level 2 and 3 in care, NVQ Level 3 in Promoting Independence, Health and Social Care to NVQ Level 4 and the Registered Managers Award. A variety of relevant training is ongoing for all staff, with a rolling programme of development days. “There is constant refresher training. They always keep you updated”, was a staff comment. The Health and Safety manager confirmed that all staff had training in health and safety, with moving and handling, food hygiene, and first aid mandatory. Fire training was also a part of the staff induction, with regular fire drills and debriefs, which would identify further training requirements. “Training is abundant. It makes staff confident. There are plenty of opportunities for staff promotion and development”, stated one of the managers. The college achieved the Investors in People Award in 2004. This is awarded to employers, by an external professional body, to those who have achieved certain set standards in staff development and training. The rotas show that sufficient numbers of staff are provided to support students’ needs at all times, and also meet those agreed in the students individual learning contracts. One-to-one support is given, and this was seen in evidence around the home. The rotas showed that new staff were placed in an experienced team. It was also noted that the turnover of staff at the college is low. At the time of the visit this was standing at 9 which is impressive in a team of this size. A selection of staff files examined showed that there was a comprehensive recruitment procedure in place, ensuring the protection of the students’ welfare. Application forms were completed, detailing any background experience, and two references and a Criminal Records Bureau disclosure, including a Protection of Vulnerable Adults (POVA) list check were made, before the person was appointed. Staff who start with a POVA First check, prior to the full CRB disclosure, are always supervised by experienced staff. “Until my CRB arrives, and until I’m also more aware of what is needed, someone is with me all the time. I’m not allowed to go into students’ rooms on my own” stated one new recruit. The manager explained how students had been involved in the recruitment process. A separate exercise from the interview for senior care posts took place, by a group of students making up a 30-minute discussion group alongside new applicants, with support from education staff. The interaction taking place was assessed, and students also fed back their opinions of the applicants to the assessment panel. The manager said that this exercise was found to work well, and was to be used as a regular feature of the recruitment Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 29 process. No written evidence of the outcomes of this discussion group was available however. Files showed evidence of probationary periods worked, and regular reviews of staff performance. Records showed that all new staff undergo two weeks induction training, one week foundation training, and then between 15 and 26 additional training days a year. Experienced staff work alongside new staff, who are guided and supervised until they are competent to work alone. “I really like it here”, commented a new staff member, “You feel part of the team straight away, and working with experienced staff gives you confidence in what you are trying to achieve.” A new policy for the supervision of staff has been made, so as to make this more standard and constant throughout the college. Previously different managers in different areas of the college had varying ways of carrying out this process. Regular supervision was noted in records viewed, with evidence of follow-ups of issues at each subsequent supervision. These covered relevant working and personal development issues, and took place every six to seven weeks. One of the managers confirmed that there is constant informal supervision, and part of the performance review is direct observation of the staff working with the students. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 30 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 & 43. The management team within the college is committed to providing a good quality service which is run in the best interests of students. Support from SCOPE has improved in recent months and managers within the college are increasingly confident that SCOPE are now committed to meeting their obligations as service providers. EVIDENCE: The college has a very well structured management team in place, each manager having responsibility for a certain area. The combined expertise and experience held by those on the management team is extremely impressive. Throughout this inspection, the management’s commitment to continually develop and improve services was evident. . Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 31 As earlier stated, the college is now without a registered manager since the retirement of the Principle in August 2005. SCOPE must propose a new manager for registration with the Commission as soon as possible. The college has recently implemented a revised quality monitoring system that is fundamentally focused on the protection of the students. Customer satisfaction questionnaires are sent out each term to parents, social workers and connexions workers; surveys are also sent to each key-worker who completes the form with their student. The results of these surveys are shown to new students and their parents and displayed on the notice board in the resource room. The inspector advised that the results of quality surveys should be made available for all stakeholders in the process, and also be put on the agenda of the student council meetings. The quality monitoring manager agreed with this advice and suggested that the survey results be put into the students’ magazine Powerful Voices. A quality steering group is in the process of being formed that will include input from the finance, facilities, programme and health/therapy managers. It was recommended that students have the opportunity to join this group as well. There is an excellent health & safety approach at the college. A full time member of the management team has been seconded to dedicate his time fully to this area. Policies and procedures are in place for all aspects of health and safety including bed rail protocols, fire procedures and a hazard reporting system, which is a system that manages the delicate gap of ‘health and safety’ and the ‘home’ environment. There is a health and safety committee that meet monthly to review and revise any issues that may have arisen. The college occupational therapist takes charge of all moving and handling issues and the provision of aids and equipment. Two first aid trainers make sure that all staff are trained in first aid and emergency boxes are checked and replenished weekly. Accidents are recorded satisfactorily and monthly debriefing meetings are held by the senior managers, who review the accident outcomes in a monthly audit. Near-miss records are also kept to help avoid any potential future accidents and again these are reviewed and audited monthly. As earlier stated, SCOPE have, in recent months, shown increased commitment to addressing the requirements made following inspections, and have acknowledged their obligations as care providers. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 32 A long term action plan has been provided to the Commission which addresses the environmental issues that have been ongoing for several years and provides realistic timescales. It is recognised that SCOPE need to access considerable funding to address all the requirements and bring accommodation up to the National Minimum Standard. The Commission also recognises that SCOPE experience additional problems due to the Learning and Skills Council’s funding arrangements and the college’s reliance of exceptional funding due to the complex needs of students. Discussions continue between SCOPE and the Learning and Skills Council about this matter. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 33 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 4 3 X 3 Standard No 22 23 Score 3 4 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 3 4 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 2 1 1 2 1 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beaumont College Score 3 3 3 4 Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X 3 2 DS0000010024.V258416.R01.S.doc Version 5.0 Page 34 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 5 Requirement Changes to the management structure of the college must be reflected in the Statement of Purpose and Service User Guide. The registered person must ensure that all medication stored within the college is labelled appropriately. An additional passenger lift must be installed. The registered person must ensure that rooms used by students have wide enough doorways for students who use wheelchairs to access. The registered person must provide the appropriate specialist adaptations and facilities to meet the assessed needs of students, for example rise and fall wash hand basins. The registered person must ensure that students have access to dining/kitchen facilities which can facilitate various types of wheelchairs. The registered person must propose a manager for registration with the Commission. DS0000010024.V258416.R01.S.doc Timescale for action 31/03/06 2. YA20 13 31/12/05 31/01/06 31/03/08 3. 4. YA24 YA24 23 13 5. YA24 23 30/06/06 6. YA24 23 30/09/06 7. YA37 8 31/01/06 Beaumont College Version 5.0 Page 35 8. YA30 23 All areas of the college must be kept clean and hygienic at all times. 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. 8. Refer to Standard YA1 YA8 YA8 YA25 YA39 YA32 YA19 YA19 Good Practice Recommendations The Service User Guide should be made available in alternative formats such as audio and video. Measures to involve students in the recruitment process should be formalised. Student should be provided with the opportunity to join the quality assurance group. All students who request it should be provided with a single bedroom. Results of all surveys held in relation to the college should be fed back to students and their families. 80 of staff should hold NVQ qualifications in care at level 2 or above. A list of authorised staff signatories should be kept with the medication administration records along with sample initials. The labelling of the blue wallet monitored dosage system for medication should be reviewed and checked on receipt into the college. Beaumont College DS0000010024.V258416.R01.S.doc Version 5.0 Page 36 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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