Inspection on 06/03/06 for The David Lewis College Residential Service

This inspection was carried out on 6th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The David Lewis College... 05/02/07

The David Lewis College... 15/06/05

The David Lewis College... 07/02/05

The David Lewis College... 26/04/04

The David Lewis College... 12/01/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 David Lewis Centre College Core Unit Mill Lane Warford Alderley Edge Cheshire SK9 7UD Lead Inspector Sue Dolley Announced Inspection 6th March 2006 09:30 David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 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 David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 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. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service David Lewis Centre College Core Unit Address Mill Lane Warford Alderley Edge Cheshire SK9 7UD 01565 640000 01565 640100 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) David Lewis Organisation Deborah Gittins Care Home 29 Category(ies) of Learning disability (29), Physical disability (29) registration, with number of places David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service is registered for a maximum of 29 service users in the categories of LD (learning disabilities and PD (physical disabilities) aged between 16 & 25 years only. The 29 service users can be accommodated as follows: * A maximum of 19 in Elizabeth Maybin House. * A maximum of 6 in 9/10 Mill Lane * A maximum of 4 in 7/8 Mill Lane The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 15th and 17th June 2005 3. 4. Date of last inspection Brief Description of the Service: The David Lewis Centre is a specialist service for children and adults who have epilepsy, and associated conditions and problems. The centre is in rural Cheshire in 170 acres of grounds. The David Lewis Centre College Core Unit consists of 3 houses which, together with separate teaching accommodation form part of the David Lewis Further Education College. The college is a residential and day college. The 3 residential are registered with CSCI as The David Lewis Centre College Core Unit and consist of: 7/8 Mill Lane (4 places) 9/10 Mill Lane (6 places), and Elizabeth Maybin (19 places). Some of the students who attend the college have complex medical needs and also learning difficulties, which in some cases require high levels of support. The service is designed to provide support for students with one or more of the following: Intractable epilepsy Moderate to severe learning difficulties Challenging behaviour Autistic tendencies The David Lewis College offers a 24-hour curriculum, which includes learning opportunities in the college, in the residential units, in the community and, where appropriate, on work experience placements. Individual programmes of residential support are available as 38 week placements or, with the inclusion respite care, 52 week placements. There is a range of specialist clinical services on site. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This home was inspected as part of an announced co-ordinated inspection of all the DLC services registered with CSCI. The purpose of this approach was to evaluate the effectiveness of the Centre in supporting each unit to improve outcomes for the people who live there. The co-ordinated inspection took place over five days and involved a team of eight inspection personnel from CSCI, including a service inspector, a regulation manager, a pharmacist and regulatory inspectors. The inspection also focused on how national minimum standards were being met across the registered services and what progress had been made to meet requirements from the last round of inspections carried out in the period from April to August 2005. As part of the preparation for the inspection, the management staff at the David Lewis Centre produced self - assessment reports that summarised practice in the individual registered units and for the whole of the service. Before the start of the inspection, the inspection team carried out a number of surveys with placing agencies, parents, carers, service users and staff. During the inspection, the service inspector and regulation manager carried out a schedule of interviews with representatives of the Trustees, senior staff, operational managers and staff responsible for clinical, administrative and technical support to the centre. The inspection process included: tours of the premises; discussions with service users and their carers; meetings with senior centre managers and staff; visits to the centre laundry, transport and the central kitchen; meetings with clinical staff; and included an evening visit. The process enabled the inspection team to obtain a clear understanding of the factors influencing development and from the evidence gathered the team were able to form judgements on the quality and effectiveness of the services provided and the outcomes for those receiving services at the David Lewis Centre. What the service does well: The trustee board and centre directors are actively engaged in developing a clear vision for the David Lewis Centre services and are prioritising developmental areas and projects. Service users have access to the multi-disciplinary team who ensure needs are addressed and met. The needs of service users within the College Core Unit are thoroughly assessed. The three -day assessment of students’ needs by the college, involving parents and carers, was illustrative of the inclusive approach to multi-disciplinary work at the centre. The routine, close contact with expert medical care provides a degree of security for carers and staff from placing David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 6 agencies. The college nurses are seen as a valuable resource by students, parents, carers and staff. All placements are planned in advance using a thorough, multi-disciplinary approach to assessment. The care common care files contain placement agreements that identify all services and facilities to be provided. Students have access to a range of healthcare facilities on site. Each student has a personal development plan, which encompasses educational programmes, living skills, healthcare and medical needs, and leisure programmes. Each student has a course tutor and an identified key worker who work closely together to help students achieve their learning goals. Students are enabled to take responsible risks. Risk assessments have been undertaken for all activities and are thorough. Staff members are encouraged to undertake NVQ training appropriate to their roles and responsibilities and there is an experienced and competent wellmanaged staff team. The publicity and information for the National Youth Advocacy Services was prominently displayed for students. What has improved since the last inspection? The college provision has been restructured and re-registered as two separate units. Two service managers have become registered managers, each having management and support responsibilities for different houses within the college provision. The College Core Unit has addressed and met the requirements of the previous inspection. A more detailed assessment report has been devised focusing on the actual care package to be offered and highlighting individual need i.e. a need for physiotherapy or additional staff. The risk assessment process continues to comprehensive and thorough. Base line assessments have been reviewed to provide details of students’ life skills. This has enabled clearer targets to be set and the recording of progress has been improved. A common care file has been introduced across the site and has significantly improved the standard of recording and organisation of student information. The statement of purpose and function has been updated and simplified. Complex medical information has been removed. There are now a variety of service user handbooks to allow for varying communication skills. The centre now includes the accredited model of physical intervention within their induction programme. The induction period has been developed into a two -week programme, which is comprehensive. The centre’s psychology department is developing a physical intervention programme for the David David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 7 Lewis Centre, which is to be submitted to the British Institute for Learning Disabilities for accreditation. Maintenance work has been completed promptly and cleanliness within the Elizabeth Maybin unit has improved. There has been a marked improvement in the catering service and the standard of food provided to students by the central kitchen. A new eight place college residential facility is being developed with a housing association. This is close to completion and will enable some students to acquire independence skills within a community setting. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 8 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 9 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 David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 10 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 and 4 Needs assessments are thorough and well written, ensuring that potential students’ needs are accurately identified. The process of students moving into the College Core Unit is well managed to ensure individual needs are met and students quickly settle into their new environment. EVIDENCE: The Statement of Purpose and Function for the College Core Unit is informative. It has been updated since the last inspection to reflect the change of registered manager and complex medical information has been removed to make the document user friendly. There are now a variety of user- friendly student handbooks to allow for varying communication skills. When potential students are referred to the David Lewis Centre College Core Unit, a pre-assessment questionnaire is completed along with a home visit. A three-day assessment is carried out usually within Elizabeth Maybin unit by the college multi-disciplinary team including input from psychology, medical, education and residential care departments to identify support needs. Students are central to this process. The free three -day assessment facility is currently under review and there may be an option to offer a two-day assessment to potential students who live within a reasonable travelling distance of the centre to make the process more cost effective. Normally other assessment documentation from placing authorities and other relevant professional bodies is gathered and considered before DLC decides to offer David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 11 placements. Prospective students have the opportunity to attend an open day in which they are introduced to the services and facilities available to them. At the start of the academic year a baseline assessment is completed within the first term to accurately reflect ability, reassessing skills, needs and goals of each student. Students are asked to complete a questionnaire at the end of term to ascertain their views. The assessment and admission process was well organised and thorough overall, although one common care file checked during the inspection did not contain sufficient assessment documentation from the placing authority and the abilities checklist did not contain the names of the assessors. In addition the individual learning plan did not state the date to be reviewed although it had commenced in 2005. See Requirement 1 and Recommendation 1. During the inspection discussions were held with the student who expressed a high level of satisfaction with the care and support provided. In interviews with two senior residential workers, it was evident that they had a good knowledge of the student and a friendly and enabling relationship was apparent between these staff and the student concerned. The common care file examined within Elizabeth Maybin provided a wealth of information about the student and information was well organised. The person centred plan was comprehensive. The daily records within the College Core Unit were informative. They reflected the current situation for each student and provided evidence of continuity of care and support. An accident record gave details of a student falling whilst at college. Unlike other recorded accidents, this accident had not been recorded on the significant events sheets. See Recommendation 2. National Youth Advocacy Services were well publicised throughout the College Core Provision. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 12 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 and 9 Each student has an individual plan of care and is supported to make choices and decisions about their care, support and life. Students are consulted on all aspects of college life and are supported to enable them to take risks as part of an independent lifestyle and within a framework of risk assessment. EVIDENCE: Students are encouraged to help determine and develop their plan of care. The person centred plan seen during the inspection was very comprehensive. The plan was written in the first person and had been agreed by the student. Personal aspirations and goals had been recorded and accurately reflected the student’s view. All students contribute to their college individual learning plans and their care plans, identifying support needs, goals and aspirations. Regular meetings are held between the student, key worker and tutor to ensure the care and educational package is right for them and to make adjustments if necessary. Timetabled programmes of activities to promote independent life skills and skills for life were available to view. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 13 Pictorial and symbol format timetables are used to suit varied communication skills. There is close liaison with the speech and language therapist to promote such skills. All necessary support was fully described. Students can access a wide range of healthcare facilities on site and two college nurses linked to the college residential houses offer support to meet the health and personal care needs of the students. Prior to the inspector meeting with a student, the senior support worker checked with the student to see if they were happy to participate and offered their support, which was readily accepted. The support worker listened attentively to the discussion providing prompts and reassurance only when necessary. The support worker encouraged the student to speak openly and to air their views. Possible risks are assessed prior to admission and assessments continued to take place during the student’s placement at the David Lewis Centre. Risk management plans were evident and in place for all students. Student meetings take place each month within the residential houses of the College Core Unit. Students have opportunities to influence key decisions and to air their views both individually and in group discussions. They are encouraged to chair and minute their own meetings. There is a high level of student and staff interaction and there was evidence during the inspection of staff members and students jointly undertaking tasks and socialising together in a relaxed manner. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 14 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 and 17 Staff members enable students to have opportunities, including various leisure and social activities, to maintain and develop skills to aid their personal development and independent living. There has been a marked improvement in the Centre’s catering service and in the standard of food supplied. Staff members ensure students eat a sensible diet to keep healthy. EVIDENCE: All students have access to an extended curriculum, which encourages them to practice and apply their new and emerging skills for life. In addition, they have a full programme of social and leisure activities. Students can access a range of educational facilities both on and off site such as literacy, numeracy, communication, horticulture, creative arts, personal and social development, information technology, personal health and social education, citizenship and team enterprise. Care staff and education staff work closely together to enable students to reach their potential. One student described their leisure pastimes and explained how staff members helped to support their interests. Examples of students’ personal development plans were seen at the inspection. They provided evidence of educational programmes, living skills tasks, health David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 15 and medical care needs and leisure programmes. Within the common care files individual achievements had been recorded and celebrated. A residential activities co-ordinator has recently been introduced to promote and maintain the extended curriculum that takes place with the college houses. The appointed person will look at further activities for students to take part in. The David Lewis Centre has a fleet of vehicles to ensure students have access to transport to participate in activities off site regularly. Many students have mobile phones and there are pay phones available and e-mail access to enable students to maintain family links and friendships. Students, particularly on the smaller houses, have opportunities to plan menus, to shop for food and household goods and to prepare meals. Staff members provide guidance regarding healthy eating. They seek appropriate advice if students consistently refuse to eat, over-eat or have other eating disorders. Any food allergies are recorded and staff members ensure that weight monitoring checks are made. There has been a marked improvement in the catering service on site and in the standard of food supplied to students and other service users. The use of 95 fresh produce for meals at the Centre has been a commendable achievement on the part of the Catering Manager. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 16 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 and 20 Students have access to a range of medical services and specialist support and their health and personal care needs are well looked after so potential health problems are promptly addressed by the appropriate health care professionals. EVIDENCE: Support workers address individual personal needs with sensitivity whilst promoting independence linked to the personal learning goals. Staff members were observed to respond quickly, calmly, and appropriately when students had seizures, providing support with sensitivity and reassurance. Students are communicated to in their preferred method to aid understanding. Staff members are trained in epilepsy, dealing with seizures, and further advice and support is provided via the college nurses and clinical staff. Staff members receive information about drugs and other preventative treatments. All students have access to a range of medical specialists and therapists, such as consultants, speech therapists and behaviour support advisors. Routine health screening takes place for all students and multi-disciplinary team meetings are held regularly to review health, social and educational support. The routine, close contact with expert medical care provides a degree of security for parents, carers and staff from placing agencies. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 17 Detailed plans of care and personal care and support contained within the common care files. Aids and adaptations are provided on houses following specialist assessments. Sex education is provided by college staff and nurses. Students receive information on H.I.V, AIDS, substance abuse, safe sex and Personal Health and social education. They are advised in small groups or individually as appropriate. All students have individual tutorials with their key worker to discuss the support given. Students also have access to the chaplain and advocacy service. Since the last inspection all houses within the College Core Unit have received further information on cultural and religious beliefs to help raise staff awareness. The college nurses closely monitor medication administration. Students who are able to administer their own medication are regularly assessed and supported. The David Lewis Centre Medicines Management Policy was approved and implemented on 6th September 2005. The CSCI pharmacist within the inspection team has recently studied the policy and a number of areas for change and improvement are currently under discussion. The policy includes a protocol for supporting service users who manage their own medication and those who do so have locked storage for it in their own rooms. Medicines were found generally to be stored appropriately in the various units of the David Lewis Centre and the systems in use were safe overall although some developments were needed to ensure that these were all appropriate for social care homes. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 18 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 and 23 Although there are arrangements in place for safeguarding service users, these were found to be unsystematic, and the arrangements for safeguarding service users’ personal finances needed to be developed further. The centre’s complaints policy and procedure need revising to ensure the systematic management and handling of complaints so that service users’ concerns are seen to be fully addressed. There is a lack of clarity in adult services about the use of an approved model of physical intervention to protect service users and staff. EVIDENCE: The centre has a complaints policy but no clear procedure for staff to follow. As a consequence some complaints records held in the centre did not contain evidence of acknowledgement letters to the complainant providing details of how the complaint would be addressed. Some complaints records were unavailable for inspection, some were incomplete and so the outcomes were uncertain. Currently the policy does not refer to the complainant’s right of access to their placing authority. Nor does the policy refer to the contact details for the Commission for Social Care inspection. See Requirement 2. Service user guides have been updated to reflect changes regarding whom to complain to and information regarding concerns about bullying has been added. Information about complaints received regarding the College Core Unit is stored centrally within the administration building by the registered manager. Advice was given as the complaints logs were not stored in number order. Otherwise the complaints recording was thorough with appropriate responses made to complainants. Staff members on individual residential houses were David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 19 unable to provide up to date verbal accounts of complaints outcomes and there was only very limited complaints information on individual files. Information about complaints and records about safeguarding of service users was not held centrally across the site or aggregated as part of the management information system. See Recommendation 3. Procedures are in place for responding to suspicion or evidence of abuse. Staff members have access to the Department of Health guidance ‘No Secrets’. This is available to staff for reference as are the David Lewis Centre’s policies regarding protection. Staff members receive training in child and adult protection and in behaviour management. The college has a policy on countering bullying and raising awareness. Staff and students have access to the on site social work department for support and guidance. The centre has a protection and social work team on site. The team are responsible for the oversight of internal protection practice and liaison with the relevant professional bodies. Following discussion with the manager of the protection and social work team, it was evident that there is a lack of clarity in differentiating between issues of protection and general concerns. There was also an unsystematic approach by management staff regarding communication, liaison and management of concerns, complaints and allegations. The internal adult protection records need a clearer indexing and reference system. Case recording must be thorough, all records must clearly identify all staff members involved and must include all the outcomes of adult protection cases. See Requirement 3. Discussions with the Senior Behavioural Support Advisor and the Clinical Psychologist provided evidence of a new behaviour management strategy to be introduced across the centre which they plan to submit to B.I.L.D. for accreditation. Currently carers of adults receive training in different models of physical intervention. The staff members in some adult houses have received breakaway training in the past. There was no recent evidence of training in this area. In other adult care houses, staff members are using control and restraint methods which are not appropriate in social care settings. Some centre staff have received training in de-escalation techniques used within the ‘Timian’ model of practice. This programme is accredited with the British Institute for Learning Disabilities (B.I.L.D.). Care staff receive this instruction within their induction programme and can later access refresher sessions. See Recommendation 4. Students across the centre are encouraged to operate savings accounts. They have access to their personal financial records and the finance department of the David Lewis Centre oversees the receipt of personal allowances. The finance department provides banking facilities for students via a branch of a high street bank and they operate systems for access to money and for the receipt of interest on savings. Students have access to the centre’s cash office David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 20 and their own bank accounts to obtain their personal money. Lists are kept of students’ personal furniture and items within the residential houses. Students are offered assistance to manage their financial accounts. There is draft procedure for the management of money and valuables within the residential houses. The procedure provides staff with guidance on withdrawing money on service users’ behalf although the document does not clarify the maximum amount of service users money that can be held for safekeeping on each house. See Recommendation 5. The management of student’s money is to be reviewed to ensure the student’s rights are respected and acknowledged and a robust system is in place to ensure the safety of money when handling transactions. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 21 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 and 30 Outstanding repairs, maintenance work, cleaning and health and safety matters have been addressed since the last inspection to ensure students have a well-maintained, clean and safe environment in which to live. EVIDENCE: The houses within the College Core Unit provide accommodation which is comfortable, bright and cheerful. All students have single bedrooms and within Elizabeth Maybin all bedrooms have en-suite facilities. Students are able to personalise their own rooms. A range of comfortable communal space is provided and there is ample outdoor space on site for a range of activities. Each house has a garden. Since the last inspection a more effective maintenance system has been developed to maintain the premises and improve the living environments. Staff members undertake fabric and furnishings checks. Maintenance audits are completed regularly and necessary repair and maintenance work are reported and completed in a timely manner. At the time of the inspection the premises were well maintained, clean and hygienic. Since the last inspection there have been regular monthly meetings with maintenance personnel via house manger meetings. Elizabeth Maybin lounge David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 22 has been redecorated and new lounge furniture provided. Also within Elizabeth Maybin a new fire panel and smoke detectors have been fitted. 9 to 10 Mill Lane has been redecorated, several bedroom carpets have been replaced and the house has had double- glazing fitted. The kitchen and laundry now need diffusers to the florescent lights. See Recommendation 6. Within 7 to 8 Mill Lane the downstairs accommodation had been repainted and some carpeting had been replaced. Within each house, fire systems, emergency lighting and aid calls are regularly checked. All substances hazardous to health are appropriately recorded, stored and used. Information and guidance is provided to staff members regarding health and safety and infection control and staff members are trained in food safety. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 23 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): 33 and 35 Staff members are approachable, flexible and motivated to ensure they have the necessary skills to care for the service users. EVIDENCE: Staff members were observed to interact with students in an appropriate manner. They were attentive, supportive and proffered help and support in a relaxed, friendly way whilst encouraging independence. Agency handbooks are available to agency staff containing information about the care service, house and college ethos. All staff members have individual training and development files. Training is delivered via the centre’s training centre offering both mandatory training and other specialist training. All staff members complete induction and foundation training. Training is specific for staff roles and training on vulnerable adults and safeguarding children is undertaken. The General Social Care Council code of conduct statements are provided to all staff and the staff notice boards provide information booklets outlining the professional standards expected. Staff members receive annual appraisals and eight weekly supervisions to review work performance and set individual objectives. Regular staff meetings take place to ensure important information is communicated effectively. Staff members are encouraged to undertake N.V.Q. level 3 training. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 24 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 and 42 Clear lines of accountability exist and the processes of managing the College Core Unit are open and transparent so students can approach the staff and management to discuss any issues. As a consequence students interests are promoted and students and their relatives feel supported. EVIDENCE: The registered manager has achieved NVQ level 4 and has other relevant qualifications. Since the last inspection, house managers have been given defined supernumerary hours to enable them to complete necessary paperwork, supervisions, meetings and training. Monthly monitoring visits occur in the houses and feedback and guidance is provided regarding standards and performance. The David Lewis College service has a three-year development plan in place to try to ensure quality within the service. House managers receive advice and support in the field of health and safety from centre personnel. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 25 Support staff members have completed mandatory training programmes for moving and handling, first aid and behaviour management. The centre’s health and safety officer has completed risk assessments regarding the premises, and support staff members refer to these. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 26 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 Standard No Score 1 3 2 2 3 2 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X X X X 3 X David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 27 Are there any outstanding requirements from the last inspection? No 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 YA2 Regulation 14 Requirement Timescale for action 01/06/06 2 YA23 22 3 YA23 13 Ensure that needs assessment documentation is obtained from the placing authority and kept on file for reference purposes. The complaints policy and procedure must be appropriate to the needs of the service user. 01/06/06 They must refer to the service users right to contact their placing authority and must include the name, address and telephone number of the Commission for Social Care Inspection. Satisfactory safeguarding arrangements must be in place 01/06/06 to prevent service users being harmed or suffering from abuse or being placed at risk of harm or abuse. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000006653.V278004.R01.S.doc Version 5.1 Page 28 David Lewis Centre College Core Unit 1 2 3 Standard YA2 YA3 YA22 4 YA23 5 6 YA23 YA24 Ensure abilities checklists contain the names of the assessors and ensure individual learning plans state the date that they are to be reviewed. Ensure significant events sheets provide details of accidents to correspond with information recorded on accident records. Ensure information about complaints and records about safeguarding of service users is held centrally across the site. Ensure that staff are aware of complaints outcomes and that all information about complaints and safeguarding is aggregated as part of the management information system. A target date should be set for the introduction of a single method for managing challenging behaviour in adult services at the centre, supported by operational guidance and training for managers and staff. Provide clear guidance to staff regarding the maximum amount of service users money that can be held for safekeeping on each house. Fit diffusers to the florescent lights in the kitchen and laundry. David Lewis Centre College Core Unit DS0000006653.V278004.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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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