Inspection on 04/11/08 for Dorton College Of Further Education

This inspection was carried out on 4th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dorton College Of Further... 06/11/07

Dorton College Of Further... 11/05/06

Dorton College Of Further... 09/11/05

Dorton College Of Further... 27/04/05

Dorton College Of Further... 14/06/04

Dorton College Of Further... 14/06/04

Dorton College Of Further... 10/12/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Dorton College Of Further Education Seal Drive Seal Sevenoaks Kent TN15 0AH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gary Bartlett     Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Dorton College Of Further Education Seal Drive Seal Sevenoaks Kent TN15 0AH 01732592600 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Royal London Society for the Blind Type of registration: Number of places registered: care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: The maximum number of service users who can be accommodated is 21 The registered person may provide the following category of service only: Care home only- (PC) to service users of the following gender: Either whose primary care needs on admission to the service are within the following category: Sensory impairment (SI) Date of last inspection Brief description of the care home Dorton College of Further Education is registered to accommodate up to 21 young adults who have a sensory impairment with additional care needs alongside students who do not fall within the remit of this report. Other educational services for younger children are also provided in separate buildings on the campus. The establishment is managed by the Royal London Society for the Blind. The College is situated in extensive grounds, close to the town centre of Sevenoaks. For the purpose of this report service users are referred to as students. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 21 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Dorton College from 10.00 a.m. until 6.00 pm. Judgements about quality of life and choices were taken from direct observation and by discussion with some students and staff. Some records and parts of the premises and grounds were inspected. The Manager had completed an Annual Quality Assurance Assessment, from which information was used to inform the inspection process. A number of survey forms were received from students and staff prior to the inspection. These indicate good standards of care at the college, although a small Care Homes for Adults (18-65 years) Page 6 of 28 number of staff are uncertain about recent changes to working practices. The Manager was unable to be present at the inspection. The Finance Director and Company Secretary, other staff and the students gave valuable assistance. The Inspector would like to thank everyone involved for their contribution to the inspection. What the care home does well: What has improved since the last inspection? What they could do better: How students care needs are to be met would be better identified through improved care planning and recording. The management team recognises the system of keeping daily care records needs to be changed to better maintain confidentiality. There have been improvements to the risk assessments, but as with the care plans, further work is required for them to more fully encompass activities undertaken by students. The college has agreed to ensure that all hand written entries on the Medication Record Administration Record (MAR) sheets are double signed to help ensure accuracy. Care Homes for Adults (18-65 years) Page 8 of 28 Shared areas in all residential units must provide enough space for students, including those with mobility problems, to relax and eat in comfort. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective students needs and aspirations are assessed and documented, prior to being offered a placement, to help ensure the college can meet their needs. Evidence: The organisation has an assessment and admission policy and procedure for staff to follow to ensure each admission is undertaken in a planned way. A senior staff member described how prospective students are only admitted to the college after an assessment of needs by specialist teams of staff. These assessments are inclusive of relatives and health care professionals and are the starting point for students individual care plans. The Finance Director and Company Secretary described how the assessment process is being further developed to be more holistic. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students care and health needs are well met in an appropriate manner. An improvement to care plan records would better evidence how this is done. Evidence: The judgment for this outcome group has taken into account the quality of life for all the students. The judgement also includes assessment of the level of knowledge and understanding displayed by staff when providing both personal and health care. Comments made by students, observation during the day of the site visit and the previous inspection report, all indicate the standard of care provided is good. Students say that staff are fully aware of their needs. Staff are aware of far more information than is recorded in care plans. A lot of information is shared verbally. The Finance Director and Company Secretary described how the Manager will be introducing a more detailed system of care planning. This needs to be done as current care plans are adequate. They contain some risk assessments and are accessible to Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: staff. Some detail of individual needs is given including personal preferences but they do not present a cohesive plan of care. The Finance Director and Company Secretary is aware that the daily records record factual information about activities and physical care but still offer little about students responses or state of being. She said this will be addressed through training and supervision. She has also agreed to implement a system of keeping daily records that better maintains confidentiality. The care plans contain some risk assessments. The Finance Director and Company Secretary is aware they are limited in scope and content. Staff spoken with generally have a good understanding of getting a balance between perceived risks and promoting independence. There have been improvements to the risk assessments, but as with the care plans, further work is required for them to more fully encompass activities undertaken by students. A key worker is allocated to each student. Students say they value this support. All students spoken with are happy with the care they receive at the college and are positive about the role they play in planning their own future. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students enjoy individual lifestyles and are supported to develop their life skills. They have the opportunity to experience a variety of social, educational and recreational activities. Evidence: There is a positive and active culture within the residential provision. From observation, discussion and records it is evident that students benefit from opportunities for personal, emotional and social development and are generally supported towards independent living skills, tailored to their abilities. However, it was observed that promoting independance is not always at the forethought of some staff. For example, in preparing drinks for students who could be encouraged to get their own. Students are treated as individuals and are consulted about their different interests and aspirations. Activities are provided accordingly, which students say they Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: enjoy. Students spoken with say they like the food and think the range of options has improved. There is a variety of food to choose from at lunchtime including a hot option. Ample staff are present and offer help or assistance where needed in a discreet and sensitive manner. Students plan menus for meals taken in the residential units in the evenings and at weekends and are involved in shopping for food. Special diets are catered for. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students benefit from personal support which meets their individual needs. Their privacy and dignity is respected. Evidence: Discussion with staff shows they are made aware as to the type and nature of the support required for students personal and intimate care needs. Staff have a good understanding of the preferred routines and varying requirements of each individual. They provide flexible support to students based on individual choice and personal care is provided in private to promote their dignity. Through discussion with some students and staff and assessing three care plans, it is evident that students have ready access to health and social care professionals. They are supported with any specialist appointments and interventions. A tour of the premises shows that students have the specialist aids and equipment they need for moving and transferring and maintaining independence as far as is possible. Staff say they receive Moving and Handling training as part of their induction Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: training and it is updated as necessary to ensure they know how to assist students safely. A procedure is in place for the administration of medication, which aims to protect students. Records show that all staff administering medications have been trained and signed off as being competent to do so. The nurse spoken with has a very good understanding of good practice guidelines for the storage and administration of medicines. She undertook to ensure that all hand written entries on the Medication Record Administration Record (MAR) sheets are double signed to help ensure accuracy. The administration of medicines was not observed on this occasion. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students and their relatives know their complaints are listened to and acted on. There are systems to protect students from abuse. Evidence: The complaints procedure is readily available to students and their relatives. They say they feel confident they are listened to and any necessary action is taken. The college keeps a record is of all complaints received by them, the result of the investigation and how the complaint has been resolved. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of students. The staff spoken with have a sound understanding of safeguarding vulnerable adults procedures. The Finance Director and Company Secretary stated any allegation of abuse would be referred to the concerned agencies without delay. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst students benefit from many of the facilities available to them, the size of some of the communal areas limits opportunities for meaningful relaxation. The environment is clean and promotes health and hygiene standards. Evidence: Since the last inspection, some parts of the college, notably the unit kitchens, have been refurbished and very much improved. These are more suited to the needs of students with visual impairment and physical disabilities and better promote hygiene standards. Staff described how there are now clear laundry procedures in respect of using washing machines that are located in the kitchens on the residential units. Those parts of the accommodation seen are clean, warm and free from offensive odours. The college provides students with adequate individual accommodation. Students say they find their bedrooms comfortable and like having the opportunity to personalise them. In some units, students still do not have sufficient communal space. In one unit, there is a very small room which serves as a kitchen, dining area and lounge. It has barely enough room for one small sofa, dining table and chairs, leaving little room to move Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: around the furniture. This is not suitable for students with significant mobility problems. It is understood that the college is looking to improve this provision but this has been an ongoing requirement in previous inspection reports. Away from the residential units the students have access to extensive well-maintained grounds, a sensory room, sports facilities and swimming pool. There is also the Student Centre for social gathering and a quiet room. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment processes are followed to ensure only properly vetted people work at the college. Students benefit from the support of enthusiastic and caring staff, who demonstrate a good understanding of students individual needs. Evidence: Recent months have been unsettled for the college with a change in management and some working practices. Most staff have responded positively, some are uncertain. From observation and discussion, it is clear the staff are focussed on the needs of the students and work closely with them. Students like the staff and find them approachable, polite and kind. Throughout the site visit there was evidence of good relationships between staff and students. Staff mentioned how much they enjoy working with the students and this is reflected in the way care and support is given. Since the last inspection, the college has recruited more permanent staff and is currently recruiting further staff. People applying to work at the college have to complete an application form, provide Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: two references and have a POVA and Criminal Records Bureau (CRB) check and attend an interview. The files of the most recently recruited staff show that appropriate checks are made prior to them commencing duties. There is an induction programme in place for new staff. Staff say there is regular training and records seen confirm this. The college has a very well maintained monitoring system that identifies individuals training needs. The records indicate the range of training courses is being extended. Staff spoke of regular supervision and appraisals. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is committed to providing a good service and recognises where improvements are to be made in the best interests of students. Evidence: The Manager has been working at the college since September 2008. He has extensive relevant experience and is currently undertaking the Registered Managers Award. From discussion with The Finance Director and Company Secretary and other staff it is evident he has a commitment to providing a high quality service tailored to the individual needs and preferences of the students. One staff member described him as leading from the front. A quality assurance process is in place, which, the Finance Director and Company Secretary said, is to be developed to obtain a true and meaningful response from students and to include the views of other stakeholders. There was some discussion about the merits of using independent advocacy schemes when appropriate. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The standard of cleanliness in the kitchen and surrounding area is good. The college has been awarded 5 stars on the Scores on the Doors scheme. The staff files seen are comprehensive and very well organised. As mentioned earlier in this report, it is recognised the system of keeping daily care records needs to be changed to better maintain confidentiality. The Finance Director and Company Secretary described how it is planned to review the environmental risk assessments and make them more holistic. There are records of fire systems checks and fire drills and training. Staff spoken with have a good understanding of emergency procedures. The Finance Director and Company Secretary stated that records of maintenance and safety checks are in order. These were not inspected on this occasion. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 10 12 The registered person shall 31/01/2011 make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users Daily records of care must be kept in a manner that preserves confidentiality, ie service users or concerned parties must be able to read records made about them without viewing personal information pertaining to other people. To be completed by the given timescale, if not sooner and maintained thereafter. 2 24 23 The registered person shall having regard to the numbers and needs of the service users ensure that the physical design and layout of the premises meet the needs of service users. 01/06/2009 Care Homes for Adults (18-65 years) Page 26 of 28 Shared areas in residential units must provide enough space for students, including those with mobility problems, to relax and eat in comfort. To be completed by the given timescale, if not sooner and maintained thereafter. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 t is strongly recommended the Manager proceeds with the intended implementation of a revised care planning system. The system used should give clear evidence of: How care and support needs are to be provided. How they have been met. Give a true evaluation of activities of daily living including how these link to care plan issues such as students goals. Responsive risk assessments that clearly state the manner in which the risk is to be reduced or removed. It is recommended the College proceeds with the intended implementation of a more comprehensive quality assurance system and incorporation of independant advocay where needed. 2 39 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!