Inspection on 09/11/05 for Dorton College Of Further Education

This inspection was carried out on 9th November 2005.

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 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dorton College Of Further... 04/11/08

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

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

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 08/07/2008.

CARE HOME ADULTS 18-65 Dorton College Of Further Education Seal Drive Seal Sevenoaks Kent TN15 0AH Lead Inspector Ruth Burnham Announced Inspection 9th November 2005 09:30 Dorton College Of Further Education DS0000023864.V249464.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 Dorton College Of Further Education DS0000023864.V249464.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. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dorton College Of Further Education Address Seal Drive Seal Sevenoaks Kent TN15 0AH 01732 592600 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) Royal London Society for the Blind Vacant Care Home 21 Category(ies) of Sensory impairment (21) registration, with number of places Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users can be admitted from 16 years of age Date of last inspection 27th April 2005 Brief Description of the Service: 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. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 9 November 2005 by one inspector who was at the college from 9.30 a.m. to 4 p.m. during which time 4 members of staff and 4 students were spoken with. The inspector was able to have lunch with a number of students. Feedback was given to the Chief Executive of the Royal London Society for the Blind at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: 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. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 6 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 Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 7 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): These standards were examined at the last inspection when they were found to have been met EVIDENCE: Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 8 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, 9 & 10 Consultation processes are good and students have a real say in decisions about their lives however, care planning and recording systems and risk management processes still do not promote consistency and may place students at risk in some circumstances, where accurate information and guidance is not available. EVIDENCE: Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 9 Students spoken with were happy with the support that they receive and confirmed that they are able to make decisions and are consulted with about all aspects of college life. Each student has an individual learning plan that sets out the goals to be achieved each term. The plan is set out for the student in a format suitable to the individual. The amount of work undertaken to ensure that the plan and other documentation is available in Braille and audio formats is impressive. Current care planning and recording systems do not promote consistency of care for students; these were tested through examination of plans, daily records and keyworker reports. The system lacks cohesion and does not work as a clear working document in support of the individual learning plan. The plans that were examined focussed solely on the physical care needs of students with no guidance for staff about emotional, social or spiritual care needs. Daily records have the same limited focus. Current risk management systems may fail to protect service users from harm in that there was no clear guidance to staff about how to minimise risk and documentation examined showed that staff completing them needed training in this area with the exception of one risk assessment which was excellent, the manager said that it was intended that the new risk assessment format would be put in place for all students. It was of concern that care plans and risk assessments are not put in place before the students arrive in September, given the higher levels of dependency this has a detrimental effect on the care which students receive in that information and guidance is not immediately available to staff who are providing care and support including agency staff, particularly at evenings and weekends. The society has a policy in relation to confidentiality which ensures that students’ privacy is respected. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 10 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 & 17 The college provides a wide range of opportunities for students however, inadequate staffing levels continue to limit access to some activities. EVIDENCE: Life skill tutors develop opportunities for students to maintain and develop, social, emotional and independent living skills. The college provides access to a variety of therapies and the college hosts events which the local community are invited to attend. Current staffing levels still do not allow for staff to support students who wish to attend local church groups and continue to restrict access to some community based activities. Students have the opportunity to undertake a number of social and recreational activities and also attend a variety of work experience opportunities. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 11 The inspector had lunch with a number of students; there was a variety of food to choose from including a hot option. Comments received from students were critical of the food provided although menus indicate variety, choice and sound nutrition. Breakfast is provided on the residential units and lunch and dinner in the college cafeteria. Inadequate staffing levels have limited the opportunity for students to be involved in shopping for food. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 12 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 Excellent support is provided for students in relation to healthcare and physical needs however, equal attention is still not being given to planning in respect of the emotional needs of all students. EVIDENCE: Personal support takes account of individual preferences and is provided in private with same gender intimate care where possible and in line with students’ wishes. College routines are flexible and relevant. Guidance and support is provided in relation to personal hygiene where necessary. Individual choice of dress and appearance is respected and students have some choice about staff who work with them. Additional specialist support is provided. Students have designated key workers however, records indicate that they still tend to work in isolation from the rest of the staff team which leads to inconsistency. Care records lacked information about emotional needs. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 13 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 Students are listened to and feel free to offer comment or complaint. EVIDENCE: Students are free to offer comment and complaint, there is a clear complaints procedure and records are maintained of complaints. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 14 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 - 30 Students benefit from the facilities that are available to them however, none of the residential units are suitably equipped for students who have additional physical disabilities. Poor maintenance and laundry facilities may place them at risk of harm. EVIDENCE: Students benefit from the beautiful location of the college that has grounds that are well maintained and accessible. The main dining room is in the student centre which was being enjoyed by a number of students who were watching TV and playing pool. There are a number of residential units on the college site; one of the blocks that has 4 units was examined at this inspection. The college provides students with, in the main, adequate accommodation within these units which includes a lockable study/bedroom, toilet and bathroom facilities and a small lounge/diner/ kitchen area. In some units service users do not have sufficient communal space, this is further compounded in one unit by the fact that there are students on this residential unit with significant mobility problems, 2 use wheelchairs and 1 walks with the aid of a walking frame. There are 2 well equipped en-suite bedrooms however, the only communal space in this unit is provided in a very small kitchen/ dining /sitting area which has barely enough room for one small Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 15 sofa, dining table and chairs, leaving little room to move around the furniture. Of further concern, was the negative impact on independence where the shower has a high step and is not suitable for students with mobility problems. The only specialist equipment seen other than that provided in the en-suite bedrooms was a bath seat in one of the bathrooms which was on the floor and staff had to lift this on and off and move it between units, this was a heavy item, no risk assessment had been drawn up and no moving and handling training provided for this activity which could place staff at risk of injury. Students may be at risk of harm where some areas were not being maintained in good repair, one kitchen area was in very poor condition making it difficult to maintain good hygiene standards, there was also concern that there were no clear laundry procedures given that washing machines are located in the kitchens on the residential units and laundry practices as described by staff could place students at risk. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 16 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, 34 & 35 Students benefit from the commitment and enthusiasm of staff however, inadequate staffing levels during evenings and weekends are having an adverse effect on the quality of life of some students. EVIDENCE: This year there are higher levels of dependency among the students and although additional numbers of staff have been recruited, the benefit of the increase to students has been swallowed up by the wider range of care needs. Therefore, the numbers and skills mix of staff on duty is still not always adequate to ensure that uninterrupted work is carried on with individuals and agency staff are regularly making up shortfalls at weekends. The main area where this impacts students is through lack of availability of staff support for activities outside of college such as shopping, attending church and other leisure activities. There have been problems with recruitment and retention which the manager said is now improving. This has impinged upon the consistency of care provided to students, although staff spoken with confirmed there are sound recruitment procedures in place, which protect students through taking up 2 written references prior to appointment and any gaps in employment records explained at the interview. New staff are confirmed in place only after completion of a satisfactory criminal records bureau check; all staff receive statements of terms and conditions and are appointed subject to a 6 month probationary period. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 17 The College has a training and development plan and dedicated training budget. Staff have structured induction training and foundation training that now includes statutory training in basic food hygiene, moving and handling, infection control, health and safety, fire safety or first aid to ensure that students are protected. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 18 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): 39 & 42 There is a good management team in place who have the best interests of students at heart, although future improvement may be hampered by the lack of an effective quality assurance system. Students could be at risk if required safety checks are not carried out. EVIDENCE: The manager has a professional nursing qualification which will benefit the students who year on year are being admitted with higher levels of dependency and disability. The commission still awaits an application to register this manager who expressed the intention to obtain a management qualification in the next year. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 19 There is still no cohesive quality assurance system relating specifically to the care standards which produces a report, as required under Regulation 24, to enable the commission to make a judgement that the quality of support for students is continually improving. The monthly reports as required under Regulation 26 are still not being provided to the Commission. Statutory training is now being put in place for basic food hygiene, moving and handling, infection control, health and safety, fire safety or first aid for the current staff team to promote the safety of students. Systems are in place to protect students, some safety certificates were examined, the electrical and gas safety certificates were not seen but will be forwarded to the commission once available. The fire log book had not been completed and it was therefore unclear if all safety checks and drills had been carried out. The manager is working on a fire safety risk assessment in consultation with the fire safety officer who has made a number of recommendations to improve the safety of students at the college. Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 20 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 x x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 2 2 2 LIFESTYLES Standard No Score 11 3 12 3 13 2 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x 2 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dorton College Of Further Education Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x DS0000023864.V249464.R01.S.doc Version 5.0 Page 21 YES Are there any outstanding requirements from the last inspection? 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 YA9 Regulation 13(4) Requirement Timescale for action 31/01/06 2 YA13 12(3)&18(1)(b) 3 YA27 23(2)(a) & (n) 4 YA28 23(2)(a) (g) & (e) Risk management systems must include clear risk assessments documented by suitably trained and competent staff with action identified and clear guidance to staff within individual care plans on how to minimise risk There should be 31/01/06 sufficient staff to ensure that students are supported to access community facilities and activities such as places of worship The registered person 31/01/06 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 in that bathrooms/ showers and toilets must be adapted to be easily accessible to all students The registered person 31/01/06 Version 5.0 Page 22 Dorton College Of Further Education DS0000023864.V249464.R01.S.doc 5 YA29 23(2)(a) & (n) 6 YA30 13(4) & 16(2) (j) 7 YA33 18(1)(a) (b)(c) 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 in that shared areas in residential units must provide enough space for students, including those with mobility problems to relax and eat in comfort. 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 in that, where services are offered to students with physical disabilities, specialist equipment must be provided including appropriate bathroom fittings, hand rails etc The registered person shall having regard to the numbers and needs of the service users after consultation with the environmental health authority maintain satisfactory standards of hygiene in that laundry procedures must be clear where facilities are sited in food preparation areas to eliminate risk of infection and kitchens must be in a good state of repair. There should be sufficient numbers of 31/01/06 31/01/06 31/01/06 Dorton College Of Further Education DS0000023864.V249464.R01.S.doc Version 5.0 Page 23 8 YA39 42 YA42 staff (excluding volunteers who should be super numerary) on duty at all times to ensure uninterrupted work with individuals. 24 & 26(2) & (3) The registered person 31/01/06 shall establish and maintain an effective quality assurance system in respect of the service provided to students under the care standards act and provide a report to the commission. The registered provider shall also provide a monthly report to the commission in line with the regulation 31/01/06 23(2)(c)&Sched4(14) The registered person shall ensure that equipment is maintained in good working order and that adequate precautions are taken against risk of fire in that all safety certificates and fire safety records shall be up to date and available for inspection. 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 Refer to Standard YA6 YA19 Good Practice Recommendations Care planning and recording systems shoud ensure continuity of care and support. Care planning should include emotional, social and spiritual needs DS0000023864.V249464.R01.S.doc Version 5.0 Page 24 Dorton College Of Further Education Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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