Inspection on 02/02/09 for Fairfield Farm College

This inspection was carried out on 2nd February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fairfield Farm College 07/02/07

Fairfield Farm College 23/01/06

Fairfield Farm College 22/06/05

Fairfield Farm College 16/02/05

Fairfield Farm College 03/11/04

Fairfield Farm College 02/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Fairfield Farm College Fairfield Farm College Dilton Marsh Westbury Wiltshire BA13 4DN     The quality rating for this care home is:   three star excellent 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: Sally Walker     Date: 1 2 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 32 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Fairfield Farm College Fairfield Farm College Dilton Marsh Westbury Wiltshire BA13 4DN 01373823028 01373859032 info@fairfieldfarmcollege.ac.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Fairfield Opportunity Farm (Dilton) Limited Name of registered manager (if applicable) Marion Clayson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: People accommodated must be aged between 16 and 24 years, except that for assessment periods only, of up to 4 nights duration, each registered house may accommodate no more than 2 children aged 15 years. The age range of persons to be accommodated must be from: 16 years minimum to 24 years maximum The maximum number of service users who can be accommodated is 29. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Fairfield Farm College is a residential college in the village of Dilton Marsh which provides a specialist service for young people with a learning disability. Students Care Homes for Adults (18-65 years) Page 4 of 32 care home 29 Over 65 0 29 Brief description of the care home attending are normally aged between 16 and 22. Students are usually at the college for a maximum of three years, although in some circumstances people may stay into a fourth year. There is a mix of male and female students. Five houses, each located within short walking distance of the college centre, provide term-time residence. One of these is new and the others have been modernised. Care Homes for Adults (18-65 years) Page 5 of 32 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: three star excellent 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 unannounced inspection took place on 2nd February 2009 between 9.30am and 5.40pm. The inspection concluded on 4th February 2009 between 9.30am and 1.00pm. Mrs Marion Clayson was present during both of the days. We spoke with some of the students and staff. We went to each of the houses. We looked at care plans, menus, rotas, staff recruitment files, staff training and our pharmacist inspector looked at the arrangement for medication. As part of the inspection process we sent survey forms to the home for people who use the service, staff and healthcare professionals to tell us about the service. Comments can be found in the relevant section of this report. Care Homes for Adults (18-65 years) Page 6 of 32 The last key inspection was on 7th February 2007. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the care home does well: What has improved since the last inspection? Records are kept of action taken in responding to issues highlighted in weight or menstruation chart. Records of complaints and their investigation are now kept centrally. All staff now receive regular training in safeguarding adults and children. The employment of a maintenance team means that repairs and refurbishments are carried out quicker. Additional washing machines have been purchased for managing soiled linen. All staff receive regular supervision. A training matrix is in place to show an over view of training needs. All staff now receive regular training in fire prevention. Night time fire drills now take Care Homes for Adults (18-65 years) Page 8 of 32 place. What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 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 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential students and families know about what the college has to offer them before they apply for a place. Students have their needs thoroughly assessed so that their placement can be successful. Evidence: Initial assessments are made with people who are considering a student placement for three years. Information is gained from the person, their family, carers, previous placements, schools and any healthcare professional involved in their care. They then fill out an application form and go through a selection process. Successful applicants then have the opportunity to stay for a week at one of the houses for further assessment. They can decide if they want to attend the college and whether a place can be offered. A review is carried out at the end of the assessment week. Students who live in each of the houses are in different years of their courses. Careful consideration is given to ensuring that new students will get on with the people already living in the house. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: The student handbook and information pack sent to prospective students and their representatives is clear about what is offered at the college. It also outlines those daily living skills which students need to have to be able to live at the college. There is a statement that the college is unable to offer places to anyone who needs regular one to one support or with challenging behaviour that needs physical intervention. The information pack is well set out in large print, with photographs of different activities including daily living skills, aspects of the college curriculum and social activities. There is clear information about how to start the application process and who to talk to. Some students may be under eighteen when they come to live at the home. Care Homes for Adults (18-65 years) Page 12 of 32 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 individual care and support needs are set out in an individual plan which is regularly reviewed. Students are encouraged to take risks as part an independent lifestyle. Evidence: All students have a plan of care and the daily records are set out for staff to report on each aspect of their plan. These areas included: personal care, independence training, behaviour support, communication, numeracy and literacy. The care plans stated long and short-term targets and personal goals for each student. Files contained information about each student, people who were important to them and contact details. We saw that recording stated positive outcomes for students and the focus was on what students could do. None of the students required any intimate or personal care. Staff may remind students that they should have a bath or shower or change their clothing. Staffing levels allow for some students to have one to one time with staff. The handbook clearly states that male staff do not provide one to one support Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: for female students. Each student has a risk assessment for all activities and tasks that they may be involved in. Students are regularly assessed in crossing the road when going from their house to the main farm and classrooms. This is done in different stages and records kept of outcomes of the assessments. None of the current students were able to be left in the house on their own. However as part of their independence programme, the aim was that some students will eventually spend some time alone and this was risk assessed. There were generic risk assessment sheets that staff filled out before any event. This included going out in the vehicle, going for a country walk, safety of the place they were going to, what could go wrong and how many staff were needed. There is guidance to staff on management of disputes between students. Staff are encouraged not to intervene, but to let any students who may be arguing to sort out things for themselves. Students are encouraged to talk about any differences they may have and to recognise any consequences of their reactions and behaviours. The college does not take anyone who has behaviours which require physical interventions. A log is kept of any incidents together with any action taken. All of the care plans and risk assessments were regularly reviewed with each student, their parents and staff. In a survey form one of the healthcare professionals told us: recognises individuals needs and potential. Encourages independence at an appropriate level. Allows social opportunities relevant to age of students. Another healthcare professional told us I have witnessed students who have come here from busy, demanding mainstream schools blossom whilst being here. The overall approach is nurturing, gentle and calm and as a result of this anxious socially poor students have gained confidence and raised their self esteem. Care Homes for Adults (18-65 years) Page 14 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students are encouraged to experience and learn about living with other people. Students decide how they spend their leisure time. Students enjoy a menu that has a good range of healthy meals. Evidence: Each student has a weekly programme of farm college courses. Some students attend Wiltshire College for literacy and numeracy courses. The programme also includes leisure time and social activities. Mrs Clayson was clear that students are enabled to maintain and learn different life skills whilst at the farm college to take with them when they leave. Two of the second year students in one house told us about living in one of the other houses with other students the previous year. They told us they would move to another house for their final year. The aim of this is for students to experience living with different people and decrease any dependency. In the AQAA Mrs Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: Clayson told us that students are no longer expected to be in their rooms at a prescribed time during the week and can have televisions in their rooms and people can have mobile phones. She went on to say that this has resulted in a less restrictive atmosphere as the college environment, as far as possible, matches the experience of students peers at main stream colleges. The college plans to support parents to find employment and further training opportunities that may be available for students after their placement. A Futures Fair is planned to give information to students and parents about transition planning for when students leave. Some students had visited ex-students to talk about what they were doing having left the college. The college provides courses for students on sexual health and relationships as part of the personal development programme. This includes discussions about rights and responsibilities, staying safe and being healthy. Mrs Clayson told us that students learn about negotiation, compromise, sharing and living with others in the houses. Information about these issues are detailed in the parent/carer and student handbooks. Students go home during half terms and at the end of each term. Parents can telephone the college at any time. There is a transition review co-ordinator who works with students and parents throughout the placement to ensure settling in and preparation for moving on when the course finishes. There are five vehicles for the houses to use. Staff told us that this enabled greater choice in activities in the locality during the evenings and at weekends. Most staff are drivers and are assessed on their driving skills. Each house has a mobile phone that can be taken on journeys for any emergency use. Throughout the college year there are different achievement awards to students. They include: the person who has achieved the most, the most considerate person and for inclusion in various community events. Six students have achieved the Duke of Edinburgh award last summer. Students use the weekly house meetings to plan their weekly menus and decide on activities for the coming week. Some students were planning a trip to London. Other activities included swimming, bowling, trips to the cinema, Gateway Club, dancing, cross country walks and meals out and going to the pub. There was a Girls Night and a Boys Night where separate activities took place that interested the two groups. There were four male staff to support some of the male students. Some students are involved in a local drama group and had participated in the pantomime. Live bands perform on a regular basis. One of the students showed us their artwork that they were doing. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: Each of the houses has a computer with internet access. One of the students told us about their work placement at a local country park cafe. Another student had work experience at a local garden centre. Students regularly go to two different sporting events where they are involved in rock climbing, trampoline other activities. Mrs Clayson told us that students raise money to help everyone to attend these activities. Some students attend local churches. Students are encouraged to follow a healthy eating programme. Information is available when planning menus in each of the houses. Mrs Clayson told us that a nutritionist from the local surgery had provided information and staff training. Each house is allocated a weekly budget for food shopping. One of the students told us about how they planned their meals for the week and made a shopping list according to their planned menu. They told us that they also went out for meals. All of the menus in each house were different. We saw that the menus showed a good range of nutritious meals. Fresh fruit was readily available in each of the houses. A copy of the college menu was available so that house menus are not duplicated. Students prepare their own breakfast before they go to the main site for their educational courses. During the day students have lunch in the dining room and activities hall on the main complex. This meal is cooked by a different group of students each day. They are supported by the catering tutor and a support tutor. Students have their evening meal in their houses. There was guidance about healthy eating on the notices boards. Students may have some support with preparing and cooking meals. One of the houses has an additional kitchen where students have sessions in cooking as part of their independence programme. Students are also involved in carrying out different household tasks as part of their training for independent living. Students have different areas of responsibility and the different task are allocated according to a weekly rota. Care Homes for Adults (18-65 years) Page 17 of 32 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 have their medical health needs set out in a health action plan. Students have good access to healthcare professionals when needed. Students can manage their own medication following a risk assessment. Safe arrangements are in place for managing students medication. Evidence: All students had a health action plan, which included any behavioural support. They register with a local GP during the time they are at the college. Students attend the surgery for any appointments, with staff support if needed. An occupational therapist had carried out assessments of all of the houses. Handrails had been fitted and guidance given about supporting students with different tasks. The occupational therapist provides input for one day each week. A speech and language therapist also provides input for one day each week. The admission criteria identifies that students are only supported with personal care. Staff will remind students and will never be present if students are washing, dressing or bathing. Staff may however be around outside the bathroom door if some students Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: are showering or bathing, to monitor their safety. Risk assessment identified which students needed this support. If students are too ill to attend their college courses, a staff member will remain in the house with them for any support required. Staff are also made available to support students if they have a period of time in hospital. Action has been taken to address the good practice recommendation we made that staff record when advice and information is given together with actions taken. This related to action to be taken when monitoring students weights and recording menstruation charts. Students are regularly weighed and any concerns are referred to the district nurse. One of the support co-ordinators has trained in healthy eating. A nutritionist from one of the GP surgeries has given advice and staff training on managing a healthy diet. Staff had been trained by the learning disability nurse in the specialised technique of administering an oral medication for seizures. Staff had also been trained in administering a medication for collapse, when a person is exposed to allergies and needs immediate medication. Records are kept of any incidents and accidents. Body maps may be used for more detailed description of any injuries. Our pharmacist inspector looked at the medication systems in the college. All medicines were secure and appropriate records of administration maintained. Staff supported the young people to use their medicines safely and involved them in the process wherever possible. Some students were able to take some responsibility for their own medicines and they were helped by the staff to undertake this role to the best of their ability. Risk assessments and regular reviews were seen. Students could obtain training awards for their self medication. The college has recently changed to a local pharmacy so that the students can be more involved in their own healthcare by visiting the doctor and going to the pharmacy with staff. Support staff had all been trained in the safe handling of medication and senior staff ensured that the policy and procedure of the college was adhered to by doing regular audits. All tutors are also trained in the use of an emergency medication which may be needed when they are with the students. This medicine is kept in the students house and another supply is available in the office or taken off site with them. All medicines are ordered by the college and a separate supply is given to families for holiday periods. Records are made of all medication entering or leaving the college. The information pack sent to people who are considering using the service states that the staffing arrangements mean that controlled drugs cannot be administered. Care Homes for Adults (18-65 years) Page 19 of 32 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. Systems are in place to ensure that students can complain about the service. Complaints are taken seriously and action taken when complaints are upheld. Students are confident about telling staff if things go wrong. Staff and management are confident in activating the local safeguarding adults or children procedures when concerns are raised. Evidence: Action has been taken to address the good practice recommendation we made that a central complaints log should be developed for easy monitoring and cross-referencing to the details kept on personal files. We saw from the log that all complaints are fully investigated. Mrs Clayson responds to all complainants with details of the outcome of her investigations and any actions taken as a result. Each complaint had a reference number. We asked all of the students we spoke with about making complaints. They all told us that they would go to either staff working in their house or Mrs Clayson. In a survey form one of the students told us not sure, I will ask someone. Another student told us not sure so would find someone and ask. There is information about how to make a complaint in the parent/carers and student handbooks. Each of the houses has a safe where students can put small amounts of cash. Records are kept of all transactions. The system is checked by senior staff and Mrs Clayson carries out regular audits. Mrs Clayson told us that people are encouraged to have Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: their own back accounts. Parents or others involved in the students care are expected to support students with their benefits. The programme for independence encourages students with money management and managing their financial affairs. Students are encouraged to save for special events, for example, a recent trip to London. There are plans to improve the system for management of students finances so that they can learn budgeting and practical money skills. Action has been taken to address the requirement we made that all staff receive regular safeguarding adults and child protection training. Mrs Clayson told us that the training is completed annually. One year the training is provided by the Local Authority training department and the other year by an internal trainer. Each member of staff had been given a copy of the local booklets on safeguarding adults and children: No Secrets in Swindon and Wiltshire and Every Child Matters. The home has its own policy on reporting allegations of abuse. This includes what happens when allegations are made, staff suspension pending investigation outcome and disciplinary process if allegations are proved. Staff and management are confident in referring any allegations or suspicions of abuse to the local procedures. Mrs Clayson is the safeguarding adults and child protection lead for the college. Further training in child and adult protection is planned. Care Homes for Adults (18-65 years) Page 21 of 32 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. Students are provided with good, comfortable, clean and warm accommodation. Some areas need upgrading by the housing association. Evidence: Some of the students showed us their bedrooms. All of the bedrooms were personalised with various different items to reflect the students personality. We saw that small cards with new students names and a picture of something that interested them was put on their bedroom door to welcome them then they first arrived. We saw that many of the students had kept the cards on their doors for a long time afterwards. Action has been taken to address the requirement we made that evidence is provided to confirm that 39a the High Street is fit for purpose. Mrs Clayson told us about discussions with the housing association, which owned one of the other houses about installing a new kitchen. We saw that some of the drawers and cupboard doors had become stained and damaged. Action has been taken to address the good practice recommendation we made that the refurbishment programme for houses is continued. Mrs Clayson told us that Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: maintenance of the buildings had improved following the appointment of the maintenance and health and safety team of one full time and two part time staff. She told us that she replaces the furniture when needed. Most of the beds, wardrobes and chests of drawers had been replaced. The budget allowed for the completion of replacement. Carpets are also replaced as needed. There are also plans to change a bathroom in one of the houses to provide two shower rooms. Windows to the first floors were restricted to reduce the risk of people falling out. All of the bedrooms in each of the houses are single accommodation. All of the sitting rooms in the houses had a large screen television with games, video and DVD. Each house had Internet access and a computer for students to use. Mrs Clayson told us that students arrange time on the computer between themselves. Access to some sites is blocked and students are given training in personal safety when using the Internet. Action has been taken to address the good practice recommendation we made that infection control guidelines should be referred to when managing soiled linen. We noted that additional washing machines had been purchased exclusively for this purpose. One of the students showed us the laundry room in thier house and explained how they each decided when they used the washing machines. They also arranged between themselves when they would use the bathrooms and showers. We saw that disposable gloves were available for dealing with spillages. Students are encouraged to do many of the household tasks as part of their programme for independence. They are encouraged to clean their bedrooms and some of the communal areas and launder their clothing. There were tasks list and rotas for setting the table and washing up in each of the houses. Each of the houses are deep cleaned by a contractor during the summer when students are at their own homes. As a consequence students are required to take all their personal possessions with them at the end of the summer term. Care Homes for Adults (18-65 years) Page 23 of 32 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. Staffing levels mean that students can be supported when needed at different times of the day and night. A robust recruitment process is in place. Staff have good access to regular relevant training. Staff are regularly supervised. Evidence: The staffing rota provides for a minimum of two staff in each of the houses when students are present. This includes during the evenings and weekends. Each of the five houses has a member of staff sleeping on the premises during the night. There is also an on call system for staff to call in an emergency. There are four male staff. They only carry out the sleeping in duty in houses accommodating male students only. There are always female staff available when male staff are working. None of the students need help with personal care. There are three support co-ordinators who support the students and staff across the five houses. They work different shifts throughout the day so that they are available to students and staff. Staff are allocated to work to each of the houses for the educational year. Staff told us they had a handover period at the change of shifts. They told us there were regular staff meetings. There were also house meetings and shift meetings on one morning each week. There is a staff handbook which is very Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: comprehensive. It gives clear details of all aspects of the work that staff are expected to do, information about policies and staff conduct. Action has been taken to address the requirement we made that all staff must receive regular supervision. Mrs Clayson showed us the plan for the coming two terms. She told us that staff have at least one supervision session during each of the half terms. This means that sessions are held six times a year. Mrs Clayson went on to tell us that if staff were having an appraisal during that half term period, they would not have a supervision session. Staff told us they received supervision at least every six weeks. Mrs Clayson told that she is gradually building up a group of bank staff to cover for sick leave. These staff are well known to the students. There was a robust recruitment process in place. No new staff work with students unsupervised until their suitability to work with vulnerable people and children is confirmed. All the documents and information required by regulation were on file. We saw that the majority of staff had had previous experience of working with younger adults or children. All new staff undertake the Learning Disability Induction Course provided by the Wiltshire Partnership. They also undertake the homes induction programme and shadow a more experienced member of staff during this time. One of the support co-ordinators told us they had completed the Registered Managers Award and NVQ Level 4 in management and care. They said they were undertaking the NVQ Assessors course. They told us they regularly attended mandatory training, which all staff are expected to undertake. These include mandatory subjects, such as: first aid, food hygiene, health and safety and medication. Other training had included autism awareness, behaviour management, and the Mental Capacity Act 2005. All staff are expected to undertake NVQ Level 3. Staff were undertaking the City and Guilds Preparing to Teach in the Lifelong Learning Sector qualification, Stages 1 and 2, a qualification to teach adult and further education. One of the staff told us that there was good access to relevant training. They said they could ask for specific training if it was not provided at the college. Staff had received training in sexual health from the NHS Primary Care Trust. Staff are trained in the use of Makaton, gestures for communication used by some people with learning difficulties. We were told that none of the current students used Makaton. Specialist training had been provided to staff in working with people with Autistic spectrum disorder. In the AQAA Mrs Clayson told us that staff receive regular training in equality and diversity. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: Action has been taken to address the good practice recommendation we made that a training overview matrix was considered. One of the support co-ordinators told us that they were in the process of uploading all staff training information onto the computer. This would enable easy access to when ongoing training was needed and completed. Mrs Clayson keeps her own paper record of when training should be undertaken. Staff qualification and training certificates are kept in individual files. All of the students we spoke with made very positive comments about the staff and how they were supported. Care Homes for Adults (18-65 years) Page 26 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students benefit from a well run home. Mrs Clayson has the relevant skills, experience and training to effectively manage the college. Students views are sought through a variety of channels. Systems are in place to ensure that students and staffs health and safety is promoted and protected. Evidence: Mrs Clayson has over twenty years of working with younger adults in health and social care. She has been registered manager for more than ten years. Mrs Clayson has the Registered Managers Award and NVQ Level 4 in management and care. She keeps herself up to date with current practice through regular training. Mrs Clayson told us that she and the responsible individual will often work some of the shifts, including sleeping in and Saturdays. Staff told us that Mrs Clayson was approachable and they could discuss anything with her. Mrs Clayson told us that the main care plans were kept on the computer together with Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: other relevant information. Parts of the information was restricted to staff on a need to know basis. Action has been taken to address the requirement we made that all staff receive regular appropriate training in fire prevention. Mrs Clayson told us that this had been provided by an external trainer. Staff had also attended training sessions from Mrs Clayson and the senior staff. A video showing different scenarios was also shown to staff. Action has been taken to address the good practice recommendation we made that fire drills should include night time drills. Mrs Clayson told us that the maintenance and health and safety co-ordinator organises drills at different times of day and night. This included early mornings when it is dark. We saw that the logs of the drills did not always record the time that the drills were carried out. Mrs Clayson told us she would relay this to the co-ordinator. The maintenance and safety co-ordinator deals with all day to day maintenance and repairs. During the summer holidays when students are not in residence, more extensive repairs or maintenance may be carried out. Staff carry out weekly checks on different aspects of health and safety in each of the houses. Risk assessments were carried out on the environment and tasks that students and staff were involved in. Individual risk assessments with students were on their personal files. All the knives in the kitchens were kept locked away. Students had received training in basic food hygiene. Two staff are qualified to teach first aid to students. We saw in the AQAA that only three staff had completed training in infection control. Mrs Clayson told us that the regular meetings with the Health Protection Agency about infection control had come to an end. She said she was trying to obtain a copy of their guidance to care homes about infection control. Following the inspection we sent a copy to Mrs Clayson. Training had been sought in infection control through Skills for Care. The college has recently appointed a quality assurance co-ordinator. They showed us the work they had done to set up the quality assurance system. They had collated requirements from reports and information in the AQAA. Different interested parties will be sent quality surveys including students, staff and parents. Different aspects of the service will be audited including amongst other things: training, risks management and medication. All the information will be taken to the business improvement meetings to decide on the action plan and target dates. The Chief Executive carries out Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: regular unannounced visits and reports on the conduct. The reports refer to findings of the last visit together with an action plan. In the AQAA Mrs Clayson told us that students are encouraged to give their views on the service at house meetings, student council meetings, meetings with the responsible individual, tutorials and personal development sessions. Care Homes for Adults (18-65 years) Page 29 of 32 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 30 of 32 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 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 2 20 24 It is good practice to record the receipt, transfer and usage of oral midazolam in a separate book. Discussions should take place with the housing association about upgrading and improving the environment for people who use the service. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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). 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