Inspection on 22/06/05 for Fairfield Farm College

This inspection was carried out on 22nd June 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 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 02/02/09

Fairfield Farm College 07/02/07

Fairfield Farm College 23/01/06

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 08/07/2008.

CARE HOME ADULTS 18-65 High Street (21) (Fairfield Opportunity Farm) 21 High Street Dilton Marsh Westbury Wiltshire BA13 4DL Lead Inspector Roy Gregory Announced 22 - 24 June 2005 nd th 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 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 Stationary 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. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 3 SERVICE INFORMATION Name of service High Street (21) Address 21 High Street Dilton Marsh Westbury Wiltshire BA13 4DN 01373 823028 01373 859032 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Fairfield Opportunity Farm (Dilton) Limited Mrs Marion Clayson Care Home 6 Category(ies) of 6 lD Learning Disability registration, with number of places High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 4 SERVICE INFORMATION Conditions of registration: 3 Not more than one child aged 15 years with a learning disability may be accommodation. 1. The maximum number of service users who may be accommodated in the home at any one time is 6 2. No more than 3 children aged 16 -17 years with a learning disability may be accommodated at any one time. Date of last inspection 16th February 2004 Brief Description of the Service: Fairfield Opportunity Farm is a residential college providing a specialist service for young people with a learning disability. Students attending are normally aged between 16 and 22. People 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 for residence, 21 High Street being one of these. It is a detached older property owned by Knightstone Housing Association. Four young people are accommodated in single rooms, each with wash hand basin, and two in a shared room. There are sufficient bath and toilet facilities, a kitchen and laundry. Communal space is provided by a through lounge/diner, with television and games console, and long rear garden. The college is in the village of Dilton Marsh, which has a small range of facilities, including a railway station. There are buses to the nearby town of Westbury, which has a wider choice of amenities. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by Roy Gregory and Sarah Talbott between 10:00 a.m. on Wednesday 22nd June and 4:00p.m. on Friday 24th June 2005. During this time the inspectors met with the majority of students of Fairfield Opportunity Farm, through the college itself and by way of late afternoon and evening visits to the residential houses. This included sharing meals with groups of students. Both inspectors visited 12 Whitecroft. Sarah Talbott made visits to 21 High Street and 35-39 High Street. Roy Gregory visited 31 High Street and 45 High Street. These visits also enabled discussions with support workers, and a review of documentation held in the houses, for example medication and fire precautions records, and students’ care records. The two inspectors spent time in the college centre reviewing other records, such as those in respect of recruitment and complaints. There were discussions with care supervisors, and individually and collectively with the senior management team, comprising Janet Kenward, Principal; Mike Rowlands, Company Secretary; and Marion Clayson, Head of Care. Commission “comment cards” were received from nine students and eleven immediate family members. Each of the residential houses of Fairfield Opportunity Farm is separately registered as a care home, although Marion Clayson is the registered manager for all of them. Whilst the houses operate with a small degree of independence, for example setting their own menus and activities, the nature of the college and of the inspection process is such that separate reports for each of the homes would not accurately reflect the experience of the students, nor the reality of the management of the college. Accordingly, the separate reports required in respect of each registered house are in fact identical. What the service does well: Comment cards received from students and their families indicated high rates of satisfaction with the service provided by the college. One parent wrote, “Since going to Fairfield my daughter has grown and matured in a positive way, which is solely due to the level of support and care that she receives from all the staff at Fairfield.” Another wrote, “I am extremely pleased with the assistance and level of tuition that my daughter receives. In the relatively short time that she has attended Fairfield there has been a marked difference at all levels of her general attitude, confidence and abilities.” Feedback by students, via comment cards and in person, was also very positive. A number, separately, considered the college to be providing what they had expected of it. Those about to complete their time there were confident for their respective futures, and could identify different ways in which High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 6 college life had helped them. The inspectors found students to be content and happy, with a good understanding why they were there. Assessment and first year students were aware of and satisfied with the information that had been supplied to them about taking up a place. The residential houses were all presenting well. A variety of leisure activity was being upheld, largely directed by students’ choices. 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. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 7 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 Standards Statutory Requirements Identified During the Inspection High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 8 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 standard(s) 1 - 5 Prospective students and their families are provided with good information, leading to informed choices about take-up of places. Students know what is expected of them as well as what they can expect of the college, both parties being greatly assisted by an assessment process that includes a trial stay. EVIDENCE: The Information Pack provided to all prospective students provides an overview of the opportunities offered by the college. The pack also details that the Statement of Purpose and the most recent OFSTED and CSCI reports contain additional information and can be requested from the college. An early informal visit, together with an invitation to attend an assessment week, provides the prospective student and their family with the opportunity to determine the appropriateness of the placement. The assessment week also allows the college’s educational and social care staff to assess the prospective student’s ability, and so adds to the assessment provided by parents/carers, school and other involved professionals. Several first year students spoke of a positive choice to have taken up a place at Fairfield, over other options available to them. A room at 12 Whitecroft is reserved for the use of prospective students, many of whom will be aged under 18 years. The support worker’s room there contained copies of all the assessment material received by the college in respect of the assessment student then in residence. The college’s assessment documentation had been commenced from the start of the week, and daily notes reflected engagement and sensitivity on the part of the support workers. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 9 The prospective student herself presented as at ease and aware of the purpose of her stay. In signing the Student Handbook the student and his/her parent/carer enter into a contract with the college, and agree to work and live within the boundaries outlined in the handbook. For example, students spoken to were aware that bullying will not be tolerated by the college. A first year student confirmed his awareness of the content of the student handbook, and said he knew before arriving at the college that he could be required in the first year to share a room, which for him was the case. While both the Student Handbook and Information Pack exist as text, the Inspector considers that an audio format may help those students who have difficulty with literacy. Inspectors were told that both documents were to be updated in the near future. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 10 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 standard(s) 6 - 9 Students are involved in the setting of personal objectives through a planning process that is reviewed and refined through their college career. Staff support and record students’ individual decision making, which in turn is backed by an appropriate risk assessment process. However, provision for students’ participation in all aspects of college life is somewhat tokenistic and lacking in structure. EVIDENCE: The college develops an Individual Learning Plan (ILP) and Daily Living Skills (DLS) folder for each of its students. The ILP contains a pen portrait of the student together with long - and short-term objectives, behaviour plan, medical and health information. There is also a generic risk assessment with specific and appropriate risks identified for individual students, although it appeared some areas of risk identified during college term took some time to become formally added to an individual’s risk assessments. ILPs reviewed by the Inspectors demonstrated reviews of both long and short term objectives, and showed students were very involved in the process. Support workers, like tutor staff, keep records relevant to individuals’ achievements or difficulties within their learning plans. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 11 The DLS Co-ordinator, who has been recently appointed by the college, assumes responsibility for the development of the DLS folder, which is designed to record acquired proficiency in a variety of daily living skills. Some but by no means all students, depending upon ability, secure a Vocational and Independence Training Award (VITA), “Home Alone”. VITAs are a means by which the college recognises achievement of many strands of independence, for example it is the approach to proving competence to take charge of one’s own medication regime, thereby fulfilling a risk assessment role. Janet Kenward said it was a priority of the college to ensure that on leaving college, students and future trainers or assessors are aware both of what they have achieved, and of areas in which they need to develop independence skills further. Each of the residential houses holds a weekly house meeting. A record of minutes is kept in a book, often written up by a student, but these gave little impression that students actively participate in and influence decisions affecting the day-to-day running of their residential house, beyond occasionally discussing inter-personal issues and how to resolve these, or commenting on broken or missing equipment. There were a few examples of additional comments or prompting by support workers, but no evidence that answers to problems would be sought and reported back on. It was noted at 12 Whitecroft that a welcome to any assessment student was always recorded at the house meeting. Examples were seen in most houses of successful negotiations between students, with staff support, to share out domestic chores. All students and staff attend a weekly “student council” in the college, and all spoken to were insistent that it was of value. However, minutes and descriptions suggested it acted as little more than an assembly, the main focus being a resume of activities decided within each of the house meetings for the rest of the week. This then allowed the staff meeting the following day to plan how to arrange staffing for and around the activities. There had also been times when the student council meeting was used as a forum for sharing of information, mainly by the principal. But the meeting had not acted in any sense as a means for students to be supported to question or influence aspects of the way the college functions. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 12 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 standard(s) 11 - 17 Individual planning combined with the ethos encouraged in the houses, leads to a college emphasis upon the outcomes sought by these standards. Support has been devised and put in place to enable students to develop personal relationship skills and the exercise of responsibility. All students are involved to some degree in the preparation of meals, and experience mealtimes as positive. They are assisted to further their access to the local community. EVIDENCE: Through its programme of vocational training the college actively encourages students to determine the area in which they would like to find employment or to further their education and training. There was evidence of good links with local employers for the provision of work experience placements, and the college itself can also offer such experience with greater oversight, for example in its retail outlet, where there are opportunities for engaging with the public. Some third years described arrangements in hand for where they were respectively to move on to, and were very happy with their plans. Through the college, some had been able to visit potential next placements. Up to the present, the college has operated one of its houses, currently 45 High Street, as a unit for five third year students assessed as most likely to benefit from opportunities for greater independence than the other houses High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 13 provide. All students in this house appreciated the platform it had given them for moving on. Equally, third years in the mixed year group houses responded to the sense of responsibility accorded to them. Although students spoke of attending the local Gateway club and a dance group, there were comments from both staff and students that regular participation in external sporting or other age-appropriate social activities was currently limited. There were few one-to-one activities that could in addition promote independence, e.g. assisting a student to buy clothes, because involvement in external and community events was restricted to group participation. This in turn related in part to the constraints of staff availability. The college itself endeavours to be a part of its local community, organizing an open day and hosting in July 2005 a barbeque for friends of the college. The college has a mini bus, two people carriers and a car to facilitate external trips, whilst also making use of public transport. The college supports the maintenance of links with family and friends, and each residential unit has a pay phone that may be readily accessed by students. Other than at 45 High Street, students are not allowed to retain mobile phones. There was evidence that the reasoning behind this had been thorough. Inspectors were told that each term students produce a newsletter, which is subsequently distributed to friends and family. Inspectors did not see an example of the newsletter. The college’s draft policy on sexuality and sexual awareness recognizes its duty to help students address issues around their emotional, personal, social and sexual development. While all staff receive training in the sexuality and potential for abuse of people with learning difficulties, the Principal also reported that a Personal Development (or Personal Safety and Health) module, is to become part of the students’ induction programme for all students. This module, which will cover the above issues, is to be introduced in September 2005, and may be expected to improve substantially the college’s current programme of support in this area, as it is intended to follow up induction work with such individual input as students are assessed as needing. The Inspectors found daily routines and house rules within residential units to be in keeping with ordinary domestic practices. Each house has both a television and a games console, along with provision of traditional games to suit various abilities. Through questionnaires and discussion with inspectors, students considered their privacy to be respected. Students are offered a healthy diet and mealtimes came across as enjoyable events. Students were very involved in preparation of food and associated tasks. High Street (21) (Fairfield Opportunity Farm) Version 1.30 DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Page 14 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 standard(s) 18 - 20 Provision for health care needs is very good. Care records indicate where personal support is necessary. The nature of in-house working relationships is conducive to such provision being strongly related to individuals’ preferences and needs for privacy. Medication practice is appropriate to the students’ needs. EVIDENCE: Records, combined with conversations with students and staff, show that provision of personal support is not a main aspect of care needs for service users. Nevertheless, issues about maintenance of personal care and appearance may occur in individual learning plans, and there was evidence of prompting being exercised where identified as needed. The Department of Health “Heatwave” guidance was observed in one of the houses, and staff confirmed encouragement of drinks and use of sun protection during the exceptionally hot weather. Through its employment of a part time counsellor, the college provides sensitive and flexible support to students with emotional needs. Other services, including occupational therapists, speech therapists and mental health resources had been accessed as appropriate. The college does not employ a registered nurse to care for ill students, so where health needs exceed those that can be met within existing staffing, accommodation and community resources, students are required to return home. All students, however, are registered with a local GP. Students are registered with local High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 15 dentists if families so wish. Records sampled demonstrated excellent alertness and attention to students’ health matters, with prompt referrals to GPs and dentists, and recording of outcomes. The Inspectors did not observe any student assuming responsibility for the retention and administration of their own oral medications, but there were examples of self-administration of, for example, eye drops and topical creams, backed by appropriate records. There was provision for students to work towards VITA in keeping and self-administering medication. There was actually limited use of medications overall in the college. Handwritten additions to MAR sheets were double-signed, but there were a few instances where some further clarification of entries would have been helpful, for example to staff covering duty in an unfamiliar house. The reverse of the MAR sheet is an appropriate place to make such entries. Some other minor recording issues were brought to Mrs Clayson’s attention. High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 16 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 standard(s) 22, 23 When received, complaints are investigated effectively, but not within a consistent procedure that students are aware of. Policies and procedures are in place to reduce risks of harm to students. The shortage of staff compromises these provisions at vulnerable times. EVIDENCE: The Inspectors noted that the college has two complaints procedures, one for students and tutors and one for students and residential care staff. While similar in content the procedures detail different individuals who will assume responsibility for investigating, and different time periods for feedback. It was suggested that a single unified procedure would be more appropriate. The Student Handbook should also clearly detail the time period during which the student can expect to receive a reply to issues they have raised, and should indicate that a student who wants help to express their views, will be provided with access to local independent advocacy. A concern raised by students in one of the houses had been treated as a group complaint. Records showed their concerns were treated seriously, together with reassurance that they had acted correctly in complaining, and led in due course to a significant outcome that protected the students. However, questions raised by students in their house meeting suggested they had not had full feedback on their complaint. Many providers would ally a tracking sheet to the complaints procedure, to ensure all parts of the process are followed. An individual student told the inspector he felt comfortable to take any concern to a trusted member of staff, and had decided for himself who that person would be for him. However, he was not aware of any formal procedure, despite three years’ residence at the college. Some relatives said likewise, via “comment cards.” There is no system in place to capture a picture of minor High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 17 complaints, which may well be adequately addressed as they occur, but which would aid quality assurance monitoring. One complaint had been received from a relative, and was not upheld on investigation. A full reply letter invited further contact if desired. The Inspectors observed that the college’s policies for protection of vulnerable adults and for child protection were available in the support worker’s room of each residential house. Care staff reported having recently received training on these issues, were aware of procedures, and knew who within the college is the designated child protection officer. The college management have recent experience of working with these procedures, both within the college and with other professionals. Care staff dealt appropriately with student’s money. While the Statement of Purpose details that students who require physical intervention will not be offered a place at the college, the Inspectors are aware that house support staff have from time to time, including in the recent past, had to address disruptive and aggressive behaviour from students on their own. Support staff have been issued with mobile phones in order to obtain oncall support quickly, but it was acknowledged that assistance may be some ten minutes in arriving; with the current shortage of staff (said to have been acute since 10th June 2005), this could be as long as thirty minutes. Such delay jeopardizes the safety and well being of other students as well as the member of staff concerned. There has been evidence in the preceding months that some referring agencies have been less than complete in information supplied about prospective students, especially as regards propensity for disruptive or unpredictable behaviour. In response, the college’s referral form has been amended, to include an indication that the discovery of information having been withheld may lead to a student being asked to leave the college. The latter sanction has been applied on occasion, as an interim or permanent measure, to promote safety for the whole student body, whilst there was also a recent example of an individual’s exclusion from a trip out in order to ensure its safe provision for the rest of the group. Any “incidents” of concern are recorded by staff, shared with the student concerned and referred for consideration by a cross section of college staff as to how best to respond. Issues around behaviour, where identified, become incorporated into ILPs. High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 18 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 standard(s) 24, 25, 26, 28 & 30 Students like their communal and private accommodation, which is homely and comfortable. Standards of cleaning, in which students participate, were very high. EVIDENCE: The Inspectors found the residential houses to be homely, safe, comfortable and clean, whilst students consistently expressed satisfaction with their accommodation. Furnishings within the homes were appropriate and generally well maintained, although those within 35-39 High Street appeared somewhat tired and well used. Students’ bedrooms that the Inspectors were invited to view were lockable and had been personalized. One student had the sole use of a kitchenette, and was supported to use this as an aid to greater independence. With regard to the then very hot weather, some upstairs bedrooms in other houses were unacceptably hot. Garden furniture was observed at two houses, although occupants of 45 High Street complained that insufficient provision there meant they could not enjoy the summer weather together for al fresco meals, despite the existence of an attractive covered patio area. A further issue there was a lack of external storage space. Considering the horticultural element in college courses, and High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 19 the number of students who appreciate the amenity afforded by gardens at each of the homes, it was surprising how undeveloped were most of the garden spaces. 12 Whitecroft was experiencing many problems with delivery of hot or sufficient water to outlets, including showers. There was evidence of management attempts to secure solutions through the owning housing association, but in the mean time poor communication between staff and the inefficiency of the house meeting as a means of opening up concerns, meant the full implications of the problems had not been recognised. It was agreed to apply greater urgency to resolution of the problems and to make contingency arrangements for ongoing failures. The inspector was able to verify during the week following inspection that a supply of sufficient hot water had been restored. The company secretary informed Inspectors of planning permission that is currently being sought to allow for the development of a new residential house in the grounds of 35-39 High Street. The proposed building will replace current accommodation at 31 High Street, and ensure that all student rooms provided by the college are single occupancy. (Presently four student places are provided in shared rooms). The proposed residential unit would also be able to accommodate a student with needs related to physical disability. Where maintenance matters could be attended to by the college’s own handyman, there was evidence of prompt attention that was greatly appreciated by other staff. The company secretary acts as responsible individual in visiting the houses periodically. These visits provide additional attention to defects and result in useful reports. Whilst these visits were reported as being difficult to sustain, they are a statutory responsibility and by delegation or otherwise, two visits per half term to a different house each time, will produce useful data to the management as well as to the Commission. High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 - 36 Staffing provision was stretched to the extent that leisure opportunities for students were limited and safety was sometimes at risk. Staff training that meets students’ needs is arranged. Recruitment practice, whilst driven by a need to improve provision for students, has been poor. Supervision of staff at all levels is erratic and insufficient. EVIDENCE: The Inspector viewed the personnel files of four members of staff. Only two files had evidence of completion of a CRB check (but all were checked against the POVA list). Of those that did not, one was of a member of staff appointed 08.05.05, the other appointed in November 2004. In only two cases had two references been obtained by the college. Mrs Clayson acknowledged she had given these tasks insufficient priority. The Inspector also viewed records detailing sickness leave taken by employees. In the last six months, reported sickness appears noticeably higher among care staff than among teaching staff and seems to corroborate a feeling of low morale among care staff. While Inspectors acknowledge that the source of low morale may be difficult to pinpoint, the use of exit interviews may help to identify themes. While the principal reported that the college was currently recruiting new members of staff, these were unlikely to be in position before the new term starts. The inspectors found that many aspects of the inspection indicated a fundamental shortness of support staff, resident and non-resident. There is a reluctance to use agency staff to cover the isolated High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 21 duty of sleep-in in the houses, because of the desire to provide continuity of care by people known to the students. But shortfalls created by sickness and vacancies create reliance upon existing staff, including managers and tutors, to cover shifts. This goodwill could be at the expense of workers’ home lives. Care supervisors said they were reluctant to join any students’ weekend activities away from Dilton Marsh, because of the level of support that can be necessary at the residential houses. The non-resident support worker posts were created to increase one-to-one support opportunities for students, but as highlighted elsewhere in this report, these are not occurring sufficiently, owing to lack of staff. Mrs Clayson said attempts in the past to create a bank of relief care staff have been unsuccessful. Care staff valued formal supervision when they received it, but this was irregular and not planned. Two staff described gaps of about six months between supervision sessions. Given the long hours and isolated nature of the support worker role, these staff understandably wished for a more systematic individual supervision regime, much as they felt supported by the every day availability of supervisors. A copy of the staff training record showed a concentration on NVQ training (level 3, promoting independence) for those support workers who have not yet obtained this. All support staff had received in 2005, training in adult and child protection, and DLS provision. High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 22 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 39 & 42 The staff group is fragmented, with no evidence of a unified approach to service delivery. The senior management team is failing to engage with other staff. The views of students and other stakeholders are not actively canvassed or harnessed to inform development of the service. Health and safety of students are largely well provided for, but a risk with respect to fire precautions has been allowed to arise. EVIDENCE: A number of staff at various levels of responsibility complained of communication difficulties between staff groups, particularly remarking some return to a historical schism between tutorial and residential staff. Management were perceived as distant from practice in the houses. This seemed somewhat related to the re-organisation of DLS training as a wholly educational matter, a facet of which is that individual students or small groups undertake DLS sessions in houses where they do not live. This is because DLS provision is through ability groups, but this is seen by some staff as undermining the integrity of the house as home, and removing scope for initiative from support workers. One support worker found all the students High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 23 from her house had been assisted to vote in the general election as a collegesupported activity, where in previous years the support worker had supported voting as a house-based activity. In fact, there were a number of regular meetings between staff built into the weekly college programme, including whole staff meetings and support workers’ shift meetings. Minutes of these meetings were in turn widely circulated. However, the usefulness of the meetings must be questioned when so many staff experience them as unproductive. In practical terms, many meetings did not appear from minutes to set objectives that were subsequently tested as matters arising, leading to repetitiveness and feelings of not being heard in the first place. A notable omission from the schedule of meetings was any regular meeting between head of care and the support staff supervisors. Staff might be encouraged by evidence of greater regularity and transparency of meetings of the college’s executive committee. The company secretary and principal have an equal management status, but the principal’s lack of access to a budget impacts upon the effectiveness of the college; for example, an identified need to buy in some individualised personal development teaching could not be acted on when it was a priority for those individual students, because a case had to be made to the board. Similarly, decisions on expenditure priorities for the residential houses are not necessarily directed by the residential care manager. At the time of inspection, and partly in response to OFSTED findings, work was afoot in the college to clarify management roles and hopefully improve the working of the senior management team. The college has appointed a DLS Coordinator who fills a previous shortfall of middle management in the college. The programme of recorded weekly house checks includes health & safety issues such as availability of first aid supplies, cleanliness and refrigerator temperatures. Fire precautions records were being upheld in all the houses, but a recent drill at 31 High Street had not achieved a good response from students, and there was no indication of any remedial action or instruction having been taken. In the same house, visits by the maintenance contractor for the fire safety equipment had not been recorded on the appropriate sheet, and so it could not be readily ascertained whether defects identified had been rectified. Inspectors viewed the college’s draft Quality Assurance Policy, prepared in response to previous requirement. It was acknowledged this was a beginning rather than a satisfactory document in its own right. Having set out the broad principles, the policy requires development to establish a useful procedure, i.e. how are the views of students, their families and other stakeholders to be obtained, who will collate these and what will be the link to business planning? It was a universal view of staff and managers that students were unaffected by the low morale of support staff, and there were no indicators to the contrary. High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 24 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 3 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 N/A 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 1 3 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 High Street (21) (Fairfield Opportunity Farm) Score 3 3 3 N/A Standard No 37 38 39 40 41 42 43 Score x 2 2 x x 2 x DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 25 NO 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 22 Regulation 22 Requirement Timescale for action 31st October 2005 2. 33 (12, 23) 3. 34 4. 36 5. 39 6. 42 There must be a unified complaints policy and procedure for all stakeholders, including use of a tracking form to indicate adherence to the process from receipt of a complaint to informing the complainant of the complaint outcome. 18(1)(a,b) There must be a review of staffing needs, to include complement, retention and possible ways to make use of agency support. 19 Arrangements must be put in place to ensure all appointments of care staff are made in accordance with regulations to ensure safety of service users. 18 (2) Arrangements for supervision of all care and support staff must be in line with National Minimum Standard 36. 24 There must be a quality assurance monitoring system that seeks and uses feeedback from students, their families and other stakeholders to inform business planning. 23 (4)(e) Any problems encountered in fire drills must be followed up immediately by further drills, DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc 31st October 2005 24th June 2005 31st October 2005 30th November 2005 24th June 2005 Page 26 High Street (21) (Fairfield Opportunity Farm) Version 1.30 training or risk assessment. 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 1 8 Good Practice Recommendations There should be an audio version of the Student Handbook Minutes of house meetings and of the student council should routinely show evidence of a wider remit than activity planning, and should include a record of progress on matters arising. Consider ways to promote individual students engagement in age-appropriate activities in the community, other than as part of a group of students. Use the reverse of the MAR sheets to record clarification of any medication additions or changes. Consider how best to record minor complaints. Consider ways to provide for cooling of bedrooms during hot weather. Consider ways of improving the facilities and attractiveness of gardens. Use exit interviews for leaving staff to assist analysis of staffing issues. 3. 4. 5. 6. 7. 8. 12 20 22 24 28 33 High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 27 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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. Extracts may not be used or reproduced without the express permission of CSCI High Street (21) (Fairfield Opportunity Farm) DD51_S28521_HIGHST(21)_v206906_220605_Stage4.doc Version 1.30 Page 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. 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