Inspection on 25/11/08 for Lanfranco Ostler Home `Croftlands`

This inspection was carried out on 25th November 2008.

CSCI found this care home to be providing an Good 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

Lanfranco Ostler Home... 06/03/07

Lanfranco Ostler Home... 16/11/05

Lanfranco Ostler Home... 08/11/04

Lanfranco Ostler Home... 18/05/04

Lanfranco Ostler Home... 25/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lanfranco Ostler Home `Croftlands` 28 Garden Road Burley Ringwood Hampshire BH24 4EA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joyce Bingham     Date: 2 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Lanfranco Ostler Home `Croftlands` 28 Garden Road Burley Ringwood Hampshire BH24 4EA 01425402145 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Jane Pritchard-Williams Type of registration: Number of places registered: The Fortune Centre of Riding Therapy care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Service users in the category LD and MD may be accommodated from the age of 16 years. Date of last inspection Brief description of the care home Lanfranco is one of three student residential units managed by The Fortune Centre of Riding Therapy, a Residential Independent Specialist College offering young adults aged 16-25, who have a learning difficulty a 3-year further education course through the media of care and management of horses. This is then transferred to personal development towards independent living. The unit is open during term time only, is located in the New Forest village of Burley and accommodates up to eight 2nd and 3rd year students (currently 7 are 18 years old or older) in 6 single and 1 double Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 0 8 8 Brief description of the care home bedrooms. During the working day, the students are provided with transport to other sites for educational activities. The registered manager is Miss J Pritchard Williams. Fees range from £1,291 to £1,811 per week. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the students who use this service experience good quality outcomes. The purpose of the inspection was to find out how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included the Annual Quality Assurance Assessment (AQAA) completed by the home, and surveyed comments from 4 students and 3 staff. An unannounced visit to the home was commenced on 25 November and completed the next day. The inspection lasted 7 hours. During this time we were able to have a partial tour of the premises, including seven bedrooms, two of which are ensuite, and two further rooms with wcs, one with a separate wc, the lounge, dining room, kitchen, laundry, and bathroom. We had private discussions with Care Homes for Adults (18-65 years) Page 6 of 31 the senior member of staff on duty and two of the staff, contact with the majority of the residents of the home and private conversations with three of the students. We were able to speak with three randomly selected stakeholders. We sampled staff and student records, policies and procedures that relate to the running of the home. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection (CSCI). What the care home does well: What has improved since the last inspection? 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Care Homes for Adults (18-65 years) Page 9 of 31 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 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective students needs and aspirations are assessed. They are given opportunity and information to test drive the home, and for the home to form a judgment about their compatibility with others. Written information about the service the home offers is made available, but is in need of updating. Evidence: The homes Annual Quality Assurance Assessment (AQAA) informed us that the Fortune Centre of Riding Therapy (FCRT) provides a person-centred service and learning opportunity for young adults that have been previously excluded from learning opportunities. There is a thorough application and admissions process that the students experience before they commence the residential course, which includes a residential seven day assessment period. Students visit Lanfranco House in the first half term of their first year, then again in their second year as part of their transition into more independent third year accommodation. We learned on inspection that Lanfranco accommodates third year students who have previously been living in Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: premises owned by the FCRT. They are therefore well known by the staff team and the teachers and have a fully documented history of needs and what they have accomplished to date. They have also had the opportunity to visit the home, and spend time there. They have become familiar with the culture of the placement, and we were told by three of the students that the expectations/rules of the house were not surprising to them. Three students spoke privately to us and confirmed that they knew about the home before they moved in and that they really like it here. I had a choice because its quiet. I love relaxing. I do love it here. Four students returned confidential survey forms and three out of four expressed positive views about the information they had received about the home and being involved in the decision making. However one student said they were not asked if they wanted to move to this home and added, No-one told us. The manager confirmed thatstaff inform students verbaly and in writing about moves into third year accommodation. Students receive full support from Group staff and Transition guides in preparation for such occasions before student moves take place. All parents are aware of moves and the criteria adopted for deciding which third year house a student moves into. We saw the Guide to Students and Parents/Guardians that detailed a wide range of matters around the FCRT facilities and the culture of the organisation. We drew to the attention of the senior member of staff on duty the aspects that require updating to bring in line with the legal standards e.g a summary of quality assurance comments, a copy of the recent inspection report. The manager confirmed that a copy of the CSCI report is available in all FCRT accommodation. Care Homes for Adults (18-65 years) Page 12 of 31 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 are continually supported to develop their ability and confidence in expressing their wishes and making supported choices. Evidence: The AQAA informed us that each student has an Individual Learning Plan (ILP), which is developed from their Pen Profile and Baseline Assessments. The student discusses the ILP with their Transition Guide during their weekly tutorial, and they sign to acknowledge their understanding and agreement, and as a transferable skill to other contractual obligations. During these weekly tutorials students discuss their learning and progress. These meetings form a part of the student feedback process. Four files were inspected and detailed records kept that confirm this. Individual risk assessments had been completed that identified risks and strategies agreed with the students to develop their skills e.g. being over confident when working with the horses, and potential to be bullied or exploited for approval. Different expectations of students in relation to going out alone or in twos or groups, and time for returning to the student Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: accommodation in the evening are determined, with their agreement, on an individual basis. Three of the students said they found their Transition Guide very helpful and could talk through any concerns with them. Regular weekly house meetings take place when students are encouraged to contribute their views and ideas about every aspect of life in the home. We asked the students about this, and they said, We can say what we like, and confirmed that the staff do heed their views. When asked if there was anything about life in the home they would change to make it better for them they responded with, nothing really. Its very nice here. The AQAA informed us that each student has an annual review involving themselves, parents/guardians, a personal external advisor and social worker, the FCRT Director and third year co-ordinator and transition guide. We learned that not all the students have good reading or writing skills, and noted that their individual learning plans were not adapted specifically in format for them. However, we were told by the senior member of staff that CD life maps are created for them but held centrally at Avon Tyrrell. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students are supported to engage with the local community and take part in meaningful and appropriate activities, as they choose. Their rights and responsibilities are respected but they are steered by staff, teachers and a full programme in terms of friendships, shape of their free time and within safe boundaries what they eat and drink and do. Evidence: The AQAA informed us that students are supported to develop their own potential, and in particular in their third year at Lanfranco they are connected with a Transition Guide to explore options and opportunities for their future. Three students told us they have a Transition Guide and that they get on well with them and find them really helpful. We found that students are visiting other residential placements e.g. Sparsholt College and Minstead Training Project and also attend short courses at Brockenhurst College. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Students use public transport to travel to work experience, and attend the college courses. We were told that the Transition Guide support students to investigate what is available in the local community which matches their interests. On the day of the inspection the students were looking forward to going out for an evening at the local sports centre to swim. One student said, I love being active and theres lots to do here. They spoke of the reindeer run they would soon be doing at a local country park, showed me some talented art work that they were completing, and talked of the vaulting they enjoyed with the horses. We were told that nearly all the students have work experience. Two gave me examples of what they were doing and said they enjoyed the work. The notice board in the hallway also detailed when students would be out on work assignment. Risk assessments were completed and on file relating to students going out alone, in ones or twos or groups, and specific activities that presented risk. We learned that students plan, budget, shop for and cook the meals with support from staff. This was observed on the first day of the unannounced visit when two students were preparing a meal of stir fried vegetables with noodles. The evening meal was taken together with staff around a large dining table, served at the table. There was good humoured banter and a happy atmosphere. A candle-lit birthday cake was brought and happy birthday sung for one of the students. We were told that there is always an alternative meal, and that individual likes and dislikes are noted in the preadmission assessment documents. The Senior member of staff told us that each of the students are encouraged to understand about healthy diets and the importance of regular exercise. The AQAA told us that students have taken part in community events such as organising a coffee morning in Burley, taking part in the Burley pantomime, the Hazelhurst Ride, Burley Youth Forum and Shout About, which was effective in persuading the local council to continue the local Cango community bus service. Students have opportunities to participate in gardening, vehicle maintenance skills and other independent living skills. They are responsible for doing their own personal laundry and share the domestic duties in Lanfranco. We saw that external cleaners visit the home and were told this is to ensure that all the high risk areas are thoroughly cleaned, and they told us they do that twice each week. Weekly house meetings take place where there is negotiation and feedback about daily living skills, menus, shopping, and management of mobile phones and social activities. The AQAA told us that students have gained qualifications in Food Hygiene, First Aid, British Sign Language, as well as BHS Stage 1 Riding and Stable Management, and National Vocational Qualifications (NVQ) Level 1 in Horse Care. The Student and Parent Handbook indicates that the development of special 1:1 relationships is not encouraged between students during their placement, that they are encouraged to relate across the whole group. One student said that they did not feel Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: happy with this house rule in the beginning but in the third year realised how important that house rule had been in enabling them to develop their interests. In practice we noticed that supported friendships do happen and people are able to go out to the pub together, and plan social activities. We noted that the students always referred to or addressed the staff with the title of Mr or Mrs and we enquired about this. We were told by the staff that it is part of the culture of the Centre and assists with maintaining appropriate boundaries between students and the staff. Not all the staff were positive about this, feeling that respect was engendered by attitude and behaviour rather than name formality. Four students returned confidential survey returns and although generally positive about the freedom they enjoy to decide on activities one said that the home is very boring at weekends-we work in the day, and we watch TV in the evenings. Another said I want more sleep and more days off. This was supported by two staff comments in confidential surveys who stated that, students have to do too much and dont get enough time to relax. Another staff comment was, students are now working 7 days a week. When not in the yard they still have to shop, clean the house and their rooms etc, almost no time for them to relax or pursue their own interests. Care Homes for Adults (18-65 years) Page 17 of 31 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 receive supervision and support with personal care, emotional and health care needs in ways that they want and working toward promoting their independence. Self medication is encouraged for those able to have the responsibility and support is provided for those who need it. Evidence: We found that in the home, personal files define the individual support necessary for the students continuity of care, as agreed by the students. No direct personal care is needed from the staff as all the students at Lanfranco can self-care with some prompts and supervisions. The AQAA informed us that the FCRT has a health care team that is headed by a Specialist Nurse, who is also a counsellor, and includes another nurse, a Physiotherapist. Any Occupational Therapy is resourced through the NHS. This team provides specialist support when required, and supports individuals to manage their own medical condition according to their ability. We were told that the Centre relates to one General Practice in Bransgore and over time a GP has taken the lead in overseeing the Centres but the students can elect to see any doctor in the practice. The group/key worker system identifies and provides emotional, as well as learning Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: support. Personal files in modular format were available and indicated that records are maintained of specialist reviews and any medical and dental events. We were told by two of the students that they make their own choices about how they spend their money and they are encouraged to save. On file we noted agreed action plans to assist students develop in understanding and maturity e.g. awareness of dressing appropriately for specific occasions. We found that no special adaptations or medical aids in Lanfranco were necessary. Each bedroom is equipped with a lockable, wall mounted drug cabinet. Where possible the students are supported to manage their own medication, including homely remedies, with regular checks by the staff. Records were up-to-date and well maintained. The controlled drugs and the register were inspected and confirmed to be in order and double signed. Information was available for staff on the purpose of specific medication and their side-effects. Care Homes for Adults (18-65 years) Page 19 of 31 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. Adequate, varied means are provided for students to express their concerns and complaints and they are supported to do so. They are protected by a multi-disciplinary team and robust procedures that ensure their protection and safety. Evidence: The AQAA informed us that the group and transition guide system and the multidisciplinary staff working alongside students give them the confidence to communicate their fears and/or concerns. All communication is recorded in the Staff Update (SUD) which was not available on the day of the inspection for the previous day as they are routinely passed up to HQ for typing on a daily basis. The lead member of staff was unaware therefore that the students had not gone swimming the evening before as planned but had visited the pub instead. It was uncertain when this paperwork would return to Lanfranco. Three students told me that they know how to complain if they are unhappy about anything-each said they would first of all talk with their Transition guide. When asked if they had ever made a complaint one said, only about my choice of horse. Another said I really dont want to change anything. Four student surveys confirmed that they knew what to do and who to talk with if they were unhappy about anything. The AQAA confirmed that all students parents/ guardians are in receipt of The Student, Parents/Guardians Handbook, which outlines the Complaints Procedure. We noted that this lacks a clear statement about the stages of complaint and the Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: timescale between the stages when a complainant could expect responses. The senior member of staff said the Handbook was in process of being reviewed and agreed this would be included for updating. The college has Child Protection policies and procedures in place ( for Adults and Children) and a named Child Protection Officer. We were told that all staff are given training in recognising types of abuse and whistle blowing. Although the records were held centrally we were told that a complaint had been made about two members of staff, and it had been thoroughly investigated and appropriate action was taken. We were unable to see this documentation although we were invited to go the main centre. The AQAA informed us and we we were told on the day by a staff member that the home has established links with an advocacy service. We discussed the two recent incidents of abuse between two students. FCRTs strategy for managing this involved a 1:1 period of staff support and the transfer of a student to another home. Physical intervention by staff to ensure student safety has not been necessary. Some incidents have occurred within the Centre since the last inspection that have not always been notified to the Local Authority under adult protection safeguarding. It has lead to the service reviewing their safeguarding procedures and giving greater priority to communicating with the local lead agency on safeguarding. The process of recording income and outgoing monies, and accessing money by the students was observed. We saw that cash is held centrally at Wootton Hall and were told that as the students visit there nearly every day they have the opportunity to deposit or draw out personal finances when they choose to. Each record has both a staff and student signature. Care Homes for Adults (18-65 years) Page 21 of 31 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 living at Lanfranco benefit from being involved directly in the routine domestic practices and in the decisions about how the home is run. The home offers a clean, comfortable, safe and well maintained environment. Evidence: Lanfranco is situated in the village of Burley up an unmade road, off Garden Road. It has a large open aspect with extensive grounds which are largely uncultivated. In one area building work for a two person Independence Lodge is nearing completion. We had been informed by the Manager that planning permission has been granted for its use. Overall accommodation may not be for more than eight persons, which when occupied, will reduce the use of Lanfranco to six persons. We arrived in the late afternoon/ early evening on the first day before supper and made a partial tour of the home. We were invited into the bedrooms of three students. One was a single with an ensuite bathroom. The student was very pleased with his accommodation and said how much nicer it was now in his third year to be in a smaller, family-style home, and that Lanfranco was very quiet and he liked that. The rooms were well equipped and well decorated. The expelair had broken in his bathroom which is an internal room and has no natural ventilation. He had not thought to comment to staff about this but it was brought to the attention of the senior member of staff who made a note to deal Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: with this. Furniture and fittings were bright and cheerful. Everything was domestic in character. Rooms were well lit and airy. The Fire log book was inspected and found to be up-to-date. We found the home to be clean and the confidential surveys from the students confirmed that the house is always fresh and clean. There were no offensive odours. While we were present in the home contract cleaners attended the home to prioritise the cleaning of high risk areas. We were told they come to clean the toilets, bathrooms and kitchen area twice each week. The laundry is sited in the grounds close to the house. It was very cold. A roster is agreed with the students for them to complete their personal laundry. The laundry is equipped with domestic machines in working order, and a sink for hand washing. Care Homes for Adults (18-65 years) Page 23 of 31 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. The Fortune Centres commitment to training and supervision ensures that staff are deployed in sufficient numbers and have appropriate skills to meet the needs of the students living at Lanfranco. Recruitment procedures are generally robust, ensuring the safety of the current students living within the service. Evidence: The four confidential student surveys confirmed that in their opinion the staff treat them well and generally listen and act on what they say. The three staff surveys confirmed there are usually sufficient staff to meet the needs of the students. During the afternoon inspection there were three staff on duty, two providing general support and the third member of the bank staff being allocated to a 1:1 support session. At night there were two staff sleeping in. Staff duty rosters were available. We noted from the AQAA that the service employs 63 staff in total and potentially any of the 59 staff involved in care can be rostered on a shift at the home. The students engage with all the staff centrally during their daytime Monday-Friday activities. However, in practice there are a core group of about 15 staff who will undertake residential shifts at the home. We spoke privately with two of the staff at Lanfranco, the Head of Personnel and a Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: member of staff at another of the premises who was working with the students in relation to managing their personal monies. We were told there is a restructuring taking place involving changes of roles and this is impacting the staff team. One spoke of staff morale being only about 60-70 currently due to the changes taking place. Confidential survey returns said staff are hard working and supportive of each other, and there is a lot of experience and knowledge amongst the staff. In general the organisation is supportive of the staff. Critical comments were made about the archaic and out of date methods of communication. They evidenced a view that contact with the Manager was limited, featuring they sometimes receive support. The lowest rating they expressed was in relation to sometimes inadequate ways of passing information between the staff and the Manager. This was confirmed by the non availablity of the previous days records, and we were told no staff time is given for handover. It was difficult to obtain a clear view of a students needs as some details were kept in separate files e.g. current risk assessments for every student (whether they lived at Lanfranco or not) are kept together in one main file. Daily updates remain with the members of staff. Summary information on staff is held at the home with photographs. The main personal and recruitment records of staff are held centrally but the Head of Personnel brought those that were randomly requested to the inspection, and these were found to be up to date and comprehensive. Criminal records checks, references, work histories, supervision/disciplinary records, and all legally required information were available. We noted that police checks are not compatible with registration down to the age of 16 and this was brought to the attention of the Senior Officer who agreed to look into this. In relation to induction and training the AQAA informed us that all new staff who have contact with the students undertake and complete the Learning Disability Qualification within their 6 month Induction period. (The number who have completed this was omitted from the AQAA). Staff then undertake the NVQ Level 2 or 3 in Social Care. We noted from the AQAA that only 15 support staff have achieved NVQ Level 2 or above which falls below the ratio required by the National Minimum Standards of 50 . The manager subsequently confirmed that 10 members of staff are working towards NVQ Level 2 or 3, and one member of staff to NVQ Level 4. The AQAA stated that advantage is taken of both formal and informal training opportunities with the dissemination of training/best practice being an important part of keeping staff up to date. New staff are encouraged to learn from observing and assisting experienced staff. Staff have their own Continuing Professional Development (CPD) portfolio, which they are encouraged to keep up to date with records of training and conferences attended, and qualifications obtained. It was acknowledged that there are opportunities for the service to improve the follow up of training needs identified through supervisions and appraisals, to motivate staff to maintain and add to their own CPDs and to ensure bank staff training is kept up-to-date. Staff surveys also Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: expressed that induction could be improved. Care Homes for Adults (18-65 years) Page 26 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students at Lanfranco benefit from positive management and leadership with regular consultation and audits influencing the development of the home. The health, safety and welfare of students living in the home is promoted. Evidence: The day to day manager of Lanfranco has been registered as manager for several years and is experienced both in management and the field of learning disability. She is also functioning as manager of the two other residential establishments, all three separated geographically from each other by a few miles. We were told that in addition she has developed a wider responsibility within the educational field and therefore experiences some time constraints in the day to day management of the residential side. The organisation has recognised that this situation requires some resolution and so a trial period of six months has been offered to another Senior officer to assess her performance in the role. This Officer assisted throughout the inspection. The home conducts a number of quality assurance processes to access student views, families/guardians perspectives, educational assessments, engagement with care Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: management reviews and an annual stakeholder survey. The AQAA states that the centre operates on Open Door policy for students and runs Parent Days giving parents and guardians opportunities to feedback their comments and ideas. We were told that all these feed into the development of the service and the annual plan. This was not available to be seen on inspection as it is held centrally at the Avon Tyrell main office. The fire log book was viewed and all records are well maintained and recorded at appropriate intervals. A sample of servicing certificates were checked. We were told that monitoring visits are undertaken by a trustee on behalf of the Director each month of the term. A record is made at each visit and a brief report filed on the general standards of the home. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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