CARE HOME ADULTS 18-65
Lindeth College The Oaks Lindeth Bowness on Windermere Cumbria LA23 3NH Lead Inspector
Liz Kelley Announced 15 September 2005 15.30 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. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Lindeth College Address The Oaks Lindeth Bowness on Windermere Cumbria LA23 3NH 015394 46265 015394 88840 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) SCOPE Limited Nicola Siobhan Buckley Care homer 46 Category(ies) of LD - learning disability registration, with number of places Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for 46 people between the ages of 16 and 25 years with a learning disability (LD) 2. The maximum number of people under 18 years of age shall be 18. Date of last inspection 27 January 2005 Brief Description of the Service: Lindeth College offers students with learning disabilities a three year structured course in education and daily living skills. It is a College of Further Education for up to 46 young people between the ages of 16 and 25. The premises comprise a large main house and six training houses. First year students are usually accommodated in the main house and second & third year students in the training houses. There are spacious grounds and appropriate areas for recreation. The college has recently built a new recreation hall.The Commission for Social Care Inspection has a remit to inspect the living accommodation and services connected to the personal care and welfare of students which are not connected to the educational function of the college. The educational provision is inspected by the Learning and Skills Council and by OFSTED.The college is owned and run by a national company called Craegmoor Health Care Ltd. The residential support workers are a separate team to the college teaching staff, and work with students outside of the college day and at weekends. The college has administration and maintenance support teams.The college operates to further education term- times and during holiday periods all students return home. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection from 3.30pm to 7.00pm and at the beginning of the new college year. Time was spent talking to new students in the main house and returning second and third year students in the Training Houses. Discussions took place with the Acting Manager, Angela Winrow, the new Student Services Manager and three residential support workers. A tour of the main house and two of the Training Houses was carried out. What the service does well: What has improved since the last inspection? What they could do better:
The female shower rooms are still in need of refurbishment to bring them up to acceptable standards and to promote greater privacy.
Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 6 The new Head of Student Services has identified areas for development, these being: improving communications with parents; formalising supervision with staff; making bedrooms more homely; and exploring sexuality and relationships in the care setting. Developing a protocol for reporting Adult Protection issues was also recommended to assist communication with both local and national social services and set agreements regarding appropriate referrals. Some students, while enjoying off-site activities said they would like to have more to do in the evenings and weekends, such as playing pool, table tennis, and basketball. The college should review its on-site sport and recreation facilities. 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. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 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 Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 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) 2,4 The college has developed good assessment procedures to ensure that students needs can be met and this had led to a high success rate of students settling at the college. EVIDENCE: A new system of staggered starting dates had been tried for the first time last year. First years had commenced college earlier than the second and third years. This had enabled the first years to find their way round more easily and for staff to give them more attention. Assessments utilised reports from Educational Statement of Special Needs, a social work assessment and reports from psychologists, speech and language therapist, occupational therapists and physiotherapist. The new Student Services manager stated he wished to review how this information is used and how best to collate all this information into a useful format to inform staff. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 9 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) 7,8 Students are well supported by the Residential Support Worker (RSW) team to make decisions and explore options and consequences in their life. EVIDENCE: The college carried out individual risk assessments on students and group/activity risk assessments. These were held both, centrally in the office to allow members of staff to co-ordinate group activities, and also within individual houses where the students live. A major thrust of the college’s work was to assist individual’s to become more independent, and informed decision-making was a large part of the student and staff activity, crossing both educational and social areas of the college. One-to-one sessions with students and RSW’s focused on decision making and the consequences of an individuals actions on others. Numerous instances were observed of students being supported to make informed decisions. Students were given a number of different ways to have a say and influence the day-to-day running of the college. A weekly activities meeting takes place for students to plan and organise the weekend. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14, Students are offered a good range of off-site activities, and facilities in the college had improved recently with the addition of the recreation hut. However, on-site sport and recreation facilities could be improved further to offer students more choice of how to spend their leisure time. EVIDENCE: Although the college was in a rural location, students had access to a range of community activities e.g. Leisure Centres, bowling, cinema, local shops, pubs, restaurants and cafes. The college, being on the outskirts of Bowness-onWindermere is quite isolated from the local community and staff used the college minibuses for these activities. Individuals stated that they took part in the following: Judo club, the gym, swimming, a cinema review group and a pub group meets regularly. The college does not have its own sports facilities, and during breaks in the college day students stood around in the car park area. The acting manager has plans to discourage congregation here by placing benches around recreation hut. Some students, while enjoying off-site activities said they would like to have more to do in the evenings and weekends, such as playing pool, table tennis,
Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 11 and basketball. Students said they would like more to do in the evenings and weekends. The college should review its on-site sport and recreational activities. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards will be judged when students have had more time to settle into the new student year. EVIDENCE: Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The college is good at seeking student views and consequently resolves many issues before reaching a formal complaints stage. Areas of sexuality, relationships and reporting of incidents to relevant authorities could be improved and explored in more depth. EVIDENCE: The college had policies and procedures on complaints that were issued by the registered provider, Craegmoor Healthcare. Students were issued with appropriate formats of the complaints procedure and were given individual support to understand when and how they can complain. This takes place in individual tutorials. The college’s student committee can take up issues, and the college also uses Craegmoor’s Home Analysis survey, which seeks views on a regular basis from students and family members. These systems allowed students, and others to openly discuss issues and raise concerns and this is reflected in the low number of complaints that reach a formal stage. The college had a staff group that was well-trained to handle aggressive outbursts and on appropriate use of intervention techniques. Staff reported that because they were trained in de-escalation techniques the number of incidents of aggression was extremely low. The new Head of Student Services was recommended to review the reporting procedures to social services and to develop a protocol for reporting incidents to include the students placing social worker, who are often in a different geographical area. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,27 Students benefited from a well-run college which has a continuous programme of improvements and maintenance. EVIDENCE: Major improvements over the summer holidays had been the rearranging of bedrooms to complete the phasing out of triple shared bedrooms- all were now either single or doubles. The college had appointed a new housekeeper, last year, who had made some significant changes by introducing monitoring and reporting guidance to ensure that all areas of the college were regularly checked and maintained. In a similar fashion the maintaince staff had good systems in place to ensure a well maintained and safe environment. Separate male and female bathrooms/showers were provided, with a recent improvement of one double downstairs bedroom having an ensuite shower room. The male showers had recently been modernised to provide individual shower rooms, and a further shower room downstairs. The female showers were still of a communal style but were due to have a similar modernisation in the near future. The student Services manager was keen to look at ways to make bedrooms more homely and individual.
Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 15 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) 31,35 The staff team are motivated and dedicated in their role of providing a stimulating and caring environment for students. There is an effective rolling programme of short courses and vocational training to ensure a well-trained and skilled workforce. EVIDENCE: An appropriate training programme is in place to ensure staff have access to a range of short courses and vocational training to equip them with the skills and knowledge necessary to meet the needs of the students. An example of this has been the development of an augmentive communication methods introduced by a senior support worker. This has been used to illustrate students timetables and activities for the evening and weekends, for example showing a table of household duties for each day. Other course discussed with staff included: fire safety, COSSH and Moving and Handling, Individual Learning plans, Autism, Sexuality and personal relationships, DDA awareness and Challenging behaviour. Staff follow the Learning Disabilities Framework for Induction and Foundation training. A programme for ensuring that the college has the required number of staff with NVQs was in place and the Student Services manager was hoping to enable this process as he is an NVQ assessor and verifier. Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 16 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) 37,39 Students and staff benefit from a well run college, and the new Student Services manager had already made a positive impression with staff and students. EVIDENCE: The principal, who is the registered manager with Commission for Social Care Inspection, was on long-term leave and the Head of Education, Angela Winrow was acting Principal. The college had the capacity and expertise within the staff team to ensure that the college continued to be well run and function affectively. Lindeth College is owned and operated by Craegmoor Healthcare who had extensive Quality Assurance systems and these had been applied to the college situation, and expanded, to suit the college needs. The Regional Manager from Craegmoor Healthcare carries out monthly visits and reports these to the CSCI. Of particular note was a Residents Questionnaire/Home Analysis for students and relatives alike to air their views on all aspects of the college. From this survey an action plan is drawn-up to address any criticisms or concerns highlighted.
Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23
ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 x 2 x x x Standard No 11 12 13 14 15 16 17 x 3 x 2 x x x Standard No 31 32 33 34 35 36 Score 3 x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Lindeth College Score x x x x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x x x F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 18 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 27 37 Regulation 23 37 Requirement Timescale for action 31.03.06 Female showers must be improved and made into private facilites The Responsible Individual must 18.09.05 keep CSCI informed of the outcome of the suspension of the Princiapal 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. 3. Refer to Standard 14 23 Good Practice Recommendations A review of recreational and sport provison should be made to improve opportunites offered to students A protocol should be devised to work with social services on approriate Adult Protection referrals Lindeth College F58 F10 s22699 lindeth college v240061 150905 ui stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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