CARE HOME ADULTS 18-65
Lindeth College The Oaks Lindeth Bowness on Windermere Cumbria LA23 3NH Lead Inspector
Liz Kelley Unannounced Inspection 22 March 2006 02:00
nd Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 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 Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) S.C.O.P.E. Limited Mrs Nicola Siobhan Buckley Care Home 46 Category(ies) of Learning disability (46) registration, with number of places Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Registered for 46 people between the ages of 16 and 25 years with a learning disability (LD) The maximum number of people under 18 years of age shall be 18. Date of last inspection 15th September 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 DS0000022699.V271315.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection from 2.30pm to 7.00pm and was mid-way through the college academic year. Time was spent talking to students in the main house and second and third year students in the Training Houses. Discussions took place with the Acting Principal, Angela Winrow, the new Student Services Manager and two residential support workers. A tour of the main house and one of the Training Houses was carried out. Only the standards not covered at the last inspection will be inspected, and for a full picture of the home the last two reports need to be read in conjunction. What the service does well: What has improved since the last inspection?
The newly appointed Head of Student Services has made significant changes in a number of areas in a short space of time. This has lead to improvements in: communication with parents and professionals; team work and morale of the care team; and a much greater emphasis on activities and leisure opportunities both within and outside the college. These have included; contemporary dance; performing arts evenings; theatre groups; IT groups; Youth clubs; Arts club and a sailing club. Care staff have recently placed an emphasis on promoting independence skills, in conjunction with education colleagues, with the result of students accessing the local community to greater levels. Improved care staffing levels have greatly assisted the college in being able to offer more opportunities to students. The College has had a real drive on training recently and have engaged a private trainer to help them improve levels of staff taking the NVQ in Care qualification. Frequency of supervision of staff has also improved with a rolling programme of individual supervisions and annual appraisals. New lounge furniture has been purchased for the training houses in bright colours which students said they liked.
Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 6 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. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 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 the following standard(s): These standards were assessed and met at the last inspection. EVIDENCE: Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 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 the following standard(s): 6 and 9 The college has devised a good system of individual plans with students that create a real sense of ownership by the student. This leads to goals that are achievable and success is celebrated. EVIDENCE: Students are encouraged and enabled to lead full and active lives. This is carried out by the use of Individual Learning and Development Plans (ILDP). Regular reviews are held with the student and their personal tutor. In the care setting weekly goals are negotiated, reviewed, and set with the personal tutor and student. These were examined and include areas such as personal hygiene, household chores, managing money etc. Students were keen to show the work they had achieved and there was a real sense of ownership and pride in their development. One student was preparing to give a presentation, using PowerPoint, to professionals on her work placement. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,15,16,and 17 Access to the local community and leisure activities have significantly improved over the last few months, and students were responding very positively to these new opportunities. Students are offered healthy and home cooked meals with the emphasis of promoting healthy lifestyles. EVIDENCE: Care staff have had a real drive on promoting independence skills, in conjunction with education colleagues, with the result of students accessing the local community to greater levels. These have included; contemporary dance; performing arts evenings; theatre groups; IT groups; Youth clubs; Arts club and a sailing club. Plans are afoot to develop a Duke of Edinburgh Scheme and one specialist area to be used is a horse skills course. The new Student Services Manager has spent time and effort promoting positive relationships with parents. This has included reviewing the information visiting students and parents are given through to gaining feedback on their initial visit. Student relationships are a key part of the work carried out by the college and recently the they have developed links with a local relationship counsellor for
Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 11 individual work with students. This ensures that the college is caring for the holistic needs of students, and that they leave better prepared for adult life. Each student’s ILDP focuses on promoting independence and responsibilities to others. Privacy was an area the college and personal tutors focus on, particularly as the students move into their own bedroom in the second and third year. Students were observed respecting the privacy of others by knocking on each other’s bedroom doors, and discussed with the inspector how they could choose which students visited their house. The college has a drive recently in promoting healthy eating and lifestyles. Healthy options now offered to students are fresh orange juice, more fresh fruit and less processed foods, as demonstrated by the new menus. The atmosphere at tea-time was lively and friendly, with plenty of conversation. Students are involved in menu planning, shopping, cooking and cleaning up after each meal. The menus examined were varied and wholesome. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, 20 The health needs of students is carefully monitored and well-managed by the college. EVIDENCE: All students are registered with the local GP practice, as is the norm for students, and revert to a GP of their choice when out of college term time. Dentist and optician appointments usually take place in the student’s home area. The college has good working relationships with the Community Mental Health Team, who provide advice on anger management, counselling and the services of a psychologist. The college also has on its staff team an occupational therapist and a speech therapist. All healthcare appointments and checks are recorded. The home has policies and procedures in place to ensure the safe handling of medicines handling including a self-medication procedure and risk assessment. Self-medication is an area identified by the Student Services Manager to develop further as there is the potential for students to gain more independence learning and skills in this area. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed and met at the last inspection. EVIDENCE: Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30 It is evident that the fabric and maintenance of the building has not had any substantial funding for sometime. The buildings require painting and are generally looking run down. EVIDENCE: In particular the main kitchen is not fit for purpose and is a potential health hazard. The floors have become porous, the work surfaces chipped and damaged, seals need replacing and tiles are old and cracked. The dishwasher has been out-of-order for six months and this serves students care staff and education staff. An interim measure has been put in place to raise the water temperature to wash pots, but this carries with it risks of students scalding themselves. The female shower rooms are still in need of refurbishment to bring them up to acceptable safe standards and to promote greater privacy. They are institutional in design and out-dated. Showers in other parts of the college have very low water pressure and are often rendered unusable. A recent audit of maintenance issues has highlighted that there are substantial amounts of woodwork that requires replacing, including those that form part of the fire escape in the Training houses. Also a water tank in the loft is
Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 15 uncovered and is unhygienic. Following this inspection these concerns have been reported to the Fire Officer and Environmental Health Officer. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 Staff are well trained and supported, and this along with improved staff morale leads to students being offered a rewarding placement. The college has robust and safe recruitment practices which safeguard students. EVIDENCE: Residential Support workers (RSWs) are quickly gaining qualifications to equip them to meet the demands of their role. The college has a good track record of training staff and frequency of supervision has improved with a rolling programme of individual supervisions and annual appraisals. RSWs are now being enrolled on the higher care qualification, NVQ level 3 as this focuses on promoting independence, and is much more relevant to the needs of students. All staff are currently being trained on a Learning and Disability Induction course. Staff are also offered a number of one day courses to enhance their knowledge such as in Adult Protection and medication training. The college follows Craegmoor Healthcare’s policies on recruitment and employment terms and conditions. These cover all the areas required by this standard. A new member of staff was interviewed and they confirmed this practice having responded to a newspaper advertisement, attending an interview, with written references taken up, and a satisfactory enhanced CRB disclosure prior to working with students. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 Students and staff benefit from a well-run college. The new Student Services manager has already made beneficial changes which have led to a more positive atmosphere with staff and students. EVIDENCE: The Acting Principal has identified where the college needs to develop and has a clear vision for future plans. A recent audit of maintenance issues has highlighted that there are substantial amounts of woodwork that requires replacing, including those that form part of the fire escape in the Training houses. Also a water tank in the loft is uncovered and is unhygienic. These concerns have been reported to the Fire Officer and Environmental Health Officer. The college does not have a sufficient delegated budget to properly maintain the college, and consequently it has reached the stage where it requires a substantial amount of resources to bring it up to safe and well maintained standards. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 18 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 1 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X X X X 2 X Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 19 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 YA27 YA24 Regulation 23 23 Requirement Female showers must be improved and made into private facilities The college must be properly and safely maintained with an adequate budget for running repairs. The rear of the training house that are the designated means of escape for Fire evacuation must be made safe Showers must be fit for the purpose and the problems of low water pressure must be resolved The kitchens must be made safe and hygienic The dishwasher must be replaced or repaired All open water tanks must have a cover Timescale for action 31/03/06 31/05/06 3 YA24 23 30/04/06 4 5 6 7 YA27 YA24 YA24 YA42 23 23 23 23 31/05/06 31/05/06 30/04/06 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 20 No. Refer to Standard Good Practice Recommendations Lindeth College DS0000022699.V271315.R01.S.doc Version 5.1 Page 21 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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