Inspection on 03/05/05 for Linkage Cluster 3

This inspection was carried out on 3rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Linkage Cluster 3 08/05/07

Linkage Cluster 3 16/09/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Linkage Cluster Three 20 Pelham Road 16 Devonshire Ave Grimsby North East Lincs DN34 4SU Lead Inspector Tina Bettison Wilma Crawford Announced 3rd May 2005 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. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Linkage Cluster Three Address 20 Pelham Road, Grimsby, DN34 4SU 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) 01472 241044 01472 242375 edward.wright@linkage.org.uk Linkage Community Trust Edward Wright CRH 14 Category(ies) of LD 14 registration, with number of places Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Devonshire Avenue. The downstairs bedroom is to become staff sleep-in room and the upstairs bedroom 1 (currently used as staff sleep-in room) to become a single bedroom for service users. This to take place when the service user currently accommodated in the downstairs bedroom leaves the home or earlier with the agreement of the service user. (Regulation 23(2)(e)) 2. Linkage cluster 3 may accommodate a maximum of 5 service users aged 16-17 years of age conditional on there being no service users over the age of 25 years of age at the home. (Supplementary standards for care homes accommodating young people aged 16 and 17 will apply) Date of last inspection N/A Brief Description of the Service: Linkage cluster 3 comprises two houses both situated in residential areas of Grimsby. Pelham Road is close to Grimsby town centre and Devonshire Avenue is close to Peoples Park. Both houses are in keeping with surrounding properties. Both houses are two storeys and have garden areas.. Pelham Road provides accommodation for 8 service users. On the ground floor there is a single bedroom, a double bedroom, lounge, dining room, domestic style kitchen and separate toilet. Upstairs there is a bathroom with toilet, a shower room with toilet, one single bedroom, two double bedrooms and a staff sleep-in room. Devonshire Avenue provides accommodation to 6 service users. On the ground floor there is a dining room, lounge, domestic style kitchen and shower room with toilet. A condition of registration is that the ground floor bedroom becomes the staff sleep-in room and the current sleep-in room upstairs will be used as a single for service user bedroom. This will give upstairs accommodation as two single bedrooms, two double bedrooms and a bathroom with shower over bath and toilet. The houses provide furniture and fittings that are of a domestic style. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Tina Bettison and Wilma Crawford carried the announced inspection of Linkage community college accommodation over 5 days at the campus, in Grimsby and Lincoln. A tour of the premises took place and staff files and care records were examined. Rotas, medication records, staff lists and training records were examined. Staff, managers, students and relatives were spoken to. Care practices and interactions were observed during the inspection. What the service does well: Linkage is a good organisation that is well run and managed from the directors to the support workers. They have a lot of policies and procedures (rules) that are regularly reviewed and changed in order to promote students rights and best interests and make sure that the staff know how to do their jobs properly. Students are at the heart of the organisation and their views/wishes are taken into account by the use of questionnaires, learner council meetings and by managers and staff that make sure they are involved. Linkage Community Trust provides an excellent service for young adults with a learning disability and other needs. The primary aim of the college is to enable the young people to develop as much independence as possible, whilst helping them to be more confident. They provide a wide range of educational college courses and training in life skills, they also provide training on the use of buses and road safety. The houses are ordinary houses located in the local community and are on a bus route making all leisure facilities and shops easy to get to, some students go to work experience placements and pursue hobbies. Linkage do an excellent job of treating students as individuals and making sure they that are listened to and that they have a say in how they live there lives. There is a very active student/learner council and regular student meetings in the houses. Students are given enough information about linkage in order to make a choice about whether to go there or not, which is provided in ways that all students can understand. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 6 Students have a good assessment completed before coming to college and care plans are very detailed and clearly state what their goals and wants are, students are involved in putting these together and making changes when necessary. Contact with families is important at linkage and all students go home at half terms, summer holidays and Christmas and families can visit when students are not in class. The staff team is provided in enough numbers to meet the needs of students and they were observed to be kind and caring and promote students independence. Comments received from relatives included “On our visits to the house we are always made to feel welcome”, “As parents we are both confident in the staff’s ability and if we have any concerns we need to raise we are confident that they are listened to and addressed”, “my son is very happy”, “ our son has developed both educationally and becoming more independent”, “We have never once doubted our sons safety and security” “ the service was well planned and organised by the transition team”. Comments received from service users include “ I wouldn’t change anything, best place I’ve been to” “I go to the pub, bowling and the pub. I visit friends and they visit me” “ I look after my money”. What has improved since the last inspection? What they could do better: Linkage needs to provide much more training for their staff, especially in the areas of mandatory training, Protection of Vulnerable Adults, NVQ level 2 and makaton, so that all of the students needs can be met. They need to improve the houses that the students stay in because some of them are in need of redecoration and updating and do not provide students with a comfortable and homely place to live in. They need to do everything that the fire officer has asked for to make sure the houses are safe for staff and students. They need to reduce the numbers of double bedrooms, so that students can have private space when they want it. Some of Linkages policies and procedures need to be changed to make sure that staff understand how to do their job properly. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 7 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. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 8 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 Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 9 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) 1,2,3 Students and their families are provided with enough information about the service to be provided for them to be able to make an informed choice. Students needs and individual aspirations are thoroughly assessed ensuring that staff are given enough background information in which to develop detailed care plans and therefore meet the students needs. Each student has a contract (purchase schedule order) from the Learning and Skills council thereby knowing what level of service they should be receiving. EVIDENCE: Linkage Community college had a statement of purpose and service users guide for individual accommodation provided, which met the requirements of schedule 1 and NMS 1.2. They gave clear information about the aims, philosophies and values of the college and what students and their families could expect from the college. Both documents were made available in written text, with photographs of the houses and rooms in the service user guide and makaton symbols and audio cassette if requested. Attached to the service user guide is a copy of the students’ schedule and purchase order, which details their contract as, provided by the learning and skills council. They fund students accessing the linkage college provision. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 10 The inspectors were able to examine all of these documents and students and relatives understood their purpose and had been given copies. Students were assessed for their placement at linkage by the Linkage Transition team. The team visit the student at home/school and students also attend college for a 5 day residential placement whereby the assessment is drawn up. The assessment also includes the student’s social worker from their home area, school, educational psychologist, medical professionals and the connexions service. Any potential restrictions/limitations are discussed and agreed at this time and any students whose needs the college can’t meet will be refused admission. The staff in the main hall have a key role in the assessment process, which is ongoing and can often determine the placements of the students in the following years. Each house provides a particular service to students at differing programme levels. Families spoken to confirmed this process and said that they were very impressed by the attention to detail of the team and that were very involved in the process and that they and their son/daughter had a chance to look around before making a decision as to whether the college was right for them. NMS 4.3 is not applicable in this care setting. The college employs a professional support team made up of qualified social workers, psychiatrist, clinical psychologist, speech and language therapist, visual impairment specialist and a registered nurse. Students enter the college with a clearly laid out plan regarding the purpose, duration and requirements of the college programme. Students spoken to throughout the inspection confirmed that they knew why they were attending the college and what skills they were hoping to develop. Minority ethnic groups were catered for, the college staff could clearly explain student’s individual cultural or religious needs and these were promoted. Any specific needs were seen recorded on students care plans. The college also hold cultural week annually whereby students can choose to undertake an activity of their choice, which helps them to understand other cultures and/or religions. Examples of this included a visit that some students took to a Sikh temple. A student commented that she had “to take her shoes off and cover her hair and bow before they sat down………the prayer hall was very bright and colourful……….We had a lovely day out” Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 11 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) 6,7,8,9,10 Students are involved in the preparation of their care plan and therefore know that their specific needs and goals are included. Students are empowered to make decisions and are consulted on in all aspects of college life. Measured risk taking is seen as an essential part of college life in order for students to try out new things and stretch themselves to meet their identified needs and goals. Student’s information is kept confidential both in terms of appropriate storage and staff practice. EVIDENCE: Samples of Care plans were examined as part of the inspection process and had been developed to cover all aspects of the students assessed needs. Staff were able to confirm that the care plans were kept under constant review and Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 12 that they were formally reviewed every 3 months. Students spoken to confirm that they are encouraged to participate in the development of their own care plan. Staff were able to explain that once students came into the college setting their needs and skills could quickly change therefore it was important to continually update care plans. The care plans complemented the formal teaching that was going on in college and ensuring a 24-hour curriculum promoting students aspirations and setting goals. Risk assessments were in place for any areas that posed a risk to students and measures put in place to minimise the risks, i.e. personal safety, road safety and leisure activities. Students are encouraged to be involved in the development and review of risk assessments. A policy/procedure for missing students was available. All students had a key worker and were able to tell the inspector who this was and explain what their specific role was. All students were enabled to be as independent as possible this was confirmed by taking to staff, students and families, who stated that the colleges main aim was to “promote independence”. All students managed their own personal allowance with support. The inspectors observed students being offered many opportunities to participate in the day to day running of their own home, there is a very active learner council, supported by an advocacy worker, house meetings once a week and leisure meetings. Students were able to explain to the inspectors how they decided as a group what the menu would be for the week, how their rooms would be decorated, they are included in staffs selection and some recently appointed staff confirmed that students were on the interview panel. Staff and students confidential information was observed to be securely kept and handled in accordance with the Data Protection Act. Lockable facilities were used and students are consulted about when and where there information can be shared. Staff were observed to knock on doors and to ask students permissions to enter bedrooms. Linkage has a policy on sharing information with partner agencies. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 13 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) 11,12,13,14,15,16,17 Students at linkage community Trust are enabled to develop as much independence as possible, whilst building on their confidence and self-esteem. They are provided with a wide range of educational college courses and training in life skills, the uses of buses and road safety. The houses are in the local community and are ordinary domestic housing and are on a bus route making all leisure facilities and shops within easy reach. Staff focus on the individual person and ensure that they are listened to and have a say in their daily lives by promoting an active student/learner council and regular meetings in the houses. Students are offered a healthy diet and mealtimes were observed to be relaxed and unhurried. Attention is paid to student’s specific dietary and cultural needs. EVIDENCE: Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 14 Student’s social, emotional, communication and independence skills are developed and maintained by the implementation of the 24 hour curriculum. Specialist intervention and support is offered by specialist staff. This was evidenced by the care plans and specialist assessments and treatment programmes implemented for some students. All students attend educational classes clearly defined in their educational plans and household activities are shared amongst the students in the houses, students were able to clearly state what their educational timetable consisted of and what their household jobs were in the week of the inspection. Some students have secured work experience placements and all students participated in leisure activities in the community e.g. bowling, swimming, shopping and pursue their own hobbies. Students told the inspector that they attended drum lessons and horse riding. Planned trips were organised on a weekend. Transport is provided by the college in the form of mini buses, people carriers and company cars, however the emphasis is on the use of public transport and independent travel. A number of students were taking driving lessons with the aim of eventually being able to drive their own car. Contact with families is encouraged and maintained all students go home at half terms, summer and Christmas holidays, and some go home on the occasional weekend. Families are welcomed to visit at times other than when students are in class and without exception all families spoken to said that staff kept them well informed of progress, problems and/or illness. Students all stated that they are encouraged to make choices and can have a key to their room if they wish. Students had unrestricted access to the houses and gardens. All students take a turn in the cooking of meals and were keen to explain to the inspectors that they held weekly meetings to agree the menus. Meal times were observed to be flexible and unhurried and students are encouraged to follow a healthy eating option but taking into account their ages, likes and dislikes and specific needs in relation to specific dietary needs, religious and cultural needs. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 15 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) 18,19,20,21 Students’ privacy, dignity and respect is promoted by a caring and professional team of staff. Students’ physical and emotional needs are met, by the provision of a wide range of healthcare professionals and outside agencies. Students are encouraged to manage their own medication where possible and supported with this when required. EVIDENCE: Students confirmed that the support they received from staff promoted their dignity, privacy and respect. Staff were observed to behave in an appropriate manner towards students and personal support is provided by staff of the same gender where this is possible. e.g. in one house were the students are all male, the majority of staff are male and alternatively in another house where the students are all female, the staff are all female with exception of the registered manager. Times for getting up and getting up were flexible up to a point, staff and students explained that because students had timetables to adhere to they had to be in bed at a reasonable time during the week to ensure that were on time Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 16 for their college courses. Individual likes and dislikes were recorded on the care plan and students told the inspector that they chose their own key worker. Records examined confirmed that students had access to a wide range of health professionals e.g. psychiatrist and psychologist, speech and language therapist and visual impairment specialist, there is also a registered nurse on the college campus that students can book an appointment with. Students are enabled to visit the GP, audiologist, and dentist and attend any outpatient appointments otherwise relatives can facilitate this when students go home. Staff in the houses monitors the student’s well being a booklet has been devised in makaton and diagrams to help students identify were they might have any pain. Linkage has robust medication policies and procedures that include receipt, storage, administration and disposal of medication. Students who wish to self medicate are encouraged to work toward this with a graduating self-mediaction programme. The college nurse will assess the student prior to commencement and a risk assessment is undertaken. Facilities are made available to students to lock their medication away. The GP regularly reviews students for their medication and the college nurse checks the systems in the houses on a regular basis, the local pharmacist also regular reviews the systems. The medication systems were examined by the inspector as part of the inspection process and found to be well managed and robust. All staff are given medication administration induction training by the nurse, which includes a competency check. NMS 21 is generally not applicable in this care setting as if any student were to become seriously ill, they would return home. However it has been acknowledged that training on death and dying would be beneficial for the staff and this is to be provided soon. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 17 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 Students are listened to and their views acted on by a wide range of methods. Linkage has a robust complaints procedure that all students were aware of. The staff team were not fully aware of Protection of Vulnerable Adults policies and procedures and their responsibilities within these therefore strategies are not in place to ensure students are protected from abuse, neglect and harm. EVIDENCE: Linkage had a complaints policy/procedure that included timescales and was provided in makaton symbols, audiocassette and DVD. All students had been given a copy and those spoken to confirmed this. All minor issues were dealt with through the house meetings and minutes were seen to evidence this. More serious issues were taken to the learner council and a mechanism is in place for responding to these areas of concern and/or complaint. The learner council confirmed this and the inspectors sat in one of the meetings and observed. Linkage has a Protection of Vulnerable Adults policy and procedure and also a Child Protection procedure and has identified a key person within the college set up for all referrals to be made through these procedures. Linkage also has a whistle blowing policy. However some staff spoken to were not clear about their responsibilities within the POVA procedures and therefore training must be provided. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.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) 24,25,26,27,28,29,30 All of the recommendations of the fire officer have not yet been actioned therefore students may not be living in a safe environment, these areas must be attended to. Some students share a room; therefore students are not provided with bedrooms that suit their needs and lifestyles. There are sufficient bathrooms and toilets and adequate shared spaces to meet students needs. The houses were observed to be clean and tidy. EVIDENCE: Linkage cluster 3 comprises two houses both situated in residential areas of Grimsby. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 19 Pelham Road is close to Grimsby town centre and Devonshire Avenue is close to Peoples Park. Both houses are in keeping with surrounding properties. Both houses are two storeys and have garden areas. Pelham Road provides accommodation for 8 service users. On the ground floor there is a single bedroom, a double bedroom, lounge, dining room, domestic style kitchen and separate toilet. Upstairs there is a bathroom with toilet, a shower room with toilet, one single bedroom, two double bedrooms and a staff sleep-in room. Devonshire Avenue provides accommodation to 6 service users. On the ground floor there is a dining room, lounge, domestic style kitchen and shower room with toilet. A condition of registration is that the ground floor bedroom becomes the staff sleep-in room and the current sleep-in room upstairs will be used as a single for service user bedroom. This will give upstairs accommodation as two single bedrooms, two double bedrooms and a bathroom with shower over bath and toilet. The laundry facilities are housed in the garage which may pose a risk to service users accessing these during the winter, the provider should consider the development of a utility area within the house for the laundry. The inspector was informed that the registered manager keeps a maintenance book. Any action releting to maintenance is recorded there and any action taken. Any major works are undertaken on a rolling programme on a priority basis. The houses provide furniture and fittings that are of a domestic style. Both houses require enough double sockets in bedrooms to ensure service users can use all of their personal equipment. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.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) 31,32,33,34,35,36 The staff team have a clear understanding about their roles and responsibilities and are appropriately supervised therefore are able to support the students. Staff training is of concern, although training is identified and courses available they are not in enough quantity to enable staff to receive training in a timely fashion, therefore all of the students needs cannot be met. A robust recruitment and selection process protects students from the risk of harm. Students receive the correct amount of staff support as determined by their assessment. EVIDENCE: From examination of staff files and discussion with staff it was evident that all staff have clearly defined job descriptions and are clear about their role and how this fits in with the linkage aims and meeting students needs. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 21 Observation of staff practices confirmed that they have developed appropriate relationships with students and treat them in an age appropriate way and with the utmost of dignity and respect whilst offering guidance and support in a sensitive manner. The staff team are supported by a wide range of health professionals e.g. psychiatrist and psychologist, speech and language therapist and visual impairment specialist; there is also a registered nurse on the college campus for advice and support. Linkage recruitment policies and procedures are robust and examination of staff files confirmed that all staff have had CRB disclosures, all identity as required by regulation was in place, references obtained and students spoken to confirmed they were involved in the recruitment process. Staff are subject to a 6 month probationary period following appointment and a detailed induction programme is undertaken. Staff confirmed that they had been given a copy of the GSCC code of practice. The registered manager had a training and development plan for the staff team that clearly identified staff training needs and all staff had an individual training and development action plan that was completed annually. A wide range of training is provided by linkage and included mandatory training, DDA, HIV/Aids, POVA and child protection, diabetes, makaton, competence to drive the mini bus, administration of medication, epilepsy, religion and culture, confidentiality, whistle blowing, every child matters, principles of care, managing challenging behaviour and human rights, however from the examination of training records it was evident that not all staff were up to date with mandatory training and not all staff had completed service specific training in a timely fashion. This must be addressed. Linkage has very low numbers of staff that are qualified to NVQ level 2 or equivalent and this must be addressed. The staff team are well supported, records examined and discussions with staff confirmed that formal supervision is provided at least 6 times a year, sometimes more and informal supervision as and when needed. Staffing numbers in the houses are determined by the schedule and purchase order that details the level of support that each student needs, this is then provided by linkage. Some students’ receive one to one support at certain times in the day others receive very little support, as per their assessment. There is a registered manager in the houses, independence tutors and support workers as determined by assessed need. Independence tutors sleep in to provide staff support throughout the night. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.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) 37,38,39,40,41,42,43 Linkage is a creditable organisation that is well run and managed from the top down, with a wide range of policies and procedures that are regularly reviewed and monitored which promote students rights and best interests. Some of these still need amending and updating. Students are at the heart of the organisation and their views are taken into account by the quality monitoring scheme, learner council and by managers and staff in the hall that promote their involvement. Students live in a safe environment however the recommendations of the fire officer must be addressed and all staff need to be up to date with mandatory training. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 23 EVIDENCE: Staff spoken to stated that the registered manager is “very dependable, approachable, supportive and thorough”. He has a City & Guilds further and adult education teachers certificate stages 1 and 2, a certificate in education, an HNC in Business and Finance management and a national diploma (BTEC) in business studies and a first aid certificate Regular staff and student meetings are held and minutes were seen to confirm this. The Residential Services Manager has been pro active in working with the CSCI in the registration of the Linkage college accommodation services. All conditions of registration have been adhered to. All students and relatives spoken to by the inspectors were aware of the inspection and without exception stated that they had been encouraged to be involved and speak to the inspectors openly and honestly. From examining the records the inspectors were satisfied that Linkage had policies and procedures that covered a wide range of topics, were detailed and clear and gave staff clear guidance on how to conduct themselves. Staff spoken to could demonstrate their knowledge of the policies and procedures and how to implement them in practice. The policies and procedures were kept under review and since registration a number had been updated and amended and new ones added. The Complaints procedure and fire procedure had been produced in a symbolised format and provided in a DVD that had been acted out by college students. Students spoken to had good understanding of these procedures and found benefit from watching them acted out in the DVD. The policies and procedures that require amendment and updating are bullying, this policy only related to staff and not service users, sexuality and relationships, recruitment and selection to include the request for CRB clearances, staff disciplinary to include referrals to the POVA list where staff are suspended/dismissed for abuse and use of restrictive physical interventions. Linkage have a Corporate Quality Monitoring system (EFQM) and a College Quality Manager who co ordinates and leads on quality issues. A year long calendar is produced that provides the framework for QA activity including surveys, audits and appraisals. Student comment cards had been translated into makaton symbols to aid students understanding and enable them to participate in the process. Linkage produces an Annual Review document and regular newsletters. All of which were seen by the inspectors. Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 24 Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 25 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 4 4 4 N/A N/A Standard No 22 23 ENVIRONMENT Score 4 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 4 4 4 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 2 3 2 3 3 Standard No 11 12 13 14 15 16 17 4 4 3 3 3 4 4 Standard No 31 32 33 34 35 36 Score 3 3 2 3 3 4 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Linkage Cluster Three Score 3 3 4 N/A Standard No 37 38 39 40 41 42 43 Score 4 4 3 2 2 3 3 J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 26 NA 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 23 Regulation 13(6) Requirement Theregistered person must ensure that all staff have received training in the protection of vulnerable adults The registered person must meet the requirements of the fire officer The registered person must provide a maintenance and renewal plan for the refurbishement and redecoration of the houses with timescales attached The registered person must ensure that there are enough electric sockets in students bedrooms for them to be able to use personal equipment and that laundry facilities are made more accessible.. The registered person must provide a plan with timescales of how they aim to reduce the numbers of double rooms The registered person must ensure that all staff receive mandatory training and that this is updated and amended as required The registered person must ensure that all staff receive Timescale for action 31/10/05 2. 3. 24 24 23(4) 23 30/9/05 31/7/05 4. 24 23 31/10/05 5. 25 23 (2f) and 12 (4a) 18 (1a) and (ci) 31/7/05 6. 35 31/10/05 7. 35 18 (1a) and (ci) 31/10/05 Page 27 Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 8. 32 18 (1a) and (ci) 9. 40 24 service specific training e.g makaton training in time to be able to meet students needs The registered person must ensure that a NVQ programme is put in place to ensure that staff are qualified to at least NVQ level 2 The registered person must ensure that policies and procedures are reviewed and amended in line with updated legislation and best practice guidance 31/10/05 31/10/05 10. 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. Refer to Standard 25 Good Practice Recommendations The registered person should consider the reduction of numbers of students to 5 at Devonshire Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hesslewood HU13 0QF 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 Linkage Cluster Three J54 61287 Linkage C3 V217258 3 May 05 stage 4.doc Version 1.30 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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