Inspection on 12/12/08 for NASH FE College

This inspection was carried out on 12th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

NASH FE College 15/01/08

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: NASH FE College Nash FE College Coney Hill Education Centre Croydon Road Bromley Kent BR2 7AG     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: Rosemary Blenkinsopp     Date: 1 2 1 2 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. that people have said are important to them: They reflect the things 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 32 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: NASH FE College Coney Hill Education Centre Nash FE College Croydon Road Bromley Kent BR2 7AG 02084627419 02084620347 acrooks@nash.shaftesburysociety.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Livability care home 43 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 43 The Registered Person may provide the following category of service only: Care home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 43 Date of last inspection Brief description of the care home Nash College is operating as Livability and is a Further Education establishment for younger adults with a complex range of sensory, physical and learning difficulty needs. The College provides accommodation for 43 students to board through the week and at weekends. Due to the percentage of students requiring personal or nursing care the College is required to be registered as a Care Home for Younger Adults under the Care Standards Act 2000. The College offers courses over a three-year period aimed at enhancing and promoting their students communication and life skills. The College is subject to inspection from both the CSCI and Ofstead. Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home The fees are £125,000.00 per annum. Care Homes for Adults (18-65 years) Page 5 of 32 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 inspection was conducted as an unannounced visit. One inspector, an expert by experience and the pharmacist conducted the visit. The manager facilitated the site visit. Periods of observation were undertaken on the site visit mainly by the expert by experience and myself whilst students were having breaks from class. Prior to the inspection the manager had completed the AQAA and forwarded this to the CSCI. This was well completed with comprehensive information on each section which was used to inform the inspection site visit. Comment cards were sent to the service and provided during the site visit . Of those received from Nash College nine were received before the inspection six from students and three from staff. A further eight were received on the day -two relatives and six from staff. Care Homes for Adults (18-65 years) Page 6 of 32 The majority of student comment cards had been completed by family members . Favourable comments were reflected in these. Staff comment cards were also very positive referring to support training and the good care students received. In one staff comment card there were a lot of comments relating to the lack of supervision training and availability of information on students. These comments formed that basis for staff interviews. Another comment card received after the inspection referred to the level of aggression towards staff by students. During the visit the expert by experience spoke to students and observed staff interaction with students . Staff were interviewed as part of the site visit . All of the information obtained from the sources identified above has been incorporated into this report. A selection of documents were inspected including care plans, complaints information as well as health and safety records. Feedback was provided to the manager at the end of the inspection. Other information which has been considered when producing this report and rating, is the information supplied and obtained throughout the year including Regulation 37 reports and complaints. Following the inspection reports were received from the expert by experience and the pharmacist and these are incorporated into the body of this report. What the care home does well: What has improved since the last inspection? There was evidence of significant and sustained improvement in many areas, not only the environment but record keeping, staff training and more person centred care for students. One area which has been of concern, and has had on going issues, was the medication. The staff have worked hard to address this to ensure medication systems are safe.The manager has addressed the lunch time medications by ordering two separate medication trolleys and splitting the round into two separate ones. This has halved the very time consuming task and may help to reduced the level of medication errors as this takes a lot of concentration. There has been more developments in respect of care plan documentation and these are becoming more person centred. The files were organised and easy to access. Staff training opportunities and regular supervision has better equipped the staff team for the work that they do. Staff literacy and numeracy courses provided by the College are to be commended. Senior management presence within the College provides greater opportunities for monitoring and auditing of care and documentation whilst the visible presence enables staff to raise issues at any time. Care Homes for Adults (18-65 years) Page 8 of 32 There had been a continually programme of refurbishment and upgrading in several areas within the College. More communal ares have been developed and designated areas such as the computer room have benefited students. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 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 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective students are subject to robust assessment procedures and have an opportunity to sample the service prior to placement. The comprehensive assessment procedures ensure that the College are able to meet all of the students needs. Students are provided with information regarding the College. The Statement of Purpose is available and information is made available in other formats such as symbols. All of these procedures ensure students are involved in the design making process and that the College themselves can effectively manage their care and support. Evidence: Two residents files were case tracked and included in them was their assessment information and records of procedures undertaken before placement was offered. There was comprehensive information received from many members of the multidisciplinary team which covered physical, physiological and social aspects of care. There was good information on the communication needs of the student, equipment Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: required. Details of their previous lifes including family relationships and home life,all provided a good picture of the person. There were reports from occupational therapists, physiotherapist and a range of professionals involved with the student. The assessment process can take some time not only for the College to undertake their own assessments but also to obtain the additional information. Once full and through assessment procedures have taken place, then the prospective student will be invited for a trail visit, overnight stay. This allows further information to be obtained and the student an opportunity to sample the service. If this is successful then the student will be accepted. Placement will be offered this will only be after funding has been agreed a this can often be difficult to obtain. A five day introductory visit is arranged to allow the maximine settling in period before classes and the return of the existing students prior to term commencement. The Statement of Purpose was available in the hall. Information is made available in other formats such as symbols. Makaton is used as one of the communication aids. Care Homes for Adults (18-65 years) Page 12 of 32 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. Individual plans are in place, which address the care,support,social and educational needs of the student. The care plans are formulated using a multidisciplinary approach and contain a good standard of information, which enables staff to provide individual care to the student. Evidence: Care plans detailed the care that students required whilst at Nash. The majority of the students have complex needs not only in relation to learning disability but physical health issues as well. Further information on advocacy, personal achievement and goals whilst at Nash were also documented. Information from families is particularly important, as in many cases they may have been caring for that person at home. Those care plans seen detailed physical health care well, particularly eating and drinking, mobility as well as their personal care needs. There was input from specialist teams such as the Dysphagia team when eating and drinking care plans were Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: developed. Specialised dietary requirements were recorded as well as specialist equipment needed. The supporting daily events were to a good standard . Under the section health care plan in one file this had not been completed. Angela Crooks, manager, stated that the information was available within the other documentation although a formalised health care plan not yet in place. The information was available in other records retained on the student, although quite cumbersome records may be difficult to extract information from. All care plans must be accessible and available for staff to use in their daily contact with residents and be reflective of the care that they require. A second health care plan, was limited in the information that was included in it and it was not fully reflective of the students needs outlining only three areas of need however in the assessment it was clear that other problems existed. The interventions for the three areas were very limited for staff to provide care from. Again other documents contained comprehensive detailed care requirements and care needed. Records of visits by the multi disciplinary team are retained in the Nurses file, and they are also recorded in the individuals file. The records provided information on the type of service visiting treatment and follow up. The College are currently assessing all students for skin integrity using the waterlow tool to ensure those at risk are identified quickly and action taken to prevent tissue damage. Risk assessments are in place to address the individuals needs, and these include use of transport, kitchen equipment and activities. Additionally risk assessments are in place to address all activities of daily living. Members of the multidisciplinary team give their expert input which gives additional support to staff who have to ensure these are workable. The use of bowel and bath charts should be avoided and this information retained individually. Whilst it is important that this information is retained these types of record charts are outdated , and an alternative system investigated. The College operates a key working system and those staff with whom we met were knowledgeable about the students needs, social activities, family support, preferences and how to best communicate with students. Key workers are where possible matched with students to promote and enhance working relationships for the best interests of all parties. Care Homes for Adults (18-65 years) Page 14 of 32 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 assisted to fulfil activities of daily living which are age appropriate . The College enables students to participate in educational recreational and social events with their peers which promotes confidence and independence whilst enhancing their quality of life. Evidence: Nash College is a residential and educational facilities for young people who have profound learning difficulties as well as other problems including physical disabilities and mental health. Periods of observation were undertaken by the expert by experience, Jackie who spent some time with students and staff who supported them, in the canteen, during mealtime period, and also had lunch with them. She used picture symbols to Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: communicate with some students. She observed the majority of staff to be sensitive to the students needs assisting them demonstrating patience whilst giving assistance as required. She reported that there was a friendly atmosphere. She observed there to be good relationships and rapport between students and staff. One example of this being a support worker singing to a blind student who turned his head towards her face and smiling. One student G said: I feel happy here, I like drama. Students were encouraged and enabled to make choices. An example of this was a staff member saying to a student in a wheelchair who had been screaming for some time: show me where you want to go. He stopped screaming, indicating where he wanted to go. She then sat with him near the entrance of the building where he chose to sit, massaging his hand. There were many examples of positive care interactions between staff and students. However one example of poor practise was witnessed as follows:One staff and student interaction was observed where the staff member demonstrated limited patience with the student. She offered him meals which he did not eat, finally she told him he would not go horse riding unless he ate the meal. this was felt to an inappropriate response to the situation and outside of therapeutic interventions. It must be stressed that this was only one of many interactions seen however this approach is inappropriate and must not be used. The meals were varied with healthy options and a vegetarian option with the dessert including choices such as fruit and yogurts. Staff were seen to actively offer choices to students and demonstrate patience whilst assisting them. A wide range of activities is available including relaxation classes, music,gym sessions, art and design swimming, horse riding and external entertainers are also arranged. The expert by experience had an opportunity to meet with a Mencap staff member who was employed to find employment opportunities for students. Currently three students were on placement in the kitchen getting work experience. This is to be commended. Care Homes for Adults (18-65 years) Page 16 of 32 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 are provided with a comprehensive package of support and care from the multidisciplinary team to ensure the complex nature of their health care can be fully met. Medications need to be more carefully addressed to ensure safety to students . Evidence: There was evidence that there was good support from the care staff as well as the multi disciplinary team members many of whom are on site. The multi disciplinary team includes a specialist in Epilepsy as well as a Psychologist. All staff work collaboratively including the educational staff for the best interests of the student. The College has the benefit of a multi racial staff group and a mix of male and female workers which can assist when key workers are allocated. Preferences regarding gender care are established at the assessment process and can be included in their care plan. Personal support needs are set out in the individual care plans which are developed from the assessment information which is obtained prior to starting College. Any equipment necessary is provided and there is also a lot of aids and adaptations in the Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: buildings. The support plans are specific to the individual student and detail the assistance required with activities of daily living. The College has a sick bay in the nurses area. Some students are registered as temporary residents with a local GP during term time, the majority are permenant. The pharmacist undertook the medication inspection. The following were her observations: At this inspection, there was evidence that medication handling has improved. The medication policy was updated in December 2007, and staff administering medicines have all had additional training. Although nurses administer all medicines whilst people are at the College, non-nursing care staff administer medicines when students are away from the College e.g. at day centres. There is evidence these staff have had training in administering epilepsy rescue medication, however no competency assessments have been completed, and these must be done according to the services medication policy. We were told that these assessments will be carried out in January 2009. We observed medicines being given at lunchtime, and this was carried out accurately. Staff were seen to take time and encourage students to take their medicines, as a result there were no missed doses and compliance with medicines is good. One person at the home has their medicines added to food. A care plan must be in place for all medicines added to food or given covertly, after the appropriate discussions and approvals at a best interests meeting. Administration records and disposal logs are kept and were accurate. There is now an improved system for the ordering of medicines, so no medicines were out of stock, however a significant number of receipt dates and quantities were missing for medicines received mid-month. Because dates and quantities of receipts are not always recorded, an audit trail could not be carried out for some medicines to ensure that all medicines can be accounted for. All prescribed medicines were stored securely. Some when required controlled drugs are stocked in excess, as these are not used often, and some were not labelled. A controlled drug destruction kit must be obtained from the clinical waste company so that the excess can be destroyed. Staff should also consider ordering when required medicines when these are needed, and not every month, to avoid overstocking. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: One prescribed item, eardrops, had not been administered for 2 days in December 2008 as the drops had been stored in the fridge in error. All prescribed medicines must be stored at the correct temperature. One inhaler was not labelled with instructions, although the medication administration chart did have instructions for use. This was because the pharmacist had labelled the box, and this had been thrown away by the perents in error. All prescribed medicines must be labelled with the instructions for use. Care Homes for Adults (18-65 years) Page 19 of 32 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. Students can be assured that all complaints and allegations of abuse are taken seriously, fully investigated and the appropriate action taken. Staff were knowledgeable about the actions to take in such an event and supported by specially trained staff. Evidence: The organisation takes complaints very seriously and endeavours to enable any person wanting to raise a concern to do so. Pictorial assistance is available and information on how to make a complaint is contained within many documents produced by the College. There are policies and procedures to follow which include time frames for responses. In previous contact the organisation has demonstrated an open and honest approach when investigating complaints and has taken the appropriate action. During the time staff met with us they were asked about abuse and whistle blowing and their knowledge of reporting such. Their knowledge of the subject, local procedures and reporting mechanisms was good and students can be assured that the appropriate action would be taken in such circumstances. Those staff who were interviewed gave good responses to questions asked and were aware of the procedures in operation as well as reporting such matters. The term whistle blowing was understood and staff aware of when it was appropriate Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: to evoke such procedures. The College records all complaints on specific forms. All complaints are carefully monitored for any re occurring themes and audits these regularly. The home has a designated POVA officers who take the lead on safeguarding issues and training. Staff stated that an open ethos prevailed throughout the College and those interviewed felt that they could approach the Management team at any point for support and advise. In one comment card completed by a relative they stated that complaints were handled satisfactorily. Care Homes for Adults (18-65 years) Page 21 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building provides an adequate standard of accommodation that is maintained. Many areas have benefited from refurbishment to give students comfortable communal and personal space. Evidence: The expert by experience who is a wheelchair user, noted the following in relation to the building The College was tidy and clean and the toilets and all the areas in the building were wheelchair accessible. It was easy to find my way around using sign posts. The College site has been adapted as far as possible to promote the students independence. The College acknowledges that the site does not fully meet the needs of some students although it continues to improve individual and communal areas. There is a vast amount of specialist equipment in use which is required by the individual student population. On occasions storage of this can be a problem although every effort is made to ensure the college is hazard free. During the visit all areas were seen to be clean and hazard free. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Bedrooms were personalised and it was obvious efforts had been made to improve the living accommodation for students. The College has full time maintenance staff on site to deal with any repairs needed, in addition service contracts are in place for all equipment. All of this provides students with safe and suitable accommodation. Care Homes for Adults (18-65 years) Page 23 of 32 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. Staff are provided in sufficient numbers to meet the students needs. Staff are provided with mandatory training and that which is specific to the area of work and needs of the students. Robust recruitment checks ensure staff are safe to work with the students. Evidence: Since the last inspection the staffing levels have been increased, more qualified staff have been employed. During the course of the visit staff spoke to us relating their experience of working at Nash College and in particular their induction, training and on going support. Staff have a one week induction which was confirmed by staff with whom the inspector spoke to. The induction is a week long and staff were clear that there was lot of learning disability topics covered. The statutory topics are included in induction with up dates on a regular basis. The staff stated that they were supernumerary and worked alongside an experienced staff member which was in her opinion very useful. Included in staff development are five INSET days which are mandatory training updates. These cover a varied selection of topics including diversity, learning disability and other topics. Learning disability training is provided during the first week by the Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: Psychologist in addition specific study days dealing with the topic were provided. Weekly supervision is in operation for all new staff. Supervision is an opportunity to raise work issues, training needs and recieve advice and support. Staff personnel files were inspected, good records relating to recruitment were retained. These included an application form, two references , POVA first and CRB checks, contracts as well as supervision and induction records. References received were on official headed paper or verified by way of a company stamp. The deputy head of care was interviewed . She confirmed that all of the above measures had been addressed prior to employment in addition her NMC registration had been confirmed as well as identity checks. One staff interviewed said that she had no previous experience with this type of setting or learning disability however she felt the induction was sufficient and she was learning on the job. She confirmed that training was provided internally as well as externally, her next training was on Autism. The training records seen indicated that a lot of training was provided on various topics and that staff attendance was good. The College has links with Bromley Primary Care Trust which provides training to staff. The specialist learning disability team, based at Bassetts Centre, also did training in the College for staff and they offer on going support and advise. One comment card did refer to the level of aggression that staff were subjected to and the stress this posed. This topic is addressed throughout training, although staff may require more extensive training on the subject. All staff are subject to through recruitment procedures and a six month probationary period which can be extended if needed. Care Homes for Adults (18-65 years) Page 25 of 32 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. The College is managed by a competent individual who has support systems in place through the organisation and within the college itself. Health and safety issues are well addressed and this provides students with a safe place to live. Quality assurance measures take into account the views of students, staff and others to identify areas where improvements could be made. Evidence: The College have a health and safety committee which meet a minimum of three times a year. There is an operational health and safety action plan where issues identified are actioned within time scales. Health and safety information has been reproduced in Makaton to enable students to us it. There are eight first aiders in the College and one is on every shift. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: There was comprehensive fire risk assessment which covered all sites which form part of the college. Fire alarms were tested weekly with extinguishers and fire blankets regularly serviced. Fire training was documented and signatures confirmed staff attendance. Attendance records showed many health and safety training topics are included in regular training sessions. All lifts and hoists are regularly serviced and 24 hour call our contracts in place in case of breakdowns. The portable electrical appliance testing was done February 2008. Nash College set strategic objectives for a three year period the current one runs from 2005 - 2008 . There are a number of quality measures in place including forums for staff, student meetings, regular reviews of students care package by care managers where the student and families are invited. Policies and procedures are in place and were reviewed March 2008. Staff are invited to participate in the annual staff survey where their views on the service and their working life are sought . Results of the survey are collated and a report produced. The student survey has been produced in pictorial format and again a report on the responses produced. There are plans to change the survey to be more user friendly and this is underway. Statistics on ethnicity and gender are produced which are used to monitor and inform the needs of the staff group. Where possible students are matched with staff of the same culture. Audits of documentation are conducted where by three students are randomly selected for tracking to ensure all relevant paper work is in place. An audit of student leisure and social activities is conducted to ensure there is a balance in work life and that all students are treated equitably when activities are arranged and not only a selected few are taken. In addition eating and drinking audits monitor students nutrition and hydration as well as food preferences choice and variation in the menu. The organisation has a Quality Assurance officer specifically to monitor quality in the service. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: Regulation 26 reports were seen in respect of the monthly unannounced visit Care Homes for Adults (18-65 years) Page 28 of 32 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 32 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 1 21 13 All prescribed medicines must be labelled with the instructions for use. Correct and accurate labels on medication will reduce the margin for error which may adversely affect the student 31/01/2009 2 21 13 Students who require covert 31/01/2009 medication namely medication disguised in food or drink must have supporting documentation in place to evidence the decision making process, review period and the specific reasons for such actions. Students need to be afforded protection in respect of medication issues to ensure they receive the correct medication for the right reasons . 3 21 13 Competency assessments must be carried out an all 31/01/2009 Care Homes for Adults (18-65 years) Page 30 of 32 staff who are involved with administering medication specifically the non nursing staff. All staff must be competent in medication administration to prevent errors occurring which may adversely affect the student 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 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!