Inspection on 06/11/06 for Portland College

This inspection was carried out on 6th November 2006.

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

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

CARE HOME ADULTS 18-65 Portland College Nottingham Road Mansfield Nottingham NG18 4TJ Lead Inspector Jayne Hilton Key Unannounced Inspection 6th November 2006 06:45 Portland College DS0000036393.V317807.R01.S.doc Version 5.2 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 Portland College DS0000036393.V317807.R01.S.doc Version 5.2 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. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Portland College Address Nottingham Road Mansfield Nottingham NG18 4TJ 01623 499100 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) quentinc@portland.ac.uk Portland College Quentin Colley Care Home 135 Category(ies) of Physical disability (135) registration, with number of places Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 Rooms measured below 10sq meters are not used for wheelchair users Date of last inspection 21ST October 2003 Brief Description of the Service: Portland College is a dedicated Further Education College offering a wide range of courses designed to enable young people with disabilities to develop to their full potential, both academically and in a wide range of daily living skills. Situated on Nottingham Rd Mansfield, Nottighamshire, the college, which is a Registered Charity provides a unique service to young adults and 16and 17 year olds with Physical Disabilities who by nature of their disability require a degree of care and support not provided by local colleges of Further Education. Portland College has 135 beds registered under the Care Standards Act 2000.The Registration covers those students with a physical disability and who receive personal care as part of their placement at the college. Fees are arranged dependent on the support needs of the individual. The Learning and Skills Council mainly sponsor the education support packages of these young people. Students are informed about CSCI inspection and how to access the reports of the inspections at an initial presentation upon admission to the college and within the Student Guide. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two Regulation Inspectors undertook the unannounced key inspection over two and half days. The Information was gathered from a pre -inspection questionnaire received at the Commission for Social Care in August 2006, examination of documents requested, by, CSCI. Many staff were spoken with including the registered manager, departmental managers, care tutors and other personnel. A sample of ten students care plans were selected and six students were case tracked [the detailed examination of students care plans and assessing how the care needs of those individuals were being met]. A tour of the many buildings was facilitated and several records, including a selection of staff personal files were examined. A large sample of students were spoken with and one relative. The Commission for Social Care received eight completed student surveys for and comments made by students have been included within the report. Because there are a small number of students at the college who are 16and 17 years of age the supplementary standards for this age group have also been assessed at this inspection and are included within the overall evidence sections. What the service does well: Student benefit from a well managed environment with an excellent ethos, leadership and management approach. Students are confident their views underpin all self –monitoring review and development of the college and that their health safety and welfare are promoted and protected. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 6 Students have the information they need to make an informed choice about their college placement and have their individual aspirations and needs assessed. Students confirm that they feel their needs are met and outcomes for students are extremely positive. Students confirmed that they have opportunity to visit and test drive the College and have written contracts for their placement and residence agreements are in place. Equality and Diversity issues are well addressed on the whole at the College and there was much evidence seen that the management, staff and students of Portland College are committed to developing a community which supports equality, diversity and inclusion. Students know, their assessed and changing needs and personal goals are reflected in their individual plan and are supported to take control of their own lives, within a robust risk management framework. Students participate in student council meetings, residential block meetings and other forums and are regularly consulted about life in the college. Students have opportunities for personal development and can take part in a wide range of age peer and culturally appropriate activities and are part of the local community. Student’s rights are respected and responsibilities recognised in their daily lives. Students are offered excellent catering facilities, support with eating and are provided with a healthy diet, enjoy their meals and mealtimes. Students receive personal support in the way they prefer and require ensuring their physical and emotional health needs are met. Students retain, administer and control their own medication where appropriate, and are protected by the college’s policies and procedures for dealing with medicines. Students feel their views are listened to and acted on. Students are protected from abuse, neglect and self – harm. Students live in a homely, comfortable and safe environment, with excellent facilities, bedrooms, bathrooms, toilets and shared space to meet their individual needs and promote and maximise independence. The college maintains standards of cleanliness and hygiene throughout. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 7 Competent and qualified staff that work as an effective team supports students. Students are supported and protected by the College’s recruitment policy and practices and appropriately trained and supervised staff. What has improved since the last inspection? Medication Management systems have been greatly improved to ensure safer practice. Student’s benefit from the many improvements made to the environment since the last inspection, including conditions of registration being met. The communal bathing facilities in the Laurels are fully refurbished by 2005 and those in the Firs are fully furbished by 2007. Fully Met. The fitted furniture in the bedrooms that are damaged through wheelchair use must be made in good order and maintained to standard. – Fully Met. New Carpeting has been fitted in the Elms and Laurels in all corridors and bedrooms. ‘Welbeck’ accommodation has all new ceiling lighting and lowered ceiling in place. The Laurels Lounge has all new carpets, dining furniture and seating and the ceiling has been lowered, the laurels kitchen has new dining furniture and fixtures. The Elms Lounge has all new furniture, TV, DVD and Video player. The Firs accommodation has new lowered ceilings and lighting, new carpets, new kitchen all rooms decorated, new lounge and dining room furniture. Combination door locks have been fitted to office areas and sluice rooms to restrict access to student’s personal information and hazardous areas. Overhead tracking hoists have been fitted in bedrooms and a number of new specialised bed systems have been installed. A new call alarm system has also been fitted providing improved and up to date facilities for students. New infection Control policies have been developed. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 8 Improvements have also been made in the disposal of clinical waste. Bin areas and new contracts have been instigated, ensuring any risk of cross contamination is minimised. What they could do better: It is recommended that the new Statement of Purpose and Student Guide documentation sets out the expectation of the college that students will take responsibility for their own leisure time during evenings and weekends. The assessment document should be further developed to ensure as much information as possible is captured. The section for Cultural and Religious needs should be expanded to address if the student wishes to bring any specific personal items for use in their room. Further development and consolidation of the care planning system would further improve the outcomes for students. Students have appropriate personal and family relationships; however further development of this area and the current policy would further improve outcomes for individuals who may wish to enjoy sexual relationships within the boundaries of the College/University lifestyle. Improved practice is recommended in relation to the record keeping of student finances. It is recommended that all staff receive at least six supervision sessions a year. It has been recognised by the students and the inspectors that the college has made the start time of classes flexible to allow more time in a morning for personal care, however it is recommended that students all tutorial and residential staff review the systems in place to further improve the communication channels in relation to the issues raised by students. Provide sanitizer dispensers in the offices/ medication storage rooms Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 9 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. The summary of this inspection report can be made available in other formats on request. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 10 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 Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Students have the information they need to make an informed choice about their college placement and have their individual aspirations and needs assessed. Students confirm that they feel their needs are met and outcomes for students are extremely positive. Students confirmed that they have opportunity to visit and test drive the college and have written contracts for their placement and residence agreements are in place. EVIDENCE: A revised statement of purpose has been produced to reflect all updated information. The College Principal is retiring late November 2006 and the newly appointed principal is to become the new Responsible Individual from this date. A further review of the statement of purpose is therefore planned. It is recommended that the new documentation sets out, the expectation of the college that students will take responsibility for their own leisure time during evenings and weekends. Information is displayed on the various student notice boards about the Statement of Purpose and how this can be accessed. Copies of the student Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 12 guide were seen displayed on notice boards around the campus and students confirmed that they receive a copy on their arrival at the college. Assessments are carried out for all students prior to commencement of their placement at the college, using a multidisciplinary approach and usually start as part of the young persons “Transitions planning” whilst at School. Once Portland is selected by the student a member of the admissions team staff visits the student and spends time explaining to students about the courses on offer and how their care and support needs will be provided for. Once the college is sure that the college can meet the assessed needs of the individual,, students are invited to attend a three-day residential assessment. It is only after this assessment visit, if all are confident is a place offered. The registered manager reported that the recent ALI/Ofsted inspection identified the multi-disciplinary assessment team approach as strength. The assessment document should be further developed to ensure as much information as possible is captured. The section for Cultural and Religious needs should be expanded to address if the student wishes to bring any specific personal items for use in their room. Equality and Diversity issues are well addressed on the whole at the College and there was much evidence seen that the management, staff and students of Portland College are committed to developing a community which supports equality, diversity and inclusion. Equality and Diversity Policies are in place and training provision for staff. Portland has its own EDI [Equality, Diversity and Inclusion] Committee, which provides students with access to advice and guidance on bullying, harassment and discrimination issues a swell as general support on EDI matters. The College held it own ONE day for the third year, in July 2006, which provided a whole college training day to embrace and celebrate diversity. The College also held its own Conference and workshops on The Disability Equality Scheme in October, which students contributed to the programme. Students are provided with a residence agreement and these were seen within the care plans examined. Care staff is matched wherever possible to meet the individual needs of students such as cultural or where English is not the student’s first language. Students spoken with reported that they were happy with the facilities and services provided by the college. Students expressed various suggestions and views about the systems in place and stated that they can also voice these Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 13 through the student Council representatives and minutes of these meetings were seen. One suggestion made by students to the inspectors is that a more user friendly and practical map of the campus is needed for new starters and that they would look to develop this within their educational groups. Students and staff discussed the systems used by the college to help new students, such a buddy system or students identified by badges which state, “I’m here to help” Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students know their assessed and changing needs and personal goals are reflected in their individual plan and are supported to take control of their own lives, within a robust risk management framework. Students participate in student council meetings, residential block meetings and other forums and are regularly consulted about life in the college. Further development and consolidation of the care planning system would further improve the outcomes for students. EVIDENCE: Care plans are devised from the original assessment and are based on the Data bridge format and sets out specialist requirements through planned interventions and therapy and these dovetail with the Individual Learning Plans which students confirm they are involved in and sign they agree to. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 15 The medical centre holds separate care plans and information in relation to the healthcare needs of students. The plans are currently under further development and those seen were written in both straightforward language and symbols for students who cannot access text. As the current systems in place hold different information about students for many different reasons, this did cause some initial difficulty for the inspectors to case track the full care input by professionals and care teams and particularly for the monitoring and evaluation of this. For example one students daily notes indicated a query about advice being sought from an on site physiotherapist about transfer equipment, yet there was no reference to a change of equipment in the actual care plan, or that this had indeed been followed up. The correct equipment was seen, to be identified on the computerised system however this is clearly an area for further development. Another example was that another students care plan did not identify information gained from staff about their knowledge of the persons preferred term of address or audit trail for language development. On further exploration it became clear that the students input from the on site speech and language therapist clearly identified and addressed the individual students needs and there was some excellent work seen on “ All about me” books that students carry with them throughout their college daily routines. One students care plan contained different information about bathing arrangements than what the student said these were and therefore needed an update. That said the complete set of plans are person centred and innovative methods are used to enable students to participate and communicate their views to the development of skills and future aspirations. A key worker system provides additional support enabling one to one involvement. All students spoken with knew about their plan and some had specific views about what information should be kept where in respect of their privacy. From both observing and speaking with management, staff and students it was clear that the ethos at the college is that students are supported to take control of their own lives and to encourage and enable them to exercise their rights and make their own decisions and choices. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 16 Students felt that they should be able to choose the frequency of one to one reviews of their plans with their key worker. These are currently reviewed at least every term time or when needed. It is recommended that this option be part of the care plan. The Plans seen contained risk assessments and describe any restrictions on choice and freedom and authorisation is included within care plans such as use of bedrails, listening devices/alarms. It is recommended that this area be further developed however to include detailed information of the risk involved and a hand signed declaration by the student/or their representative that they are fully informed of the risks and have made their choice/agreement based on these. Thus ensuring that an informed choice is always facilitated for students to take risks. Where a student is for example not permitted to travel independently off campus this is sensitively recorded within the plan with relevant justifications and risk assessments. The student guide informs students that they will be involved in any decisions if it is felt they should be prevented from doing something or taking part in an activity. Advocacy services are to be provided shortly, by a local advocacy service that is to attend the college twice a month. The agreement for this package was seen. Further improvement within care plans is recommended to include alcohol, smoking, personal relationships, personal care, shaving options and assistance with facial hair, gender preferences, preferred term of address and general evaluation and follow up, cross reference to other plans and professional input and dates and signatures. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17, Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Students have opportunities for personal development and can take part in a wide range of age peer and culturally appropriate activities and are part of the local community. Student’s rights are respected and responsibilities recognised in their daily lives. Students are offered excellent catering facilities, support with eating and are provided with a healthy diet, enjoy their meals and mealtimes. Students have appropriate personal and family relationships; however further development of this area and the current policy would further improve outcomes for individuals who may wish to enjoy sexual relationships within the boundaries of the College/University lifestyle. EVIDENCE: Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 18 Each student has a dedicated learning plan that identifies transition planning via connexions. Students have access to work experience programs and a wide range of vocational activities. The College has a dedicated independence team that works with the educational team to deliver independence sessions. All staff work towards maximising independence opportunities for all students. Students have access to work experience programs and a wide range of vocational activities as the college has partnerships with local sector provider, schools and colleges and students are encouraged to engage with local community events and activities. The college arranges various fundraising events, which are supported by the local and wider community. Students were able to take part in the FREDA event in May 06. FREDA stands for Future Recruitment and Education Development Again. The aim of the event is to encourage students to consider all aspects of their life after Portland so with clear aims and targets students are able to make the most of the opportunities in learning, qualifications and independent living on offer during their time at the College. The ‘One Day’ Event to celebrate Equality and Diversity and Inclusion has already been reported upon earlier in the report. The college has a dedicated enrichment and sports co-ordinator and which a wide range of activities are on offer in and outside of the college. Events and excursions were seen posted on the notice boards. Trips are also arranged annually such as exchange trips with students from other countries. The Enrichment guide states that “The Enrichment Programme is about, providing opportunities, increasing awareness, developing skills, building self esteem, trying things out, taking responsibility, having informed choices, being supported, gaining information and advice and most importantly FUN!” The Enrichment Guide includes, Archery, Art Group, Boccia, Cinema Club, Communication Club, Computer Club, Christian Union, Disco/Karaoke, Drama Club, French Club, football, Handicruisers, Hydrotherapy, Live band nights, new start Bar/club, Physiotherapy, Pop In, Power Chair Soccer, shopping bus, signing club[Makaton], S.M.I.L.E [Saturday Mornings in Laurels] Student Forum, Table Cricket, Wheelchair Basketball and Rugby, Women’s Groups and Youth achievement. Trips out include local, regional and national amenities, Drayton Manor Park, Trafford Centre, Deep, Cadburys World, Twycross Zoo, Museums, Air shows etc There is an expectation of the College that students will take ultimate responsibility for their own leisure time on evenings and weekends and there are facilities such as New Start club, a social club [bar and disco] and sports Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 19 clubs, Youth Service on site. The college its own bank on site supported by HSBC bank and which students work in also. Some students expressed that they can be bored at weekends and one relative felt that her son would benefit from more support to engage in activities at a weekend. It is recommended that the care plans explore this area in more detail in respect of choice, motivation, provision and ability to express needs to key worker and any action by key worker in supporting students to engage in activities of their choice. Students also felt that although they appreciated the opportunity of the provision of bus trips into the local town, that this was not always as often as they would like at weekends due to the logistics of a fair system that also has to take account of wheelchair space in the bus. The Enrichment guide indicates that the bus shuttle service starts at 9.30am and runs through to the last pick up from the town at 4.15pm. Students have voiced their concerns within the student forums and the college has introduced shopping trips throughout the week as part of student’s independence programmes where possible. Two students informed the inspectors that they were involved in a personal relationship and that this was respected and supported by staff under College Rules. There is a policy in place to support students to develop and maintain relationships as part of their residential experience. Using external agencies and internal support the college endeavours to offer a diverse range of services to support students to develop relationships that reflect equality, promote individuality, respect rights and choices whilst promoting their physical and emotional well being. It is recommended that the policy be reviewed to include clear guidance for students and staff of how this is to be reflected in practice and rules on accommodation blocks for visitors. Students are encouraged to maintain contact with their family carers whilst at the college. Many students have their own mobile telephones and there are payphone facilities throughout the campus. Internal telephones are equipped with Hands Free Kits to promote access to privacy. Friends and carers are able to visit at any time though the college request that visitors are mindful that students need to attend classes and respect controlled access and visitors protocol. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 20 Students confirmed that they are issued with keys for their room and for lockable facilities and some were observed using them to gain access to their rooms. Access to the accommodation blocks is via security cards. It is recommended that care plans be implemented for the use of keys. Students and staff explained that keys are sometimes lost or forgotten on return from term/weekend breaks and that they are a costly item for the college to keep replacing. It is recommended that the college explores with students and staff innovative ideas to reduce the number of replacement keys needing to be provided. Students confirmed that mail is given to them unopened and staff provides assistance. A post box is sited within the campus for outgoing mail. A sample menu was submitted and provides evidence of a nutritious and varied range of meals on offer for students to choose from. The provision includes a soft option, hot servery, salad bar, theme bar and the catering department continues to develop its excellent services. The College has adopted the Government’s Agenda for Healthy Eating and the vending machines supply more healthy snacks and drinks. A brunch has been introduced at weekends as students had requested more flexible weekends. The College has successfully retained the hospitality assured status for the second year. The food bars include colour cues for students to identify the five food groups and healthy options, which are offered everyday. There are also indicators to identify which food is suitable for vegetarians and those which contain nuts etc. The speech and language therapists and the nursing team work closely with the catering staff to support students with special diets for medical reasons. There is a ‘healthy club’ one night a week and the catering team have produced a range of leaflets to assist students with healthy eating and how to understand the colour cues. The dietary needs and wishes for people from minority and ethnic groups are catered for. The catering manger was able to demonstrate how this is facilitated and explained that special arrangements have been agreed to accommodate one particular student’s cultural and specific catering needs. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 21 Special moulds are used to ensure soft diet options are served in a more appetising way. This information was noted to be fully documented in one of the student’s case tracked. The inspectors sampled food from the menu during the inspection and agreed with student’s views that the food was of excellent quality. Some students naturally said they preferred their parents or carers cooking and some said they would like more things like pizza and the catering department have introduced an evening take away service, which also promotes healthy eating. Active independence programs are in place to encourage students to participate in food and meal preparation as well as family eating as part of the curriculum. Students were observed undertaking these activities. Where students require support for eating this was observed to be carried out appropriately and sensitively. There were many individual aids and methods of assisted feeding observed to be in use and individual care plans were discreetly placed within the dining room to ensure that all staff can access information of any individual should they need it. Students made comments that they sometimes have to queue for their meals at peak times, one student reported that he chooses to go to the dining room when the rush has calmed. The queues observed during the inspection appeared to be soon dispersed particularly in respect of the many food bars and choices on offer for students and the traffic created by wheelchairs. The atmosphere could be compared with any College or University dining room/canteen and staff observed to assist students with communication difficulties to make choices. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 22 Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Students receive personal support in the way they prefer and require ensuring their physical and emotional health needs are met. Students retain, administer and control their own medication where appropriate, and are protected by the college’s policies and procedures for dealing with medicines. EVIDENCE: As stated previously care plans are devised from the original assessment and are based on the Data bridge format and sets out specialist requirements through planned interventions and therapy and these dovetail with the Individual Learning Plans which students confirm they are involved in and sign they agree to. Care Co-ordinators are appointed on each residential area to ensure standards are met and maintained. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 24 Whilst students are at the college they register with a local medical practice. The medical centre staff are qualified nurses who oversee and co-ordinate the health care needs of all students, including mental health needs and sexual health issues. The medical centre holds separate care plans and information in relation to the healthcare needs of students. Plans include strategies for dealing with challenging behaviours, interventions, therapies and health issues and for eating and drinking and moving and handling, tissue viability, medication, continence etc. Students have access to excellent onsite facilities and professionals such as physiotherapy, speech and language therapy, hydrotherapy and a separate medical centre. One student and relative made comments that personal care such as shaving, and facial hair, nose and ears were perhaps not attended to as preferred. The personal care charts seen were not always completed and there was an indication that the record sheet for this purpose needs review. Observations on the day evidenced that personal support is provided in private and students confirmed their dignity, was upheld by staff when assisting them. Accommodation blocks have wheelchair charge and maintenance rooms. Gender preferences of staff are met wherever possible. The student charter states “At Portland College all students will be treated with respect and valued as individuals” Be given opportunity to state their own needs independent of any other influences. Have their own beliefs, choices, preferences and wishes recognised and respected. Be given the right to privacy and confidentiality. Be given information, which is clear and helpful when it is needed. Students and staff confirmed that bedtimes and getting up times were flexible at weekends however students are expected to take responsibility for getting up in time for college tutorials. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 25 Whilst students spoke highly about the assistance and support they get from staff, they explained that sometimes they can be late for classes due to having to wait for assistance when staff are busy supporting other students or dealing with events as they arise. The students said that most tutors are, understanding if they are aware of the difficulties when they arise, but it was evident that the communication systems at these times could be improved between residential units and the teaching staff. Students also voiced that tutors sometimes have to change class rooms on occasions for valid reasons, but that it sometimes causes unnecessary distress and confusion to students, particularly if they cant read notices and they are late because of having to wait for their care needs to be met. It has been recognised by the students and the inspectors that the college has made the start time of classes flexible to allow more time in a morning for personal care, however it is recommended that students all tutorial and residential staff review the systems in place to further improve the communication channels in relation to the issues raised by students. A follow up visit was made to the College after the last inspection, which focused on the area of medication. A pharmacy inspector visited the College on 10th December 2003 and January 2004 to view the facilities and give advice on medication issues. Since the previous inspection the college employed the services of an independent consultant and has employed a medical centre nurse manager. Medication administration has been devolved to the responsibility of staff on the accommodation units with oversight from the nursing staff in the medical centre. All staff responsible for administration of medication has undertaken accredited training. A monitored dosage system is in place and care plans contain detail of individual’s medication. The college has developed its protocols, under a risk management framework to ensure medication errors/near misses are fully evaluated and minimised. The policies now in place aim to maximise student’s independence and these have been developed and improved over the last two years. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 26 Service users can retain their own medication should they wish to and evidence of risk assessments and capacity of consent documentation was seen for this. Lockable cabinets are provided in student’s rooms. All records received, administered and leaving the home or disposed of, were found to be satisfactory as was a sample cross reference and balance check. The system is complex and was excellently organised. Observation of staff administering medication on one accommodation block was satisfactory. Staff were observed to ask students their identity and confirm preferences for pain relief medication and how they took their medication. Innovative practices have been introduced such as staff wearing identifiable tabards when administering medication, which informs students and staff not to distract the responsible staff member from their medication duty. A Pharmacy Audit by the Primary Care Trust was undertaken in July 2007, no requirements were made at the visit. Key staff held medication keys, on the day of the inspection and a system is in place to ensure handover and security of these. It is recommended that hand scrub is provided within the offices/medication storage areas. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 27 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students feel their views are listened to and acted on. Students are protected from abuse, neglect and self – harm. Improved practice is recommended in relation to the record keeping of student finances. EVIDENCE: The College has a clear 3-stage complaints procedure. Evidence was seen that complaints are fully recorded and that the college looks at improving service where shortfalls may be identified. Multi disciplinary meetings are held weekly to discuss students of concern. Students are informed about how to complain by posters on notice boards around the campus, within the student guide, and on the college intranet. One student commented that they did not know how to make a complaint but all of the students and relative spoken with confirmed they knew how to make a complaint and said they felt confident that they would be heard and complaints would be dealt with. Between September 2005 and June 2006 there have been six recorded complaints dealt with formally. Five were partially substantiated and one is pending an outcome. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 28 A number of actions were implemented in direct response to those complaints judged to be, partially substantiated. Student council meetings provide a forum to raise any concerns. The Student Voices Newsletter identifies many areas of improvement achieved, such as re-allocation of hoists in some areas, new hand towel machines, additional mirrors purchased, water fountains provided, improved communication and information shared. Improved social and independence activities held on residences. Door settings modified to increase ease of access. Marked clearway extended to the coffee shop. Vegetarian yoghurts now available, Saturday Brunch style grill now available, fresh orange juice available, more handled non slip trays purchased for dining room, The pre inspection questionnaire states that complaints are responded to within the 28 days. Evidence seen in the complaints records supported this. Notifications have been received by CSCI, which evidence that the college follows the Nottinghamshire protocols for Adult Protection and Child Protection. The College responds promptly to any allegations made by students and has clear procedures for staff to follow with guidance for support for individuals, staff and students whilst investigation ensues. Multi-disciplinary team meetings are held weekly. Staff receive training in abuse awareness and the College has launched two new initiatives-Keeping U safe, which is a campaign for ensuring that all students and staff are aware of the issues facing students, work on protection issues and provides clear guidance and support relating to the safety and well being of children and young people. EDI- the college’s Equality and Diversity and Inclusion Committee, provides advice and guidance on bullying, harassment and discrimination issues. Records evidence staff training in adult and Child Protection, Equality and Diversity and Dealing with Challenging Behaviours. A student made comments that the College are ‘straight on with Bullying and send a clear message that bullies are not clever’ Policies seen included Absence without Authority, Personal Relationships, Reducing Problem Behaviour Student Charter, Dealing with Challenging Behaviour, Physical Intervention [includes restraint, Incident Management policies for child protection, adult protection and the prevention of bullying. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 29 The college has a CCTV system of which cameras are placed strategically around the campus and a security fence is now in place around the Elms and Laurels to reduce possible access to buildings from intruders. A sample of student finance records, were examined. Most students manage their own monies either through their own bank accounts or by means of allowances which the College hold on their behalf and provide support and accounting for. Of the sample of ten records examined, two of these identified areas for improvement. Not all transactions were supported by two signatures. Students should sign the finance sheets wherever possible. The sheets had gaps in entries of what the expenditure had been used for or the balance amount not entered. It is recommended that the record keeping and auditing systems for student finance records be improved. Staff dealing with student’s finances should be fully conversance with all of the spreadsheet columns on the system used. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 30 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Students live in a homely, comfortable and safe environment, with excellent facilities, bedrooms, bathrooms, toilets and shared space to meet their individual needs and promote and maximise independence. The college maintains standards of cleanliness and hygiene throughout. EVIDENCE: The College campus has been designed for people with physical disabilities and continues to be upgraded and modified over time to meet the changing needs of students and to comply with the Disability Discrimination requirements. All areas were well maintained ensuring a safe environment for students. The various units of accommodation are homely and students are involved in choosing décor and furnishings when these are renewed. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 31 There have been many improvements made since the last inspection, including conditions of registration being met. The communal bathing facilities in the Laurels are fully refurbished by 2005 and those in the Firs are fully furbished by 2007. Fully Met. The Fitted Furniture in the Bedrooms that are damaged through wheelchair use must be made in good order and maintained to standard. – Fully Met. New Carpeting has been fitted in the Elms and Laurels in all corridors and bedrooms. Welbeck accommodation has all new ceiling lighting and lowered ceiling in place. The Laurels Lounge has all new carpets, dining furniture and seating and the ceiling has been lowered, the Laurels Kitchen has new dining furniture and fixtures. The Elms Lounge has all new furniture, TV, DVD and Video player. The Firs accommodation has new lowered ceilings and lighting, new carpets, new kitchen all rooms decorated, new lounge and dining room furniture. Combination door locks have been fitted to office areas and sluice rooms to restrict access to student’s personal information and hazardous areas. Overhead tracking hoists have been fitted in bedrooms and a number of new specialised bed systems have been installed. Bedrooms were well equipped and personalised. Students confirmed they have keys to their rooms and lockable facilities. The toilet and bathroom facilities are excellent with the most up to date aids and adaptations to meet student’s needs. Students aged 16years and 17 years do not share bedrooms with others of significantly different ages. Facilities are provided in bedrooms to study seating, desk, storage space lighting etc. Call alarms are provided as required and type to each specific individual need. A new system has been provided. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 32 The College has its own Domestic Team to promote day- to- day hygiene to the minimum industry standards. Its team have all achieved NVQ1 in domestic support. An infection control working party is being developed by the nurse manager to look at practices and improve the quality of infection control procedures. All areas now have as an added support from the installation of hygienic skin sanitizer dispensers and there is a “Rub and Scrub” campaign across the college to promote hand washing and hygiene. Policies were seen for Infection Control. These are newly developed. Improvements have also been made in the disposal of clinical waste. Bin areas and new contracts have been instigated. All areas of the college were cleaned to a high standard and smelled fresh. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 33 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. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35,36 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Competent and qualified staff, who work as an effective team, supports students. Students are supported and protected by the Colleges recruitment policy and practices and appropriately trained and supervised. Staff. EVIDENCE: Staffing levels are based on the assessed needs of individuals and the learning Skills Council matrix criteria. Staff on duty on the day of inspection and as indicated on the duty matrix appeared satisfactory. There have been no complaints in relation to staffing levels provided. The Head of Care and Registered Manger reported that the meet on a regular basis to discuss and agree rescourcing requirements to ensure that the needs of students are met. The staff compliment includes a vast list of Departments with Departmental Heads and Teams and in house specialists such as physiotherapists, speech therapists and medical staff. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 34 Three shifts work a rota system, which consist of a Duty Manager, a Team Leader and Care tutors and a nursing team. Rigorous recruitment policies are in place, which reflect the practices followed. Six personal staff files were selected and examined. All were well maintained, with the initial recruitment documentation, Criminal Records Bureau Disclosure checks and two written satisfactory references. Further checks are made as needed to check identity of referees, validity of information supplied and Criminal Records Bureau Disclosure checks are renewed after three years. There are no volunteers reported to be working with students currently. Disciplinary actions were fully documented with support details for both staff and students. Induction records were seen. Staff confirmed they undertake an initial fiveday induction then mandatory training events held for all staff. Staff spoken with confirmed they are issued with a copy of the General Social Care Councils Code of Conduct Booklet. NVQ’s are a fundamental part of staff training at the College. All staff are working towards or hold relevant qualifications. The training Projection for September 2006 provides evidence that eight staff will be supported to undertake NVQ2 and eleven staff to undertake NVQ Level 3. Training provision evidenced Risk Assessment, Team Development, Child Protection, Adult Protection, Eating and Drinking, Health and Safety [includes infection control], Management of Electric Beds, Handling and Moving, Pressure Relief Management, Understanding Spina Bifida, Skills for Life, Hydrotherapy, Fire Safety, Equality and Diversity, NAPPI, Continence Management, understanding Autism, Heart start, Bereavement Counselling, Understanding MRSA. First Aid, Care File Management, basic food hygiene, Data bridge, sign language, communication skills, Makaton and safe handling of medicines Examination of Staff files provided evidence of regular one to one supervision and all staff are appraised annually. Staff spoken with said they found the session useful and productive. It is recommended that all staff receive at least six sessions a year. Staff who work with 16 and 17’s are aged at least 21 years. Induction training for staff working with 16 and 17’s includes guidance on child protection. The College holds the Investors in People Award Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 35 Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 36 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Student benefit from a well managed environment with an excellent ethos, leadership and management approach. Students are confident their views underpin all self –monitoring review and development of the college. The health safety and welfare of students are promoted and protected. EVIDENCE: The Registered Manager has the required qualifications and experience, is highly competent to lead the care staff in meeting the Colleges aims and objectives. The manager has sound knowledge of both strategic and financial planning and review and provides value for money through effective management. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 37 The manager is visionary in his approach to the service and communicates a clear sense of direction. He is able to demonstrate through formal qualification and experience and ability that he is highly competent in a range of areas such as service specific, good practice, current legislation and proposed developments, the quality assurance systems, equal opportunities issues, developmental and implementation of the service policies and procedures, good people skills, strong leadership of staff, responds to need and provides an excellent role model. Other professionals see the manger as an imaginative leader who consistently provides high quality services. The manager undertakes regular training. The management approach of the college creates an open positive and inclusive atmosphere. The Registered Manager demonstrated a clear knowledge of all students and the inspectors judgement made from observation throughout the inspection is that the there was a good rapport and mutual respect between all students and the Registered Manager who acknowledged every student met and made comment about something personally to each. The inspectors were also impressed with the mutual rapport and respect between care staff and students, the trust students had in staff and the positive attitude and happy environment engendered by all. Quality assurance systems are clearly in place offering a wide range of opportunities for students to bring forward their views. There is Quality assurance Overview, 2005-06 Annual operating Statement, Governors Meetings Minutes, Review and Monitoring, 2006-07 Annual Operating Statement. Self - assessment reports, Regulation 26 Provider visits and student assessment reviews and surveys. The College employs a Director of Quality, Planning and Development. Health and Safety Policies are in place and the College employs a full time Health and Safety Manager responsible for day- to- day Health and Safety of students and staff, who makes regular tours of the environment to ensure compliance. A sample of health and safety records were examined including electrical circuit test records, PAT [Portable Appliance Testing] records, call bells servicing and records for the prevention of Legionella and fire safety records. All were satisfactory. The Environmental Health Officer visited the College on 10th August 06. A recommendation was made to clean the extraction fans in the refrigeration room, otherwise the report states that at the time of the inspection, conditions Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 38 and procedures were found to be good and the college was found to comply with the Safer Food Better Business Regulations introduced in January 2006. Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 39 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 4 2 4 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 X 32 X 33 3 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 4 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 4 4 X X 4 X Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 40 No 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. Standard Regulation Requirement Timescale for action 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 YA1 Good Practice Recommendations It is recommended that the new Statement of purpose and Student Guide documentation sets out the expectation of the college that students will take responsibility for their own leisure time during evenings and weekends. 2 YA2 3 YA6 4 YA15 The assessment document should be further developed to ensure as much information as possible is captured. The section for Cultural and Religious needs should be expanded to address if the student wishes to bring any specific personal items for use in their room. Further development and consolidation of the care planning system would further improve the outcomes for students. Review the current system taking into account all aspects relating to care plans throughout the report. Students have appropriate personal and family relationships; however further development of this area DS0000036393.V317807.R01.S.doc Version 5.2 Page 41 Portland College 5 YA18 6 7 YA20 YA23 and the current policy would further improve outcomes for individuals who may wish to enjoy sexual relationships within the boundaries of the College/University lifestyle. It has been recognised by the students and the inspectors that the college has made the start time of classes flexible to allow more time in a morning for personal care, however it is recommended that students all tutorial and residential staff review the systems in place to further improve the communication channels in relation to the issues raised by students. Provide sanitizer dispensers in the offices/ medication storage rooms Improved practice is recommended in relation to the record keeping of student finances. 8 YA36 Provide supervision sessions for staff, at least six times a year Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 42 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Portland College DS0000036393.V317807.R01.S.doc Version 5.2 Page 43 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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