Inspection on 27/02/07 for Queen Alexandra College

This inspection was carried out on 27th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Queen Alexandra College 15/10/08

Queen Alexandra College 21/03/06

Queen Alexandra College 30/11/05

Queen Alexandra College 06/10/04

Queen Alexandra College 26/05/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Queen Alexandra 49 Court Oak Road Harborne Birmingham West Midlands B17 9TG Lead Inspector Amanda Lyndon Key Unannounced Inspection 27th February 2007 09:05 Queen Alexandra DS0000016808.V328609.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 Queen Alexandra DS0000016808.V328609.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. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queen Alexandra Address 49 Court Oak Road Harborne Birmingham West Midlands B17 9TG 0121 428 5050 0121 428 5048 enquiries@qac.ac.uk www.qac.ac.uk Queen Alexandra College 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) Mr Michael Gray Care Home 40 Category(ies) of Learning disability (40), Sensory impairment registration, with number (40) of places Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 21st March 2006 Brief Description of the Service: Queen Alexandra College hostels are registered to provide accommodation and support for forty students and specialise in meeting the needs of people with visual impairment and other disabilities. Students are supported to develop essential skills in order to prepare for independent living and personal care is generally not provided. This inspection report is in relation to the registered residential accommodation comprising of four fully equipped “hostels”, three on the college campus and one a short walking distance away on Lordswood Road, Harborne. The college has a number of other houses both on the campus and in the local community that are not registered but are providing supported living for students attending the college. The college is located in Harborne, Birmingham, is easily accessible by public transport and there are a variety of shops, restaurants, pubs, library and other facilities close by. There is ample off road parking on campus. The registered hostels are as follows; Thornton House: This house is made up of two units namely Hambland and TSB, (named after Trustee Saving Bank following a donation). Each unit is self-contained and is situated on the college campus. TSB, had ten bedrooms, two communal lounges, kitchen and a laundry. There is also an assessment room for prospective students. Hambland House has nine bedrooms, a communal lounge, kitchen, staff office and sleep in room. Thornton House accommodate higher dependency students. Winfield House: It is situated away from the main college campus, on the Lordswood Road and accommodates more independent students. It has twelve bedrooms, two lounges, separate laundry and kitchen with a dining area. Students who live at this house learn a mobility route from the college to the house, which they will access independently. In the summer of 2000 Winfield House was extensively refurbished. On the ground floor there is an office, a large lounge, large kitchen, dining room, laundry, smokers lounge, toilet facilities and three bedrooms. On the first floor there are a further nine bedrooms, staff sleeping in room, bathrooms, shower rooms and toilets, and a small kitchenette. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 5 Woodville House Woodville House is situated within the college campus there are eight bedrooms and a separate self-contained flat to enable the opportunity for one student to live more independently. All bedrooms are for single occupancy and are decorated in homely and appropriate styles. Aids and adaptations provided meet the needs of students staying within the hostels and staff are available to support and guide students as deemed necessary. Students are permitted to smoke within designated areas outside of the college. A copy of the most recent CSCI inspection report was not on display within the college and hostels for students, their parents and other interested parties to refer to. Funding is provided through the Learning and Skills Council or Jobcentre Plus and a fee of between £22,000 and £67,000 covers tuition, accommodation and food dependent on the student’s individual support needs. Items not covered by this fee include toiletries, washing powder, magazines and some leisure pursuits. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report includes the findings of two field work visits to Queen Alexandra College. The first visit was undertaken by one Inspector during an evening on an announced basis so that any students who wished to speak with CSCI at the end of their college day had prior notice of this. The second visit was unannounced and was undertaken by three Inspectors over the duration of one full day. There were thirty four students residing at the college during the second field work visit. Information was gathered by speaking with the Registered Care Manager, students, four staff members, case tracking three students and examining a number of written records including care plans, medication charts, staffing and health and safety records. A full tour of the college and hostels (with the exception of Hambland hostel) was undertaken. Prior to the field work visit the Registered Care Manager had completed a pre inspection questionnaire, giving some information about the Home, students and staff which was taken into consideration. Prior to the field work visits a number of positive comments were received, made by students at the college including “I have found it really helpful living in TSB as the staff help me out when I need support. I can tell the staff my problems and they can help sort them out” “I came to visit the college before I came to stay here” “They take me out to the cinema, swimming, shopping and to the safari park, I have a lot of fun” Negative comments were received including “The cleaners and maintenance don’t do their job properly” “The hostel is hardly ever clean and fresh” No immediate requirements were made during the visits to the college. What the service does well: Prospective students are encouraged to visit the college to meet staff and students. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 7 The college will only accept people to stay there if their needs can be met there. Students are encouraged to develop their life and social skills so that they can lead independent lives in the future. The manager and staff encourage the students to recognise their full potential by setting them achievable targets. Students are provided with clear guidelines about the expectations of behaviour and “ground rules” within the hostels. College and residential staff work closely together ensuring that students are encouraged to develop new skills at all times Students can choose to do the things that they enjoy each day after college and at weekends. There are lots of activities on offer that students can choose to do. Students are invited to take part in group meetings to discuss their lives at the college Staff are enthusiastic and are positive role models for students The staff work closely with parents concerning the overall care and well-being of the students and visitors are welcome. Students can continue to practice their religions whilst staying at the college Staff provide support to students ensuring that they access health care whilst staying at the college. Students receive their medication at the times they require Students are provided with a clean living environment and can bring in their own belongings to decorate their bedrooms so they feel comfortable and relaxed. Students have a choice of healthy and tasty meals. Aids and adaptations are provided if required in order to promote students’ independence. Staff work in small teams and have a good understanding of students’ individual support needs. There is a good system for the safekeeping of small amounts of students’ money should they choose to use this facility. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? What they could do better: Some written plans must include more detail of the individual support that students require from staff. A risk assessment must be undertaken in respect of an identified student’s “target” of arranging a weekend trip away from the college. Doctors permission must be obtained before the administration of medicines that are not prescribed. Skin disinfectants must be stored safely and be for single person use only Some areas of the hostels need to be redecorated and some kitchen furniture and work surfaces need to be replaced New staff must not start working at the hostels until all checks have been completed on them A copy of the CSCI report should be on display for students and visitors to read Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 9 Students should sign for all money given to the hostel staff for safe keeping and all money returned to them. Extra dining space should be provided in Woodville hostel so that all students could sit together at meal times. 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. Queen Alexandra DS0000016808.V328609.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 Queen Alexandra DS0000016808.V328609.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 good This judgement has been made using available evidence including a visit to this service. Prospective and existing students and their families are aware of the facilities and support provided at the college so that they can make informed decisions about whether they would like to reside there. EVIDENCE: The statement of purpose and service user guides were available in a variety of formats including large print, braille and audio CD so that they were accessible to all interested parties. One student said “ I got a book about QAC to help me decide to come here” All prospective students and their families are invited to the college in order to sample what life would be like to reside there. This may include an overnight stay and trial period in order to assess how well a student settles in. During this time comprehensive assessments of prospective students’ individual strengths, interests, medical health and support needs are undertaken. Assessments included detail of initial recommendations made about the support needs of individual students in preparation for coming to stay at the college. One student stated that she was very happy as she had been able to visit the college before she came to stay so she knew that she would like staying there. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 12 On occasion, the Care Manager will visit prospective students in their own home or school environment in order to assess any specific support needs that they may have. This may be in respect of communication and mobility needs to ensure that these could be met if residing at the college. Following assessment written confirmation is sent to prospective students and their families stating whether their support needs could be met living at the college. Each student had a comprehensive contract of residence so that they are aware of the terms and conditions of their stay however one of the contracts sampled had not been signed by the student or her parents as confirmation of agreeing to the content of this There are four registered hostels and accommodation is allocated to students with similar support needs. Thornton House accommodates higher dependency students and those who are living away from home for the first time. Winfield is located as short walk away from the College and accommodates students who have been at the college for a while so that their independence is encouraged. The CSCI inspection reports were not on display in all hostels and this may prevent students and their families from having knowledge about the content of these. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 13 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 are supported to lead safe and fulfilling lives and are supported in a respectful and appropriate manner by residential staff so that their confidence, dignity, self- esteem and social skills are promoted. Systems in place for student consultation are good. EVIDENCE: On coming to stay at the college, comprehensive assessments of students’ individual support needs are undertaken and action plans are derived from this information. These are written plans that outline the strengths and weaknesses of individual students and the support required by staff to meet their individual needs/targets. Most action plans gave good detail of the specific support required by staff however a number of these pertaining to students residing in TSB hostel required further development. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 14 Most action plan “targets” were realistic promoting students’ independence and the development of essential life skills. Targets were measurable and students were involved in the planning and reviewing of these. Comprehensive personal risk assessments had been completed in order to minimise any risks identified whilst encouraging students to lead fulfilling lives, both on campus and within the local community. These included risks associated with the activities that students were involved in, their behaviour and their vulnerability. An exception to this was that a risk assessment had not been undertaken in respect of an identified student’s “target” of arranging a weekend trip abroad. The majority of the preparation for this had been completed by the student however the Care Manager was not aware of this. A risk assessment must be undertaken in respect of this “target” so that his “goal” could be achieved if possible. Students are actively encouraged to participate in making decisions about the running of the Home and have the opportunity to take part in group meetings in order to discuss their lives within the hostels and put forward any suggestions for improvements. The first part of the meetings involve students only so that they have the confidence to put their views forward and staff are present for the remainder of the meetings. The minutes of these are often written by the students and were on display in the hostels for students to refer to. Students had agreed a number of “hostel rules” for example preferred visiting times within each hostel so that students lived amicably together. Students were able to make decisions about their daily lives outside of college and at weekends and were able to have a “lie-in” until a reasonable time. Residential staff assist students to manage their financial affairs as part of their individual support plans. A secure facility for the safekeeping of small amounts of students’ money was provided and two signatures were obtained for all monies in and out of this in Woodville hostel, including students’ signatures when able. This however was not found to be the case in TSB hostel as only one signature was obtained. A sample check of two students’ financial records was undertaken in Woodville. Money held did not balance with one account by a very small amount however receipts for items purchased were available to verify expenditure. The system for this had not been audited since November 2006 and it is recommended that this be undertaken regularly in order to safeguard both students and staff. Financial records were regularly audited in TSB hostel. Individual inventories of students’ personal belongings and valuables were maintained so that items brought in to the hostels were accounted for and this safeguards both students and staff. It was evident that residential staff supported students in a respectful and sensitive manner promoting the development of their confidence and selfQueen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 15 esteem. There were pay phones available for students’ use in each of the hostels and in addition to this a number of students had mobile phones if they wished to make telephone calls in private. Pay phones were adapted for ease of use by students with sensory impairments. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 16 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. The activities and opportunities for social, leisure, religious and personal development meet the needs and expectations of students. The choice of healthy and well presented meals meet any special dietary needs of students for reasons of taste, health or cultural/religious beliefs. EVIDENCE: Residential staff support students to gain and develop essential skills in order to lead fulfilling and independent lives. For example, students are encouraged to prepare meals and undertake telephone orders for take away meals and taxis as part of their personal development plans. Students stated that they had developed new skills and that their confidence had grown since coming to stay at the college. Students were encouraged to decide how they spend their time after college and at weekends. Students participate in a range of activities and leisure pursuits based on their interests both on campus and in the local community. These included sports, Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 17 computers, arts and crafts, cookery, cinema, bowling and local pubs/restaurants. There was evidence that students were involved in the planning and booking of leisure pursuits ensuring that their interests were maintained. Students had access to a well stocked library and this included talking books, braille books and large print books for students with visual impairment. There was a fully equipped gym on campus and students were encouraged to use this either for fun or as part of their individual health action plans. A number of students had recently been involved in the production of a successful pantomime. Students have opportunities to participate in short holidays and weekends away. One student said “It is great here, we are going swimming tonight” Good links were maintained with the local community and students regularly participated in social events so that they could form friendships with people of similar ages/interests both at the college and outside of the college. One student worked as a volunteer in a charity shop and a number of students were currently involved in fund raising for a local childrens’ hospice. Families and friends were welcome to visit students at the hostels at all reasonable times and good rapports had been built between students’ parents and the staff team. Approximately half of the students chose to stay at their parents’ homes during weekends and students expressed their satisfaction about how their lives were organised between college and home. Opportunities were provided for students to continue to practice their chosen faiths whilst staying at the college and a prayer room was provided. Students are supported to attend their chosen places of worship and separate food storage/preparation areas were provided for students as required respecting their chosen faiths. During week- days students are served their lunch and tea in the main college canteen and the menus identified a variety of nutritious and healthy meals. Special dietary requirements could be arranged for reasons of health, taste or religion/cultural preferences. Healthy eating options were clearly identified on the menu using a heart symbol in order to encourage students to choose these options. Menus were in a large print and braille formats so that they were accessible to students with visual impairments. One student stated that he really liked the food provided at college, especially ham sandwiches and curry. Residential staff, college staff and students eat together and this promotes a positive environment in which essential life skills could develop. On the day of the visit, all Inspectors had lunch with students and staff and the food was tasty and well presented. The lunch time meal was relaxed and unhurried and there were good social interactions between students and staff. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 18 Breakfast, supper and all meals at weekends are prepared and served in the hostels with the exception of meals out and take-away meals. Students are involved in food shopping and the planning and cooking of meals so that they have food that they enjoy and develop essential life skills. Students have access to a microwave if they wish to prepare hot snack meals during the night. Senior staff stated that they tried to encourage students to eat healthy foods however this was not always possible if students chose not to, however. students are referred to the medical centre if concerns are raised about their diet. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 19 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 good This judgement has been made using available evidence including a visit to this service. Systems in place ensure that students receive their medication at the times they require. Students are encouraged and supported to lead healthy lives. EVIDENCE: Personal care is not provided at the college with the exception of one student and one to one support is provided to this person. Personal support plans included good detail of the specific support required by staff in order to meet students’ individual needs based on their age, abilities, preferences and any health limitations. An exception to this was that a personal care support plan pertaining to one student did not identify the specific support required by staff in order to ensure that an acceptable standard of personal hygiene was maintained based on her preferred routines. Behaviour support plans were written as required however one of these did not give information about the management of behaviour and one behaviour plan did not include detail of identified “trigger factors” for aggressive behaviour pertaining to that person. This may prevent the staff from providing appropriate and consistent guidance in this area. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 20 Health plans detailed the support required by residential staff and outlined the care provided by the college’s medical staff. One health plan pertaining to a student that was overweight included good detail of the support required by the residential staff in this area. Students are encouraged to promote and maintain their physical fitness however staff had not included detail that one student often became short of breath and the effect that this may have when participating in physical exercise. Individual daily records were kept and these included good detail about the activities that students had engaged in. A key worker system is used so that students are able to build good rapports with named staff members who are available to provide support, guidance and advice as needed. Staff met during the unannounced visit had a good knowledge of students’ individual support needs Students’ individual targets are reviewed at the end of each college term in order to assess the progress made by students in respect of their academic and essential life skills. An annual review is held involving students, their parents (if applicable), key workers, team leaders, social workers, Care Manager and funding officer. This is an opportunity for all involved to put forward any suggestions for changes to support provided if required. There is a medical centre on campus, managed by registered nurses and supported by a local General Practitioner’s (GP) surgery so that students’ health is monitored and treatments are continued whilst residing at the college. The nurses provide information for students about health care issues, thus promoting their health and well-being and a good rapport with the local GP surgery had been built. Students have access to a range of health and social care professionals, for example, speech and language therapy, physiotherapy and dieticians and there was evidence that the residential staff support students to access these as required. Staff responsible for the administration of medication had received training in this area and systems in place for the management of medication were generally good. Students were encouraged to be involved in the administration of their medication and staff provided support in this area. Medication administration charts (MAR) were well maintained and the majority of medication is obtained by students’ parents. There was a small number of “homely remedy” medications held at the hostels however there was no evidence of GP consent being obtained prior to these being administered to individual students. There is a risk that these may Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 21 interact with prescription medications therefore medical consent must be obtained prior to administration. Two signatures had not been obtained for hand written entries on to medication administration charts and it is recommended that this be reviewed in order to ensure that a second staff member verifies that hand written entries are correct. Stock balances of medication held at the Home were not always recorded on the MAR charts and this will prevent an accurate audit trail from being undertaken. A skin disinfectant prescribed for an identified students’ personal use had been left in one of the communal bathrooms in Woodville Hostel and there was a risk that this was also being used by another student which may be detrimental to their health. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 22 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. Good systems are in place enabling students and their families to raise concerns as required and systems are in place to protect students from harm. EVIDENCE: Since the last field work visit CSCI had not received any concerns, complaints or allegations about the support and facilities provided at the college. The complaints procedure was on display in the hostels and students stated that they were familiar with this and knew who to write to if they had any issues to raise. Comment cards were available in the foyer of the college and a comment box had been made by a student in TSB hostel for students and their visitors to use if they wished to compliment the services provided or raise any concerns. Students had access to an independent confidential counselling service if they wished to discuss any concerns in confidence. The complaints register identified that since the last field work visit four complaints had been made directly to the college and all of these had been investigated by the Care Manager. Written evidence of the action taken and outcome of one of these was not available on the day of the visit. The adult protection policy included local multi agency guidelines so that staff were aware of who to contact in the event of alleged or actual abuse. All staff had received training about the protection of vulnerable adults so that they had the necessary knowledge in this area, protecting students from harm. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 23 One student stated that staff had been supportive when fellow students had attempted to bully her and that she was confident that she could approach any member of staff if she had any problems. The Care Manager stated that at times there was friction between students due to their different personalities and disabilities and staff provided support in order to minimise this. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 24 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 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Students are provided with a clean and comfortable living environment in which their privacy is respected. Aids and adaptations are provided so that students’ independence and comfort is promoted. EVIDENCE: Hostels were decorated in homely styles and offered comfortable accommodation for students. Decoration was generally of a good standard with the exception of the paintwork on the stairs in Winfield hostel. Photographs of social events enjoyed by students were on display and there was internet access and satellite television in each of the hostels. Plans were in place for new furniture to be provided in TSB and a new games room had been created. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 25 All students had their own bedrooms that enabled them to enjoy private space during term time. Bedrooms contained students’ personal items, posters, stereos and televisions that reflected their interests, hobbies, age and culture. Student stated that they liked their bedrooms and were happy that they could bring in their own personal possessions so that it was homely. All bedrooms were lockable and students were able to have their own keys. Students also had keys for the front door of their hostels however they were not permitted to enter these during college hours as staff were not provided during this time. Call bells were provided in all rooms within the hostels so that students and staff could summons assistance if required. A lockable facility is provided in each bedroom for the storage of private or valuable items. Consideration is given to the allocation of bedrooms within hostels for example it was pleasing that one student who found it difficult to mobilise due to poor eyesight had been allocated a bedroom next to a fire exit. There were sufficient baths, showers and toilets in place for the number of students and these were maintained to an adequate standard. Communal toilets within Woodville hostel were clean however space within these was very limited. A bath hoist and handrails were provided in Woodville hostel, however none of the current students required this equipment. None of the students living in the hostels were wheelchair users. There was a musty smell in the shower room in TSB hostel, the extractor fan was not working and the ceiling in this room required repainting. There were a number of toiletries belonging to students that had been left out in this room and these should be removed and stored separately to prevent the risk of cross infection. There were lounges, dining rooms and kitchens in each hostel, offering sufficient communal space for students with the exception of Woodville hostel that did not have adequate dining space. Funding has been approved to add a conservatory to this area thus increase the dining space for students. Talking microwaves were provided in hostels for students with visual impairments to use. The work surface in the kitchen in Winfield hostel was chipped and this may cause the spread of infection so must be replaced. The kitchen table and chairs in TSB hostel were showing signs of wear and tear. Students have access to a variety of garden and patio areas and barbeques are enjoyed in these areas during warmer months. Students residing in Thornton House had to go outside in order to access all parts of the hostel and plans were in place to create an undercover walkway. All the students had access to the facilities available on the college campus situated on twelve acres of land including the student centre where the students are able to socialise and play pool, computer games and listen to music. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 26 Prior to the visit negative comments were made by two students about the standard of cleanliness within the hostels, however this was not found to be the case on the day of the visit. Hostels are cleaned and vacuumed daily and students have the option of cleaning their own bedrooms if they prefer. Students are encouraged to wash their own personal clothing as part of their personal development and a hygienic system for the washing of bed linen was in place. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 27 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): 31, 32, 33, 34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Students are generally supported by an adequate number of appropriately trained and recruited staff. EVIDENCE: Assistant Care Managers provide support to the Care Manager and team leaders have lead responsibility for each hostel. This ensures that students have access to senior staff and that residential staff are supported within their job roles. There were clear lines of accountability within the senior staff team. Residential staff are responsible for the overseeing of the social activities that students participate in and the development of essential life skills. Staff turnover is very low ensuring continuity of support for students and agency staff are used as a last resort, with the exception that agency staff provide one to one support for one student. The gender mix of staff reflected the gender mix of students so that students felt comfortable with the staff providing support to them. The Care Manager stated that the staffing ratios were three residential staff working with eight students and one “sleep in” staff member for eight Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 28 students. In addition to this there was one “waking” staff member covering the hostels at night. Staff met during the visit expressed their general satisfaction about these levels and plans were in place for extra staff to provide support for students when participating in activities. Managerial “on call” support is provided to the staff on duty during night time and weekend hours so that staff on duty can seek advice if required. Residential staff do not undertake cleaning and laundry duties as ancillary staff are provided. It was evident that staff were enthusiastic about their job roles and that a good rapport had been built up between students and the staff team. There were good systems in place for communication between residential staff and college staff and this ensuring that a consistent approach to meeting individual students’ support and development needs was maintained. One student stated that she had found all of the staff to be supportive and she liked all of them. Staff recruitment files included most of the information required by regulations with the exception that only one reference was available on one staff file. The College had deemed all staff to be safe to work with vulnerable people. All new staff undertake induction training covering the first six weeks of employment and staff had undertaken recent training about health and safety issues including fire safety, food hygiene and infection control. Staff had not undertaken recent training about safe moving and handling and this may place both students and staff at risk of injury. 44 of staff had achieved a minimum of NVQ Level 2 in care and other residential staff were currently working towards this so that they had the appropriate knowledge to support students well. Other training undertaken by staff included Autism Awareness, Disability Awareness, Sighted Guide training, Risk Assessing and Eye Awareness. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 29 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 good This judgement has been made using available evidence including a visit to this service. The service is regularly monitored for quality and is run in the best interests of the students residing there. Measures are in place to ensure that students’ health, safety and well -being are safeguarded. EVIDENCE: The Registered Care Manager has been in post for eleven years and it was evident that he was enthusiastic, had an excellent knowledge about his job roles and was striving to ensure that students had opportunities to develop essential life skills. Positive comments were made about his management Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 30 style. One staff member said “ He is very supportive and this filters down and benefits the students”. Service satisfaction questionnaires are distributed to students and their families and a quality report based on the findings of these is produced. The outcomes of the most recent report identified that the majority of students and their parents were satisfied with the support and facilities provided at the college. A number of students had stated that they had found the college questionnaire difficult to complete as it involved a lot of writing and it is recommended that this be reviewed. A quality improvement plan had been produced following suggestions made by the student focus group and self-assessment report for 2006/2007and action had been taken and services had been revised in response to these. Staff meetings were held regularly and comprehensive minutes of these were available. This ensures that staff are informed about any new procedures, individual student support needs and staffing issues The Principal visits the hostels regularly in order to monitor the quality of the service provided. Comprehensive reports of the findings of these visits are sent to CSCI. These included details of discussions with students and staff in order for them to put forward their views about the service provided. A number of students had expressed their dissatisfaction about his early morning visits as they preferred not to have visitors whilst getting ready for college and this should be reviewed. Accident records were held on each student’s file, were well maintained and included detail of any action taken following these. Records were audited so that any trends in accidents could be detected thus measures could be implemented to reduce the risk of further accidents of a similar nature. Fire safety risk assessments had been undertaken and there was evidence that remedial action had been taken following the most recent Fire Officer’s visit. A fire drill had been undertaken recently so that students and staff were familiar with the procedure to follow in the event of an emergency. Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 31 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 2 29 x 30 3 STAFFING Standard No Score 31 4 32 2 33 3 34 2 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 4 2 x LIFESTYLES Standard No Score 11 4 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 x 3 4 3 x x 3 x Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 32 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. 1 Standard YA6 Regulation 15 Requirement Individual plans and students’ “targets” must identify the specific support required by staff in each area A risk assessment must be undertaken about an identified student’s “target” of arranging a weekend trip Individual personal support and behaviour guidelines must be further developed and include detail of the specific support required by staff in these areas Health plans must include detail of any physical limitations of students and identify any risks associated with these GP consent must be obtained prior to “homely remedy” medication being administered to students An accurate audit trail of medication held at the hostels must be maintained Timescale for action 01/06/07 2 YA9 13(4)(b) 15/04/07 3 YA18 15 15/05/07 4 YA19 12(1) 15 15/05/07 5 YA20 13(2) 01/05/07 Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 33 6 7 YA20 YA22 13(2)(4) 17(2) Prescription items must be stored safely at all times A record of action taken in response to complaints must be kept Decoration must be of a good standard in all areas of students’ accommodation. Adequate dining space must be provided in Woodville hostel 15/04/07 01/05/07 8 YA24 23(2)(d) 01/07/07 9 10 YA24 YA27 23(2)(g) 13(3) 01/09/07 01/05/07 Action must be taken regarding the shower room in TSB hostel 23(2)(d)(p) to include: • Students’ toiletries must not be stored in there • The ceiling requires repainting • The extractor fan must be in working order 23(2) (c ) Kitchen furniture and work surfaces in Winfield hostel and TSB hostel must be of an acceptable standard At least 50 of staff must have achieved a minimum of NVQ Level 2 in care Two satisfactory references must be obtained and available for inspection prior to new staff commencing employment All staff must undertake training about moving and handling 11 YA28 01/07/07 12 YA32 18(1) 01/08/07 13 YA34 19(1) 15/04/07 14 YA35 13(5) 31/05/07 Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 34 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA1 YA5 YA7 Good Practice Recommendations The most recent CSCI reports should be on display in the hostels The statement of terms and conditions of residence should be signed by students and their families Two signatures should be obtained for all monies in/out of students’ accounts and the system for money held on students’ behalf should be audited regularly Two signatures should be obtained for all handwritten entries on to medication administration charts It is recommended that students be consulted about the timings of Regulation 26 visits and a review of this be undertaken The content and format of the student satisfaction questionnaire should be reviewed in order to reduce the amount of writing involved in the completing of these. 4 6 YA20 YA37 7 YA39 Queen Alexandra DS0000016808.V328609.R01.S.doc Version 5.2 Page 35 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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. 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