Inspection on 05/02/07 for Westgate College for Deaf People and the ROAD project

This inspection was carried out on 5th February 2007.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westgate College for Deaf People... 21/12/05

Westgate College for Deaf People... 04/05/05

Westgate College for Deaf People... 07/03/05

Westgate College for Deaf People... 07/12/04

Similar services:

89 Hastings Avenue

39 Westway

24-26 St John`s Road

David Gresham House

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

CARE HOME ADULTS 18-65 The Royal School for Deaf Children - Westgate College Royal School for Deaf Children, Westgate College Victoria Road Margate Kent CT9 1NB Lead Inspector Pat Gough Announced Inspection 5th February 2007 9:00 The Royal School for Deaf Children - Westgate College DS0000034680.V324983.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 The Royal School for Deaf Children - Westgate College DS0000034680.V324983.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. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Royal School for Deaf Children - Westgate College Royal School for Deaf Children, Westgate College Victoria Road Margate Kent CT9 1NB 01843 836300 Address 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) Royal School for Deaf Children/Westgate College for Ms Ros Facey Care Home 80 Category(ies) of Sensory impairment (80) registration, with number of places The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The registration to include Westcliffe House, St Gabriel’s, Thanet Lodge and Allen Wing 3 and 4. A Maximum of forty 16-17 year olds is permitted to reflect the change in the college population. 21st December 2005 Date of last inspection Brief Description of the Service: Westgate College is registered to provide residential accommodation for up to 80 young people and adults aged 16-65 although current service users fall within the 16-25 age range. The accommodation and facilities for the service users is provided on three separate sites, with two of the buildings located in Westgate-on-sea and three in Margate on the site of the Royal School for Deaf Children Margate. Westcliffe House, the main college site, which has commanding views over the channel, has seven residential areas as well as office areas for the administration team, senior managers, some teaching space and a medical/specialist room. St. Gabriels, the other premises in Westgate, provides accommodation for up to 20 students. All bedrooms are single occupancy. This building also provides education facilities, including an ICT suite and a kitchen designed for the teaching catering courses. Thanet Lodge, a detached two-storey building, has ten single occupancy bedrooms and like the other remaining premises, Allen Wing 3 and 4, is located on the school site in Margate. Allen Wing 3 is a detached building with accommodation for seven students and at the time of the inspection offered single sex accommodation. Allen Wing 4, situated alongside 3 is also detached and has can accommodate four students. Local shops, other facilities and public transport are accessible from all three sites. Westgate college is recognised as both a further education department of the Royal School for the Deaf Margate and a specialist national college providing educational facilities for people who are deaf. The young adults, who are referred to as learners, have a wide range of support needs and all are deaf or have a hearing loss. The monthly fee charged to funding authorities for the placement varies given that placements are made by Local Education Authorities, Social Services Departments and the Learning and Skills Council. The minimum monthly fee for residential placements is £3035 rising to a maximum of £10256. The statement of purpose is sent to placing authorities and inspection reports are made available. The learner’s guide is made available to the young adult prior to admission. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted over three days. The inspector was supported by two independent interpreters for a seven and a half hour period on the second day to assist with the communication with deaf staff and the learners. Residences on all three sites were visited, including the basement flats in Westcliffe House, and the inspector participated in the lunchtime meal with the learners in Westcliffe House and the evening meal in St Gabriel’s. There was an introductory discussion with the college principal followed by an interview with the head of care who is also the director of the community adult learning programme. The inspector met with a group of learners, observed the student council in session and spoke with individual learners throughout the inspection visit. Meetings were also arranged with the care deputies, team leaders, two groups of staff including a group of deaf staff, the designated staff for child and adult protection and the community adult learning coordinator. Representation was made by the facilities manager, the maintenance manager and the health and safety officer. Meetings were held with the head of the specialist team, the matron and deputy matron of the medical centre and the human resources manager. Four personnel files were inspected as well as learners’ main files, documentation presented for the inspection visit and the learners’ ‘working’ files within the residences. Pre-inspection questionnaires were sent to learners, parents, placing authorities and staff. Thirteen responses were received from learners, fourteen from parents, three from staff and there was no response from placing authorities at the time of writing the report. The learners’ views on the premises described the bathrooms as being reasonably or very private. The students indicated that the bedrooms were good, they liked the ‘first floor’ accommodation in Westcliffe House but two of the students commented on the need for the dining room to be re-decorated. 75 of the students said the food is usually good and 25 said it is very good. There was a mixed response when asked about activities ranging from ‘plenty’ to ‘hardly any I like’. Two students indicated that they are sometimes bullied by students of their own age. Punishments were described as being ‘almost always fair’. 75 of the parents stated that they were very pleased with the way their child is being looked after. All of the parents stated that the communication by the school is very good. All the parents confirmed that they had received all the information on what the college offers in written documents although three parents said they had not received anything on how the college deals with bullying. There was a mixed response to the question on the quality of the food ranging from ‘good’ to ‘could be better’. The parents were satisfied with the range of activities available although it was noted that one parent suggested The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 6 that they were not all accessible for wheelchair users. The parents were complimentary about medical care at the college and indicated that they do everything to prevent underage drinking, substance abuse and access to inappropriate literature. It was indicated that the college has appropriate systems in place to protect the young people and the adult students. On the whole all of the parents were complimentary about the level of care provided for the students. The staff indicated that they are well supported, were complimentary about the management and leadership and one member of staff stated in reference to what the college does particularly well, ‘the college has a good support system in place and residents have a say and choice in their life/day to day activities’. There are many elements of good practice, which the college could share with other providers including, its healthcare provision, safeguarding, care planning, consultation and response to young adults and its management of staff. What the service does well: There is good management and leadership. The senior and middle management structure is designed to provide the optimum level of support and includes well-qualified and experienced personnel. The recent restructuring exercise undertaken within the college has strengthened the team and whereas in the past there were serious deficits in human resources, facilities management and maintenance, these are now operating effectively. There is a strong, committed and cohesive care staff team, which has been bolstered by good leadership and more effective procedures and systems. The staff have a good understanding of the purpose of the college, the learners’ needs and engage good care practice. The approach to supporting and supervising the staff is positive and purposeful in that the staff training and development plan is largely derived from identifying training needs from that process. The induction package is seen as being both informative and a good preparation for further training. New employees are assessed within their probationary period at three and six monthly intervals and must meet the required standard before their role is made permanent. There is an impressive in-house training plan in place, which provides specific programmes for care staff as well as cross-college training. There is an effective holistic framework and approach to the provision for learners, which appears to work very well and whilst the key worker and key tutor work closely together with the learner, the specialist team which includes The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 7 the psychologist, speech and language, occupational and physiotherapists as well as the medical centre team, make valuable contributions. There are effective safeguarding policies and procedures supported by regular child/adult protection training for all staff. What has improved since the last inspection? What they could do better: There are still facilities, which should be improved in the interim period pending the realisation of the college’s future plans for a new building on the The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 8 Victoria Road site and change of designation for St Gabriel’s. The senior management have indicated their intention to focus on improving the accommodation at St Gabriel’s in the coming financial year and it is recommended that this occurs as planned. Safety measures such as the fixture of restrictors on the windows of the upper floor overlooking the inner courtyard should be a priority. The male learners in St Gabriel’s should, like the female residents, have access to a lounge facility in the later evening. Internal monitoring of the care practice must be formalised, written evidence provided that it occurs and that it is purposeful in that it contributes to annual planning and improvements for learners. The personnel files should contain all the relevant documentation pertaining to the recruitment including reference telephone checks and interview notes. Consideration should be given to how the learners at St Gabriel’s, having acquired certain independence skills, can continue to practise them and work towards achieving more. 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. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 9 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 The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 10 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): 1,2,4. Quality in this outcome area is good. There is adequate information through the statement of purpose and the student charter to enable parents and learners to make an informed choice about placement at the college. The learners’ needs are competently assessed and there is a positive approach to preparation for admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose was reviewed in September ’06. It contains all the necessary information on management and the staff structure, accommodation and key areas of operation including important procedures such as arrangements for dealing with complaints. There is clear information for parents and learners on the quality of life, values and principles promoted by the college. There is an intention to further develop the document through an additional statement on the philosophy of care currently being prepared by a working party comprising staff representatives from each discipline. The student charter is available in video and signing formats. Detailed needs assessments are completed prior to the learners admission, which determines their fee banding and the staffing requirement. Whilst there The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 11 is often a lack of documentation or useful information on the learner’s current functioning, those pupils, which transfer to the college on leaving school benefit from a more complete transition process involving the availability of essential information, frequent liaison between the school and college staff through the transition process and beyond. There are plans to further enhance this service and in order to achieve this the college has seconded a senior practitioner to the school staff team for a limited period so as to ensure that the prospective learners are fully informed of the purpose of the college and how it supports learners and the promote good communication and cooperation between the school and college staff. Currently school pupils are enabled to visit the college during their final school year on a number of occasions including overnight stays so that they can experience college life. Meetings are held between school key workers and college staff to determine appropriate accommodation, key staff, courses and resources. Prospective learners from schools outside the organisation participate in a similar process. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 12 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 excellent. The care plans and supporting individual learning plans are well written, consistently implemented and regularly evaluated and are reflective of purposeful interaction between the staff and the learners. The learners are encouraged and enabled to make choices and participate fully, according to their ability, in college life. Learners are supported to engage in on-site and off-site activities in order to increase their life and social skills learning, through regular risk assessments. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care planning process initially driven by the thorough assessment of the student’s needs has many facets. Each student has a ‘care plan’, which provides a detailed outline of the routines that should be followed each day from the point of waking, 7am, until bedtime. The plan includes reference to their degree of independence, what they like to wear, medication dosage and The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 13 time of administration, their daily educational timetable, activities, before and after the evening meal, and preparation for night time. There is also a summary of ‘important information’, which can range from medical issues to behavioural. Each plan varies in content and length depending on the primary needs of the learner and the complexity of their needs. The purpose of this plan is to ensure that all staff are conversant with the students routine, their likes and dislikes and what approach and interventions are likely to succeed. Each learner then has an individual learning plan, which is determined by the learner, their key worker and tutor and based on their college course, such as for instance, independent living skills or community adult learning programme. This part of the care planning process has more specific targets broken down as appropriate into objectives with success criteria, methods of intervention and recorded levels of progress and achievement. Two specific plans were case tracked and others were viewed to assess how they were implemented. Good consistency of implementation was evidenced, irrespective of residence or the programme being followed by the learner. The daily logs were detailed in their content and bore much evidence of regular implementation and review of the learner’s targets. Some daily logs contained a copy of the learner’s targets so that in observing and supporting the learner the key worker could align their interventions with the targets and the record of the learners’ response also reflected them. Achievements were recorded as they occurred and signatures and dates on the plans indicated that they were monitored regularly by the team leaders, senior staff and the regulation 26 visitor. Learners’ choices are indicated in the care plan. There are many examples where learners are provided with the necessary information to make choices pertaining to food, activities educational programmes, daily living and their living environment. The learners are given information on their rights and there is a range of communication systems available to support them. The college promotes good advocacy through more able learners advocating for less able. This was evidenced in the learner council meeting. A learner representative meets with the principal and the catering manager regarding food provision. Each learner has an independent advocate and representation on the learner council. The learners are surveyed on their views regarding a range of issues and enabled to participate through a range of mediums including signing, picture exchange cards, object referencing and symbols. Documentation is set out in different formats. At the beginning of each learner council meeting the representatives are given feedback on the issues raised and action from the previous meeting. Risk assessment training is provided for all team leaders and staff teams, and generic and individual risk assessments are completed in each residence. These are reviewed at least annually and more regularly to reflect changing circumstances or incidents. They were signed and dated by the team leader. Risk assessment was included in the content of ‘stay safe’ sessions. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 14 The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 15 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): 12,13,15,16,17. Quality in this outcome area is excellent. The college has the necessary educational programmes in place to satisfy the needs of the learners and has been flexible in providing extra resources to maintain and enhance the level of care and support for learners with more complex needs. There is a good level of community involvement through participation in local college courses and use of local amenities for leisure and social purposes. Daily routines are very clearly indicated on each learner‘s care plan and the staff are actively involved in enabling the learners to enjoy a good quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Appropriate courses are identified for individual learners dependent on their assessed needs. There is a focus on increasing their adult life chances through tailor made education programmes and life skills learning opportunities. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 16 Through good interdisciplinary cooperation and planning, each learner has overarching targets, which can be implemented within the classroom setting, the living environment and social experiences. These targets include literacy and numeracy. Through applying this concept with learners who have a range of complex needs, the staff have concluded that the principles of operating this methodology is not appropriate to their needs and they need to focus on personal care objectives. This has been recognised by senior staff and flexibility of implementation has been agreed. The college has reassessed its provision and relocated some learners with complex needs from the main building, Westcliff House, to smaller residences on a different site. This has been a major success resulting in a significant reduction of behaviour incidents and much evidence of positive outcomes, particularly a better quality of life. A negative impact of the relocation exercise was the movement of more able learners from a position where they had engaged in independent learning programmes within a small group setting to a larger group living arrangement in St Gabriel’s, where their independence living opportunities are more limited. In discussion with the inspector, a group of learners expressed their concerns about this and their desire to progress their independence skills. This was communicated to the senior management team who agreed to give consideration to the issue. The learners are enthusiastic participants in local community events and activities and those that are able to access community amenities and facilities independently, do so with the help and support of the staff. Where some learners regularly attend local nightclubs a member of staff has made contact with the clubs in an attempt to ensure that the learners are treated with respect, are fairly treated and where difficulties might arise the night club managers are encouraged to make contact with the relevant staff. During the inspection some staff and learners referred to a recent incident whereby a local hostelry was engaging in discriminatory practice against the learners. The college is responding appropriately in supporting the learners whilst encouraging good relationships with local services. There was good pictorial evidence in the learners files and in the residences of their participation in community activities. Good staff/learner relationships were observed. The staff demonstrated a good understanding of the learners’ needs and how to achieve the optimum results through their participation. The learners, in turn, responded positively and with a clear sense of enjoyment. There were good-humoured exchanges between the staff and learners. Each learner has a key worker and tutor and indicated that they feel they can approach any member of staff for support. Learners commented on the support they receive and one learner said, ‘the staff are great and I don’t want to move from here’. Staff/learner ratios are based on need and much thought is given to required support to the extent that one learner has a designated team of staff to supervise, work with and support him in a self contained living environment. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 17 As commented upon previously, the care plan details the learners’ daily routines and clearly states their preferences. Learners have appropriate levels of support and supervision and are able to choose when they wish to be alone or participate in an activity. Their privacy is respected both within their bedrooms and in bathrooms. Each bedroom is lockable and has a facility to indicate when there is someone at their door, such as a vibrating flashing light. Meal choices have improved through regular consultation with the learners and positive responses from the catering department. The inspector participated in the lunchtime meal provided in the main dining room. There was a choice of meat and vegetarian as well as a cold buffet. There was fruit available. There were positive and negative comments from the learners during the inspection ranging from ‘the food is good’, ‘ I like the food most of the time’ to ‘its not that good’ and ‘sometimes the food is not hot enough’. Most of the learners who completed the pre-inspection questionnaires indicated that the range and the quality of the food is satisfactory. There is a food committee, which meets termly and issues relating to food can be addressed through the learner council. There was evidence in the residences that the learners had chosen evening meals and been involved in the preparation. Learners are given the opportunity to plan menus, shop for ingredients and prepare the meal. This is indicated in the ILP targets and encompasses the overarching literacy and numeracy targets. The mealtimes were well organised, supervised and orderly. There are many references to healthy eating within the learner’s health plan, the curriculum and daily records. It also features in annual review documentation. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 18 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. The medical centre team continues to provide the appropriate level of support for the learners and has the necessary facilities and other resources to engage the principles of ‘every child matters’. The students receive good advice and guidance related to their personal care and health and are encouraged to lead healthy lifestyles. The staff are well supported to assist the learners through the provision of daily contact with a qualified nurse and essential training on health matters. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As stated previously, each learner is designated the appropriate degree of support on a personal level and within group settings and activities. Throughout the inspection visit the learners confirmed that they get on well with their key workers and were observed to relate comfortably with all staff. The staff were able to indicate how they would provide intimate personal care, The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 19 referring to privacy and dignity training they had received and safeguarding risk assessments. Each student has a health plan, which contains essential information on medical conditions. It is very closely aligned to the ‘every child matters’ ‘being healthy’ objectives and the format directs key workers to focus on specific elements to promote a healthy lifestyle. There are sections of the plan, which refer to relationships, learning and educational achievement, nutrition and diet, physical activity, sleep patterns, smoking, alcohol and drugs and more. Attached to the plan there is the outcome of a hearing assessment for each learner as well as, where appropriate, an eating and drinking assessment conducted by the speech and language team. The specialist team comprising of the educational psychologist, the medical centre team, audiologist, speech and language team and occupational and physiotherapists, plays a major role in providing programmes and support for individual learners. It also provides the necessary guidance and support for care and education staff to implement the programmes with the learners in various settings. Emotional and mental healthcare is provided on-site and externally through CAMHS and other community health services. The health plan is monitored on a daily basis and development recorded in the daily logs. The plan is updated as circumstances change. The importance of care and education staff and medical centre staff liaising regularly, in respect of changes to the health information, was noted. The medical centre is managed by a matron and has a team of qualified nurses and healthcare assistants, which ensures that there is a qualified nurse and healthcare assistant on duty day and night. Health plans are completed in conjunction with the key worker and if appropriate with the learner. The centre serves both the school site and the college sites and has accommodation for learners who might have to be temporarily isolated due to their illness. A nurse attends the Westcliffe House site each morning for clinical purposes. All staff which administer medication must complete training and their practice is regularly monitored to ensure correct procedures are followed. Where a member of staff is observed to engage in poor practice they are suspended from engaging in medication administration tasks until they are re-trained. The medical centre team also provide regular, and as necessary, training on other medical procedures such as CPR, epilepsy and asthma. Sexual health sessions are provided for male and female learners as well as health education support with smoking, drugs and alcohol related abuse. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 20 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. The learners are facilitated to register concerns and complaints through a well advertised system and a complaints format, and the trust that currently exists between the learners and the staff promotes openness and dialogue. There is a robust protection policy and procedure to ensure that learners regardless of their age and ability status are safeguarded and good training programmes to support the policy and practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints policy, which is detailed in the statement of purpose and in the ‘student handbook’. The handbook, which is currently out of date because of recent staff changes, includes photographs of senior care staff and is illustrated throughout. It identifies the staff that the learners may wish to talk to if they have a problem. There is a section on ‘how to complain’ and the format to use if doing so. The complaints book was seen and provided evidence that complaints are normally responded to within the stated timescale, ie., seven days. There were no unresolved complaints. The child/adult protection handbook produced for school and college staff adequately details the necessary guidance for the staff to recognise signs and symptoms of abuse and the manner in which they should respond. The various types of abuse are well defined and examples are given of six prevalent types with behavioural indicators. Equal attention is given to child and adult protection with special note taken of children in need but not necessarily in The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 21 need of protection. The handbook contains a flowchart, which details the sequential action that needs to be taken if abuse is suspected, witnessed or disclosed. There was a notice in each of the residences relating to what action to take in the event of suspected child/adult abuse with the levels of concern illustrated through a ‘traffic light system’. The policy was originally written in line with the local authority procedures. The whole process is supported by a rigorous behaviour management programming process for those learners with challenging behaviour. Those learners have an individual management plan which serves to provide them with the correct level of support to help them modify their behaviour, to keep them safe and to protect other learners and staff. The college has devised and implements a comprehensive incident/accident report format, which is put on a database and monitored to identify patterns with a view to engaging successful methods of intervention. The process is monitored by the senior management team and the regulation 26 visitor. The learners stated that they feel safe with staff and within the residences and were complimentary about the way the staff respond to bullying and other related issues. The parents indicated that they have been made aware of the college’s approach to the protection of learners although a minority of parents stated that they had no recollection of receiving related documentation. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 22 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): 24,26,27,30. Quality in this outcome area is good. The improvements made to the accommodation have brought them up to an acceptable standard and will serve to provide, during this interim period whilst the new building is being constructed, a more suitable living environment for the learners. There is equal access for all the learners, albeit for some through the use of public transport, to local services and amenities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The college’s plans to construct a new building designed to provide better facilities and an improved living environment for the learners has been delayed due to circumstances beyond the control of the governing body. Whilst this is disappointing, the college has implemented a programme of refurbishment and redecoration, in the past year, to improve the standard of the accommodation The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 23 and some communal areas in Westcliffe House and the Allen buildings on the Victoria Road site. The majority of the residences were visited and all were found to be clean, nicely decorated and most were personalised either by the learner or by the staff. The furnishings are much improved with bedrooms and lounges equipped with good quality furniture. Where the best furniture is not used the alternative furniture is in good condition. The college management made some strategic decisions regarding the accommodation of learners with complex needs, which has had many positive outcomes. The learners were observed to be enjoying their new surroundings and there was evidence that the smaller group living settings was having a positive impact on their social interaction and social behaviour. The staff confirmed that the accommodation strategy combined with improved staffing and training has improved the quality of life for the learners. The learners, in their questionnaire responses and in discussion with the inspector, expressed their satisfaction with the accommodation. The residences on the Victoria Road site are close to Margate town amenities and services, whilst the main site in Westgate is further removed from those services, however it has other benefits and is within walking distance of public transport. The college also provides its own vehicles for use. The learners at St Gabriel’s, a large residence within the local residential community, expressed a concern about their remoteness, however they too have public transport facilities nearby. Whilst female learners in the St Gabriel’s complex have a small lounge facility for use in the later evening the same provision, promised to the male learners has not yet materialised. Each learner has a single room with sufficient furniture for storage and comfortable living. There is adequate lighting and ventilation. Bedrooms are lockable and the doors are fitted with flashing devices to alert them if some is at door. Some rooms have washbasins and all have easy access to bathrooms and toilets. There are three basement flats within the main building, each comprising of a bedroom, lounge, kitchen and bathroom, two of which are used for learners that are engaged in independence programmes and one which is used to provide a comprehensive support package to a learner with complex needs. All three flats are sufficiently spacious, furnished and equipped and adequately fulfil their designated purpose. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 24 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): 32,33,34,35,36. Quality in this outcome area is good. The residential staff team is managed effectively and the team has a good spread of knowledge, skills and experience, which enables it to deliver good quality programmes of care. The recruitment process is sound and supports the robust approach to safeguarding the learners. The retention and filing of recruitment related information on personnel files needs to be improved however so that there is better evidence of good practice. The college has produced an impressive staff training and development programme, which is being implemented within a specific timescale and features all the necessary required mandatory elements as well as a good range of other relevant training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The learners commented that they feel able to approach any member of staff for support and advice. The staff team has a good balance of qualified and experienced carers and has a strong induction structure to bring in The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 25 inexperienced members. Some newly appointed staff confirmed that the induction package was effective and gave them the necessary knowledge of policies and procedures to engage confidently in the practice. One of the new staff indicated that more in depth training on signing would have been beneficial although basic level training was provided. All the staff receive British Sign Language level 1 training and there is an expectation that they will progress to level 2. Other means of communication are used to good effect. The medical centre team are proactive in providing training on specific medical conditions. The staff, through observation of their practice, discussion and their written records indicted that they have a good understanding of the learner’s needs and the required interventions to meet the needs. There are sufficient staff to maintain continuity and consistency of care within the residences and the staff/learner ration is determined by the complexity of their needs. This is largely identified prior to their admission but can be altered in line with updated progress or need. There are regular residence team meetings and a team leaders meeting is held each Friday attended by members of the senior management team. Minutes of these meetings confirm that relevant discussion occurs and is focussed on practice issues and the needs and achievements of the learners. The staff indicated that there is good communication from senior management and commented on their ‘openness’ and consultative approach. The deaf staff are few in number but play a prominent and effective role in a number of residences. It was stated that the learners particularly appreciate the opportunity to consult and communicate with the deaf staff. Some deaf staff commented that they sometimes feel that they are not included in full discussions about the learners on their residence and might, on occasions, receive only a ‘summary’ of the content of the discussion. This was attributed to ‘hearing’ staff forgetting deaf staff’s inability to hear verbal conversation. These comments were conveyed to the head of care for consideration. There is an effective care management structure with a head of care, two deputies, and a team leader for each residence supported by senior residential social workers. There is better management of staff absence with more rigorous monitoring and clearer expectations. This as well as other management strategies, has resulted in a more cohesive and committed team. The recruitment processes are robust and are a contributory factor in the reduction of adult protection referrals. Newly appointed staff stated that the process was rigorous and the initial induction training was effective. Four personnel files were sampled and most of the required recruitment information was on file. Two new staff commenced employment prior to the completion of the necessary checks, however senior managers stated that up until the checks were completed they have been supervised at all times whilst on duty. This was confirmed by some new staff and team leaders. The human resources manager stated that reference telephone checks are made on each prospective employee prior to appointment, however this was not documented on file. There was no record of interview notes on file, however when this was raised The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 26 with the deputy head of care it was confirmed that interview notes are taken and retained. It was recommended that such information should be kept on file. It was acknowledged also that the human resources team, which serves the school and the college is heavily involved in another project and management might need to consider extra resources so that files are frequently updated. Reference has already been made to the good induction package with a focus on ‘skills to care’ leading to NVQ training. Core training including child and adult protection, health and safety and medication administration is planned to take place on a regular basis. The college has a comprehensive residential inhouse training programme for ‘06/’07 with the programme offering opportunities for all staff across the campus ‘to develop their knowledge and skills’. There is a focus on the training needs of each tier of operation with training for team leaders each Friday and some additional twilight sessions. The plan includes identified training, with dates, for the care staff, which include the necessary content to equip them with the skills to address matters outlined in ECM objectives. The head of care stated that the college is committed to enhancing its practice to benefit learners and shortly a party of staff are due to visit an establishment identified as a model of best practice. The staff spoke enthusiastically about the high level of training that they receive and confirmed that there is continual evaluation, within supervision and appraisal, of its impact on their practice. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 27 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): 37,38,39,40,41,42. Quality in this outcome area is good. The current management structure supports a cohesive and committed care staff team and focuses on providing a quality service for the learners. There is an open management style, which encourages the staff to play an active part in improving the service. Although the internal monitoring systems have yet to be formalised the practice documentation and the implementation of practice is audited regularly through supervision and team meetings. External monitoring processes are effective. Learner’s records and those that reflect various elements of the management of the college are well maintained. There are good safe working practices supported by better maintenance, routine safety checks and regular training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 28 The current manager, recently registered, was appointed to the post of head of care in July ’06 and has considerable relevant experience of management and practice within specialist education and care. The head of care has a clear mandate and receives the support of the college principal and governing body to ensure that the aims and objectives of the college are achieved thereby also ensuring that each learner receives the necessary resources and support to aid their development and prepare them for adulthood.The staff commented favourably on the positive impact that the senior management has had since the restructuring process indicating that there is good consultation and open dialogue. In conversation with the head of care, the inspector was given examples of staff achievements being acknowledged through letters of appreciation. There were numerous examples of the college’s positive approach to the preservation of learner’s rights, cultural heritage and the promotion of equal opportunities through the provision of food, celebration of events and learner’s access to public services and amenities. The ‘residential review’ conducted in August ‘06 featured disabled access and other equal access for staff to IT services. Whilst the college management intend to provide equal access to IT services for all residences there is a current deficiency which prevents some staff having easy access to communication systems and from producing communication materials, such as widget, for specific learners. A survey of learner’s views on a range of issues highlighted their conclusions on what are the college’s strengths and identified areas of need, some of which have been subsequently addressed. External monitoring has proved very beneficial with specific college residences being targeted on each visit. The quality of the monitoring visit reports indicate the measure of commitment to effective and objective scrutiny of practice and the learners’ living environment and following one such visit, which looked at the provision for a learner with complex needs all the recommendations were swiftly executed to access the necessary resources to enhance the quality of his care. The learner’s parent made specific reference to this in the pre-inspection questionnaire. Some of the staff whose residences had been subjected to monitoring visits commented on the quality of the exercise and how they had benefited from the process. The head of care has plans to formalise and evidence the internal monitoring practice according to the requirement of regulation 24. There was evidence, however, in the practice documentation seen by the inspector that various members of the residential care management team fulfil that purpose. All the necessary policies and procedures are in place although the college management is advised that they are reviewed to ensure that they truly reflect the college requirements given that they are written for the school and the The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 29 college. The record keeping is good and the ‘working’ documentation kept in the residences is regularly reviewed and updated. The residential audit also focussed on safe working practices and looked at health and safety checks and training and better maintenance particularly in the learner’s residences. Many of the residences were visited and individual accommodation seen. On the whole much has been achieved with improved maintenance schedules and implementation. The accommodation was well maintained and the necessary safety precautions taken as a result of satisfactory risk assessing. The facilities and maintenance managers and the health and safety officer work closely together in coordinating safe working practice and the safety of equipment. Fire safety equipment is routinely serviced and visually checked and fire drills are conducted regularly. Some team leaders conduct ‘silent’ drills on a weekly basis to ensure staff and learners remain alert to dangers. A full fire evacuation was attended by the fire service on 26/6/06. All other installations are inspected within the required timescale including portable appliance testing and two environmental health service inspections on 13/11/06 and 4/12/06. Recommendations from these inspections are being met. Generic and individual risk assessments are conducted and copies of the assessments kept in the residence to inform staff. The staff training programme addresses many elements of health and safety training, such as manual handling and first aid at work. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 30 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 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000034680.V324983.R01.S.doc 4 4 3 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 X 15 4 16 4 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 3 3 3 3 3 3 X Version 5.2 Page 31 The Royal School for Deaf Children - Westgate College 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 YA24 Regulation 13 Requirement The registered person must ensure that restrictors are fixed to the windows on the upper floor of St Gabriel’s overlooking the inner courtyard. The registered person shall establish and maintain a system for reviewing at appropriate intervals the quality of care provided in the college residences and supply the Commission with a report on the findings. Timescale for action 07/02/07 2. YA39 24 31/03/07 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. Refer to Standard YA12 YA12 Good Practice Recommendations The individual learning plans for the learners in Allen Lodge should be reviewed and consideration be given to future targets reflecting their abilities and needs. The college should consider the needs of the learners accommodated in St Gabriel’s and their provision of continued access to opportunities to practise their DS0000034680.V324983.R01.S.doc Version 5.2 Page 32 The Royal School for Deaf Children - Westgate College 3. YA24 4. 5. YA34 YA34 6. YA38 independence skills. In consideration of their ability level, all learners in St Gabriel’s should have access to a lounge facility other than the main lounge for their use, particularly in the late evening, where they can meet and socialise. Written evidence relating to telephone reference checks and interview notes should be placed on respective personnel files. The college should obviate the necessity to allow care staff to commence employment prior to the necessary employment checks being completed by reviewing its timing of recruitment advertising and the completion of the process. All staff should have equal access to IT systems in order to maintain effective communication and create communication materials for the learners. The Royal School for Deaf Children - Westgate College DS0000034680.V324983.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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