Care Home: Beaumont College

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Beaumont College Slyne Road Lancaster Lancashire LA2 6AP The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Val Turley Date: 0 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 36 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home Name of care home: Address: Beaumont College Slyne Road Lancaster Lancashire LA2 6AP 01524541400 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): principal@beaumontcollege.org SCOPE Name of registered manager (if applicable) Mr Michael Alexander Sheppard Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 77 0 care home 77 physical disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Physical disability - Code PD The maximum number of service users who can be accommodated is: 77 Date of last inspection A bit about the care home Beaumont College is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 77 students. Care Homes for Adults (18-65 years) Page 4 of 36 The college offers students a wide range of pre-vocational courses and individually tailored learning programmes, based on their own strengths and needs. Whilst education is a primary function of the college, residential care services are also provided to the majority of students who study there. As the educational standards within the college are inspected by OFSTED, inspectors from the Commission for Social Care Inspection assess standards which are associated with the residential care service provided at the college. The college is conveniently located in a residential area of Lancaster, close to a variety of facilities and amenities. Accommodation is provided over three floors and there are two passenger lifts available for the use of students. In addition to the main building, further accommodation is provided for one group of eight students and another group of two, in separate and smaller buildings situated in the grounds of the college. Due to their size and layout, these buildings offer accommodation which is more domestic in character. Due to a reduction in the number of students living at the college, a higher proportion of accommodation is now offered on a single room basis. Support staff (the majority of whom are qualified to NVQ level 2 or above in care) are on duty at the college on a 24hour basis. The registered provider of this service is SCOPE, a national, non profit making organisation whose headquarters are based in London. Information about fees is available from the principal of the college. These vary considerably and are based on the Care Homes for Adults (18-65 years) Page 5 of 36 specific support needs of each student attending the college. They are agreed prior to admission. Care Homes for Adults (18-65 years) Page 6 of 36 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 36 How we did our inspection: This is what the inspector did when they were at the care home The last inspection on this service was completed on 18/1/07. This inspection of the service included a site visit which was carried out by a team of three inspectors over one day in February 2009. During the visit discussion took place with students, staff and managers. A number of documents were also examined. A tour of the college was undertaken and time was spent with the students in their living areas. In addition to the above we undertook a case tracking exercise. This involved the inspectors closely examining all aspects of selected students care from their point of admission to the college. Before the site visit we asked the manager to complete an Annual Quality Assurance Assessment to tell us what they felt the service did well and what they needed to do better. This helped us to determine how well the service is managed. We were accompanied on this inspection by an Expert by Experience. This is someone who has had experience of using or visiting a similar service or is knowledgeable about the needs of people Care Homes for Adults (18-65 years) Page 8 of 36 who have similar needs to the students at Beaumont College. We were able to ask the Expert by Experience to look at various aspects of life at the college and to speak to the students directly about their experiences there. We visited the college before the site visit and met with a group of link students. We asked them to distribute a number of surveys to fellow students. These invited the students to express their views about the care and support they received at the college. The link residents collected the completed surveys and returned them to us. A total of 18 surveys were completed and returned. The feedback from these surveys is included within the main body of the report. We also sent a number of surveys to the staff who work in the residential areas of the college. These invited staff to comment on the service the college provides and also on how well they were supported to undertake their duties. A total of 11 surveys were returned and again the feedback from these surveys is included in the main body of the report. Care Homes for Adults (18-65 years) Page 9 of 36 What the care home does well The college uses a person centred approach to working with the students who live there. This is evident as the work with prospective students starts several months before they are enrolled and involves lots of contact between college staff, students and their families. Additionally there are many specialists from the college who get involved in the assessment process such as a dietitian, a speech and language therapist and behavioural therapists. The information gathered in these early stages gives the college an in depth knowledge and understanding of the students social and health needs and the information gathered is used to produce a detailed and sensitive support plan for the student. These plans are of an excellent standard and give the support staff clear guidance as to how best they can support each student. Students are involved at all stages of the planning process so that they can ensure that staff know their preferences. Students observed during the visit appeared to be very content and many were seen to be making their way around the college freely with groups of friends. Groups of friends were also seen to meet up in one of the many communal areas. A number of the surveys returned included positive comments about the college. Some of these were:Care Homes for Adults (18-65 years) Page 10 of 36 I think college is a good place. I have met new friends, learnt new skills and I have more confidence. I like it here. There is plenty to do. There are nice friends and nice staff. There are a number of ways that the students are enabled to express their views and opinions and contribute to the running of the college. There is a students forum which meets on a regular basis and a college magazine Powerful Voices which is edited and produced by students. Students also work with staff and management on a number of different working parties giving them further opportunities to influence the running of the college. Students at Beaumont College benefit from an extremely high standard of catering and a great deal of thought and effort goes into catering for students with special dietary needs. All of the staff consulted during the visit demonstrated a very good understanding of their roles and a genuine commitment to promoting the rights of the students. Staff benefited from good training and support. Some of the staff had written comments in the surveys they had completed about their views of Beaumont College. These included:Page 11 of 36 Care Homes for Adults (18-65 years) I love working here. It cares so much more about the students than any other place I know. The college is constantly looking at ways to improve the service and continually putting new ideas into practise. There is a range of staff experience and knowledge within the college, so you always have someone to seek advice from. The turnover of staff at the college is very low which means students benefit from receiving their support from a familiar and consistent staff team. What has got better from the last inspection Since the last inspection the college has addressed all of the requirements and most of the recommendations that were made on that occasion. The college now has a registered manager in post. The college has a much more thorough approach to dealing with complaints and concerns raised by students. The students have a number of different ways that they can raise a concern or make a complaint and these are promoted around the college. From the surveys returned and from discussion with students it would appear that students are aware of how Care Homes for Adults (18-65 years) Page 12 of 36 they can do this. Only one student stated in a survey that they did not know how to make a complaint. Documentation showed that any concerns or complaints were dealt with in detail and that any conclusions or decisions reached were fed back to the individual students. The college has been very thorough in dealing with any possible matters of abuse and have reported them under the Safeguarding Vulnerable Adult Procedures. The details have been reported on to the Commission for Social Care Inspection and the outcome of any investigations have also been reported to us. The supervision of staff has been improved and there are formal sessions with staff on a regular basis to discuss their work with them and to help them develop their skills and knowledge. Procedures for managing staff with performance issues have also been improved and documentation showed that the college dealt with any such concerns in a thorough but sensitive way. The recommendations in respect of managing medication at the college have been met in the interests of good practise. Whilst the college has not been able to make all the changes to the college building that it would like to, a large number of improvement have been made to the environment. These including the refurbishment of some bathroom and toilet facilities, the refurbishment of one of Care Homes for Adults (18-65 years) Page 13 of 36 the lounges, the installation of a new sluice room, widening of doorways where possible, more rise and fall sinks fitted in bedrooms were possible, refurbishment of all hall, landing and foyer areas, the fitting of doorbells on all living areas to improve respect for privacy, the main residential areas are now covered by a new sprinkler system and a new call-aid system offering greater coverage and flexibility has been installed. What the care home could do better Whilst SCOPE have continued to make significant improvements to the environment, it has been recognised for some time that the college falls short of some minimum standards. Due to the structure of the building there are some improvements that cannot be made. Some doorways cannot be made wider and rise and fall sinks cannot be installed in all of the bedrooms. On some living areas the kitchen facilities are not accessible and some communal areas would benefit students if they were larger. There are not enough single bedrooms to ensure that all students who require a Care Homes for Adults (18-65 years) Page 14 of 36 single room can have one. SCOPE are continuing to examine these issues and plans have been drawn up for a new college building. Further developments will be subject to the provision of adequate funding. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Val Turley Lancashire Regional Office 2nd Floor Tustin Court Port Way Preston PR2 2YQ 01772 7301100 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You Care Homes for Adults (18-65 years) Page 15 of 36 can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 03000 616161 Care Homes for Adults (18-65 years) Page 16 of 36 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 17 of 36 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Students individual needs are thoroughly assessed prior to their admission to the college so that support staff can plan their care effectively. Evidence: The Statement of Purpose for the college is regularly updated to provide accurate information about the service. Some of this information is also available electronically making it available to a wider group of people. As well as information about the college publications are produced that give additional information about college life and the services SCOPE provide. The college are continuing to work on a film called a Day in the Life of a Student. This will form part of the Service User Guide when completed and will provide another valuable resource for people who are considering applying to the college. There are extremely thorough processes in place to ensure that the college have an in depth knowledge of a students needs prior to their admission. As well as a full assessment of their support needs the college undertake a Person Centred Planning exercise with students before they are admitted to the college. This process gives students opportunities to make choices and decisions about their own future. The Care Homes for Adults (18-65 years) Page 18 of 36 Evidence: college recognise that this process could be improved by having earlier contact with prospective students and dealing with any anxieties and early enquiries. There are also plans to develop workshops for new students families to attend when there will be an opportunity to look at the Mental Capacity Act. Already information regarding this has been placed in prospective students information packs. As part of the inspection process we looked in detail at the files of two students. From these it was clear that the college had worked hard with the students and their families prior to their admission to help ensure that the college were able to fully meet their support needs. Discussion with staff also helped to confirm that the college take the pre-admission work very seriously to give all new students the best possible start when they arrive at college. Surveys returned by students also indicated that they were involved in the admission process and the decision to move to the college. The assessment takes place over a number of months before a planned admission. This includes visits to the students home and visits by the student to the college. The college look at all available information in terms of a students support needs and their own health care professionals are involved in the assessment process. This includes a physiotherapist and a speech and language therapist. In addition to the above each students assessment details are routinely examined to identify any training needs for staff. For example if a prospective student has a specific condition, managers will ensure that staff are provided with relevant training before the student is admitted to the college. Care Homes for Adults (18-65 years) Page 19 of 36 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The individual needs and choices of students are central to the support planning process. Students are assisted to take responsible, well managed risks to enhance their personal development. Evidence: Students within the college have well written individual support plans which are of an exceptionally high standard. The plans cover all aspects of a students care needs and clearly state how these needs can be met and the skills that the staff team require to meet these needs. Students care plans are developed using a person centred approach. This means that the students own views and opinions are taken into account to as great an extent as possible and there is a notable emphasis in promoting independence and increasing opportunities, although this is done in as safe a way as possible with all risks being taken into consideration. Restrictions to a students freedom or choices are only in place were they are Care Homes for Adults (18-65 years) Page 20 of 36 Evidence: necessary to safeguard their well being. Where such restrictions are in place they are clearly recorded in the students support plan and a record is made of the discussions that have taken place to show that any restrictions have been agreed by the relevant people. As part of the inspection process we tracked the care of two of the students. We looked at all the documentation in respect of those students, observed and spoke to staff supporting them and where possible spoke to the students themselves. In each case the care plans were detailed and staff were able to describe the care and support that they needed. Both students appeared to be happy and relaxed in the presence of the staff who spoke to them sensitively, taking into account their feelings and wishes. One of the students was able to to confirm that she was happy at the college. Surveys returned by students indicated that they were generally happy with the care and support that they received at Beaumont College and that the staff treated them well. Most students who completed a survey said that the staff listened and acted upon what they said, although three said that they only sometimes did. In terms of making decisions and choices all the students said that they could make choices and decisions about what they did although some felt that there were sometimes limitations here perhaps because of difficulties with staffing levels or during handover when staff are busy. The college are aware of these difficulties and are constantly reviewing the ways in which they can reduce these restrictions. There are a number of processes in place to enable students to be involved in the daily daily running of the college, including a students forum and regular community meetings. Students are represented on the health and safety board and equality and diversity group. There is also a parents network to enable parents to meet on a regular basis. Care Homes for Adults (18-65 years) Page 21 of 36 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Students at Beaumont College are enabled to chose from a wide range of fulfilling activities and are supported to make choices and decisions about their lifestyle. Evidence: Students at Beaumont College enrol on a three year programme which is designed to support them through their transition into adulthood and develop their independent living skills. Education is provided alongside residential support and both the key worker and the colleges personal development tutors work with the student following the ten foundations for independent living. Every student has the opportunity to participate in a wide range of activities. Each students individual plan contained a leisure timetable which included opportunities to take part in community activities. As part of the inspection process we tracked the care Care Homes for Adults (18-65 years) Page 22 of 36 Evidence: of two of the students. Their interests and hobbies were included within their individual plan and there was evidence that they were supported to follow these. The college work hard to enable students to enjoy activities on a one to one basis as opposed to large group outings. Most of the students who returned a survey said that they could choose what they would like to do at any time although a few recognised that sometimes staffing levels prevented some activities taking place and one said that sometimes a shortage of transport was a problem. The college are addressing these issues on an ongoing basis and have purchased additional vehicles to give greater flexibility in planning activities outside of the college. The college also recognises that some students feel that the necessity of undertaking risk assessments can influence any involvement in community activities and that more work needs to be done in this area to make sure that students understand the process fully and appreciate the need to undertake activities in as safe a manner as possible. There are also lots of activities organised within the college including a beat box night each week, a film club, arts and crafts and beauty therapy. The Expert by Experience visited the residential areas and reported that there were details in these areas giving students information about what activities were on offer and also displays of photographs of the students involved in some of the activities that they had enjoyed. The college have very impressive systems in place to ensure that students dietary needs are met. Students undertake a full nutritional assessment before they enter college. These assessments are carried out by the college dietitian and speech and language therapist in close communication with the student, their family and any other relevant professionals. The information is then given to the catering manager, who makes sure that staff are very aware of any specialised diets and that written records and daily records are kept. There is an extensive choice of foods at each mealtime and students are made aware of the options in several ways. There is a written menu, a push button communicator which gives a verbal description and a sample meal out on display. Each option is colour coded and students can pick a card to express their preference. The Expert by Experience saw these arrangements and felt that they offered the students good opportunities to make individual choices about meals. A multi disciplinary eating and drinking special interest group meet regularly. Each Sunday evening there is a takeaway event in the restaurant and vending machines have healthy options available. One student wrote in the survey that they returned to us I think college is a good place. I have met new friends, learnt new skills. I have more confidence. A second wrote I like it here, there is plenty to do , there are nice friends and nice staff. Care Homes for Adults (18-65 years) Page 23 of 36 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The students health and personal care needs are carefully assessed and detailed plans are developed to ensure that their needs are met. Evidence: We looked at several students support plans and found very detailed information about how their health care needs were to be met. Information was clearly written and when we spoke with support workers they were very knowledgeable about the individual needs of each student and this information matched what was written in the students plans. The college used a person centred approach with respectful support provided based upon the rights and preferences of the students. We looked at how staff carried out health care tasks and how they were trained to do them safely. Written procedures described in detail how to carry out these specific tasks and staff received regular medicines handling training and supervision to help make sure they have the necessary skills. All staff had received first aid training and a new programme was being developed that was more relevant to the individual needs of the students. Two qualified nurses were employed by the college to make sure the health care needs Care Homes for Adults (18-65 years) Page 24 of 36 Evidence: of the students were safely managed. These nursing staff and other senior managers carried out regular audits of the medicines and health support plans to help make sure the students needs were being fully met. Regular monthly reviews were carried out and records were promptly updated when the health care needs of the students changed. GP and other health care professionals input were clearly recorded and when necessary the relevant parts of students support plans were updated. The students were provided with a range of technical aids to encourage maximum independence. Good written procedures for the handling of medicines were in place and when we checked current stock and records we found that these procedures were safely followed. Medicines were securely stored and records of medicines received, given to students and disposed of were well organised making it simple to fully account for them. Medicines were handled with the needs of each individual in mind and the student care plans and records supported this. We were shown a new written policy about how students were to be supported when looking after their own medicines and this was comprehensive and highlighted best practise. However, at the time of the visit no students were looking after their own medicines so we could not assess how these procedures would be put into practise. We also looked at how students were assisted with their personal care needs and in particular at two students. Their care plans gave details of their preferred daily routines and specifically how staff should help them follow those routines. Staff had signed to say that they had read these and in discussion were able to explain the care needs and preferences of the students. Care Homes for Adults (18-65 years) Page 25 of 36 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The college has comprehensive policies and procedures in place to help ensure that students are safeguarded as far as possible and that any concerns, complaints or allegations of abuse are investigated and dealt with efficiently and sensitively. Evidence: Since the last inspection the college has worked hard to ensure that all complaints, concerns and allegations of abuse have been dealt with thoroughly. Students are able to report any concerns that they may have in a variety of ways, depending on what they feel most able and comfortable with. The college itself has developed a positive approach to listening and managing any concerns and feel sure that support staff do and are able to pass on any worries they may have about a students welfare. Similarly they have encouraged staff to report when things go well for a student. Of the 19 surveys returned by students, 17 wrote that they knew how to report any concerns or worries that they may have. One person wasnt sure and another said that they did not know how to report any concerns. There has been an emphasis on training staff to a high level of awareness with regard to the reporting and management of concerns or allegations of abuse but there is also a recognition that there is still work to do in this area, especially in the area of sexuality and relationships. Scope have a national safeguarding team who are also able to provide advice and Care Homes for Adults (18-65 years) Page 26 of 36 Evidence: guidance to the college. There are several opportunities for staff to raise any concerns they may have and there are daily meetings within the college to discuss these and decide upon a course of action. Any records of concerns, complaints or allegations are also looked at by the safeguarding team and the manager at regular and frequent intervals to ensure that issues are being dealt with in a satisfactory manner and also to identify any trends which may become apparent. In instances such as these the college would then take steps to address these. The Expert by Experience spoke to students about how they would raise any concerns that they might have. They told her of the different ways they could complain and said they were happy with the way their concerns were dealt with. Two students took the opportunity to raise concerns that they had not mentioned before. This information was passed on to staff and who quickly spoke to the students and began the process of resolving their concerns. Students are also provided with an information pack as they start college and this includes information about making a complaint. Care Homes for Adults (18-65 years) Page 27 of 36 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . SCOPE have made a number of significant improvements to the college over recent years, however there are still a number of residential areas that do not meet the minimum standards. Evidence: The college premises are 30 years old and as such do not meet todays standards, SCOPE have worked extremely hard to improve the environment where the students live. At a practical level there are still some areas where it is not possible make improvements, for example not all doors can be made wider for easy wheelchair access and it has rooms where it has not been possible to install rise and fall sinks. However on a positive note many improvements have been recently made. These include the installation of a new sluice room on the second floor, the installation of overhead tracking in lounge areas for safer moving and handling of students, a new call aid system offering greater coverage and flexibility, a new sprinkler system in the main residential areas and refurbishment and redecoration in many areas including bedrooms, halls, landings and foyer areas. There is a recognition however that these improvements will never provide an environment that fully meets the needs of the students and plans have been submitted for a new college building, but any progress on this is subject to the availability of funding. Several staff made comments about the environment in the surveys that they returned to us. They recognised that the environment is not ideal and that students would benefit from single rooms with enCare Homes for Adults (18-65 years) Page 28 of 36 Evidence: suite bathrooms, that lounge areas should be more comfortable enabling students to relax and that kitchen areas within the residential areas should be accessible by the students. They also recognised that in spite of the environment every effort was made to enable students to increase their independence skills. Despite their shortcomings the residential areas of the college have been made to be as homely as possible. Bedrooms are painted in bright vibrant colours and are personalised by the students with posters, pictures and other personal and treasured possessions. All bedrooms have a picture of the students on the doors so that rooms can be identified more easily. Those rooms which are shared have a privacy screen and these are used as a matter of routine throughout the day for the benefit of the students. There has been an increase in the number of rooms which are lockable and where students hold keys. A new flat screen television had been installed in one of the lounges and the students were able to use assistive technology to control this. We were informed by one of the management team that there were plans to extend the use of assistive technology to further enhance students lives in other areas, for example access to bedrooms. Where students are not able to access the kitchen in their residential area, arrangements have been made for them to use kitchen areas within the college itself should they wish to practise their cooking skills. The Expert by Experience who visited the college as part of the inspection process said she was very impressed by the residential areas. She liked the idea of students having a photograph of themselves on their bedroom door so that they could easily identify their own room and she liked the way in which the residential areas had photographs of the activities that they had been involved in. The college do not have enough bedrooms to ensure that all students can have a single room. However this issue is addressed as part of the assessment process. Prospective students are asked about their preferences and every attempt is made to ensure that those students who want a single room are provided with one. On the day of the site visit the residential areas were seen to be generally clean and tidy. It was however noted that some areas were cluttered with items being stored inappropriately. In some areas sanitary bins were placed outside of bathrooms in the corridor, a practise which compromised the privacy and dignity of the students. A member of the management team recognised that this was not good practise but said that they had not been able to identify a more suitable area to place them. Of the surveys returned by students, most said that they were always happy with the standard of cleanliness in the college, three however said that sometimes it could be improved. As the majority of cleaning services staff work during the week this may account for the criticisms from these students as cleaning duties will be reduced at the weekend. There are also some areas of the college where more independent living is encouraged and students are assisted by staff to carry out cleaning duties. It is possible that the criticisms are as a result of these arrangements. Care Homes for Adults (18-65 years) Page 29 of 36 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Students receive care and support from sufficient numbers of well trained staff who receive one to one support on a regular basis to enable them to develop their skills and knowledge. Evidence: The staff team at Beaumont College are well trained and are committed to supporting the students they work with. One member of staff wrote in a returned survey the individual student is the keystone of the college. Everything is done to ensure that they get the best out of college and are given the best introduction to independent living and their future. Staff consulted also showed a good knowledge of the students needs and how to care for them. We tracked the recruitment process the college followed for three members of staff. The college showed that it had a good awareness of the procedures that needed to be followed in order to recruit staff safely. There was however some evidence that records and or procedures in this area could be improved. Any discussion regarding gaps in an applicants employment history should be recorded as should discussion with referees to confirm the details of references received. Students were regularly involved in the recruitment process although this may benefit from formal procedures being developed in relation to this. Care Homes for Adults (18-65 years) Page 30 of 36 Evidence: The college has three members of staff who are responsible for co-ordinating the staff training. All staff are encouraged to undertake a nationally recognised qualification in care and over 60 per cent of the staff team have achieved an NVQ in care. Training is also provided in a number of specialist areas and staff can study up to degree level in a range of subjects including learning disability and social care. There was a core training programme in place for all senior staff. We were advised that the training programme is largely influenced by the needs of the students and any relevant training is provided before a student starts at the college. Induction was well managed with staff receiving training in all essential areas to enable them to work safely and competently. Students are also involved in staff training especially in the training of outside agencies. Recently students made a video about their experiences of going into hospital and this was delivered to NHS staff. Discussion as to how students can be involved in training within the college is underway. In relation to training in equality and diversity, one member of staff wrote that regular training in this is provided and that staff are encouraged on a daily basis to promote it. A member of staff wrote Beaumont College gives everyone a wide knowledge and skills base, continuing with refreshers, updates and new training. Another wrote If I felt that I did not have enough experience, I can ask for more training to help me to understand. Staff received regular supervision and there was evidence from staff records that this was effective in that it helped staff to extend their skills and knowledge and also addressed any weaknesses that they may have in their practise. We looked at the staffing levels across the residential areas. Staffing levels are decided on the basis of the needs of the students living in the different areas and there is a dedicated staff team for each area which means that the staff have good knowledge of the students needs and are able to provide consistent support. There are two duty managers working at all times as well as non duty managers who are able to spend time with staff and students in the area that they manage. The students who spoke to the Expert by Experience said that they had a good relationship with the staff. Care Homes for Adults (18-65 years) Page 31 of 36 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The college is well managed and managers demonstrate a commitment to constantly improving standards for the benefit of both students and the staff team. Evidence: Since the last inspection the college has appointed a registered manager who is supported by a well qualified, committed, experienced and enthusiastic management team. The college constantly strives to improve the service it provides to the students. The college is enjoying a much improved relationship with SCOPE and the manager stated that he felt that they are supportive of the college and have a better understanding of how the college is run. There remains a very good approach to health and safety at the college. These are overseen by a dedicated Health and Safety manager who has a relevant qualification in this field. All staff undertake mandatory training in health and safety issues within the first two weeks of their induction training. This helps to ensure that the students are supported by a staff team who know how to work safely and will report any concerns that they may have about the working practises at the college. This includes the reporting of all incidents, accidents and near misses. There is a robust system in place Care Homes for Adults (18-65 years) Page 32 of 36 Evidence: to analyse all of these incidents with the intention of introducing measures to reduce the likelihood of any re-occurrence. The manager stated that the college has an excellent working relationship with the fire service and environmental health service. The last environmental health inspection took place in December 2008 and they received a very good report. The fire service visit the college regularly and are always on hand to give advice. Due to the complex needs of the students the fire service have assisted the college to constantly update and improve fire safety. Health and safety procedures include a daily health and safety audit prior to a staff handover. This is recorded and the detailed form used prompts the person carrying out the audit to examine all areas. Other audits include records of observations of staff practise, an annual self assessment that involves 30 per cent of the staff team and an introduction of an electronic system for students to make anonymous feedback to the college, although this is in the process of being fine tuned to enable students to access it more easily. Student council members periodically attend Student Support Management meetings to offer feedback and to ask questions. There are student takeover days when they act as Principal for the day to give them an opportunity to implement their ideas within the college. There is also an improved system of monthly monitoring visits from a local unit which gives a good feedback on which the college acts. Since the last inspection there has been an improvement in the way incidents and accidents have been reported to the Commission for Social Care Inspection with managers showing an appreciation of the work that needs to be undertaken when incidents and accidents occur. Students finances are well managed where the college holds day to day spending money for them. There are very robust policies and procedures in place and a daily audit is carried out in every area to ensure it is managed safely. The management team have clear ambitions over the next month in terms of how they can make further improvements at the college. They intend to revisit all policies and procedures and produce them in a common format and also produce a mini booklet for visitors which will include essential health and safety information to supplement that already provided on visitor badges. Care Homes for Adults (18-65 years) Page 33 of 36 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 34 of 36 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 1 24 The Service User Guide should be made available in alternative formats such as audio and video. There should be suitable designated areas within the residential areas to store supplies. This will help to keep the areas tidy and free of clutter. The number of single bedrooms should be increased to ensure that all students who request one can be provided with one. Further consideration should be given to the siting of clinical waste bins so that the privacy and dignity of the students is not compromised. Care should be taken to keep detailed records in relation to the recruitment procedure 3 25 4 30 5 34 Care Homes for Adults (18-65 years) Page 35 of 36 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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