Care Home: Lindeth College

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What the care home does well Lindeth provides a lively, stimulating environment where students are supported to try out new things and make the most of opportunities offered to them. Students said they were very proud of their achievements and were eager to share their experiences of work placements, volunteer opportunities and new hobbies. Overwhelmingly they said they really valued the opportunity to make new friends and very much enjoyed the social aspects of college life. These areas for personal growth and engaging in social activities are supported through careful assessments and planning. Each student has an individual plan, which is regularly reviewed to ensure that each person is challenged and supported to gain new skills. What has improved since the last inspection? A full time permanent appointment has been made to the position of Student Support Manager and the postholder has a Level 4 Registered Care Manager qualification. The college middle management team has been given line managerial responsibilties and this has raised the professional standards of the remaining staff team. The college has developed systems to report and record serious incidents and is consistent in this. All staff have completed POVA training. The college has strengthened links with the Learning Disability Team and Adult Protection Team. A greater number of staff are now competent in using strategies to support students with communication needs. A wider range of adult appropriate, community based activities are available for individuals and groups during evenings and weekends. Use of good quality agency staff has improved ratios of student support over evenings and weekends. What the care home could do better: The college needs to understand and consider the impact of the Mental Capacity Act on decision-making for its students and seek training in this area. It was recommended that student photographs are added to the medication records to reduce the potential for errors. The grounds were also looking overgrown, and the college should seek to employ a groundsman as the size of the gardens is far to big for current staff to keep on top of. The college needs to carry out a further assessment to ensure that they have done all that is reasonably possible to facilitate students with disabilities by removing barriers to learning and social interaction. The kitchen for example now allows for a student using a wheelchair to prepare food but the cooker is still not accessible. CARE HOME ADULTS 18-65 Lindeth College The Oaks Lindeth Bowness on Windermere Cumbria LA23 3NH Lead Inspector Liz Kelley Unannounced Inspection 5 March 2008 10:00 th Lindeth College DS0000022699.V348413.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 Lindeth College DS0000022699.V348413.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. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lindeth College Address The Oaks Lindeth Bowness on Windermere Cumbria LA23 3NH 015394 46265 015394 88840 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) S.C.O.P.E. Limited Position Vacant Care Home 46 Category(ies) of Learning disability (46) registration, with number of places Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for 46 people between the ages of 16 and 25 years with a learning disability (LD) The maximum number of people under 18 years of age shall be 18. Date of last inspection 20th November 2006 Brief Description of the Service: Lindeth College offers students with learning disabilities a three year structured course in education and daily living skills while living on the college campus. It is a College of Further Education for up to 46 young people between the ages of 16 and 25. The premises comprise a large main house and six training houses, which are self contained with kitchens and bathrooms. There are spacious grounds and appropriate areas for recreation, including a recreation hall. The Commission for Social Care Inspection has a remit to inspect the living accommodation and services connected to the personal care and welfare of students, which are not connected to the educational function of the college. The educational provision is inspected by the Learning and Skills Council and by OFSTED. The college is owned and run by a national company called Craegmoor Health Care Ltd. The residential support workers are a separate team to the college teaching staff, and work with students largely outside of the college day and at weekends. The college has administration and maintenance support teams. The college operates to further education term- times and during holiday periods all students return home. Fees are worked out by each level of students needs using the Learning and Skills formula incorporating both education and care, and is set for each college year. This is paid for by the Learning and Skills Council. A handbook is issued to each perspective student, which includes details of CSCI inspection report findings. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This was an inspection where two Inspectors, Liz Kelley and Margaret Drury, assessed all the key areas of the National Minimum Standards. Students, and their families, and members of staff had given their opinions regarding the service and care to the inspectors. These comments, and the observations made by the inspectors, have informed the judgements made in this report. The inspectors also: • Received questionnaires from professionals and other people working with the home • Interviewed the manager and spoke with staff • Visited the college, which included examining files and paperwork • Received an Annual Quality Assurance Assessment (AQAA) form completed by the Manager and Vice Principal. The overall picture gained by the Inspectors was that students were being offered a consistently high quality service that meets their needs individually and collectively. All students and relative survey cards were positive about their experience of the college. What the service does well: Lindeth provides a lively, stimulating environment where students are supported to try out new things and make the most of opportunities offered to them. Students said they were very proud of their achievements and were eager to share their experiences of work placements, volunteer opportunities and new hobbies. Overwhelmingly they said they really valued the opportunity to make new friends and very much enjoyed the social aspects of college life. These areas for personal growth and engaging in social activities are supported through careful assessments and planning. Each student has an individual plan, which is regularly reviewed to ensure that each person is challenged and supported to gain new skills. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 7 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 Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 8 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 and 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A full and rigorous assessment process is in place to ensure the needs and aspirations of the students are met. EVIDENCE: The registered provider had produced both a Statement of Purpose for the college and a Service Users Guide. Range of fees was available at inspection and was determined using the Learning and Skills formula incorporating both education and care and was set for each college year. The Statement of Purpose and Service Users Guide had been produced in a wallet format to allow for flexibility and to target different groups according to ability and need. The Service Users Guide contains student views of the establishment, and a summary of the most recent CSCI report. The Statement of Purpose also clearly states that the funding of a placement through the Learning Skills Council was primarily for education purposes and a student’s placement was dependent on attendance at lessons. A new system of staggered starting dates had been tried for the first time last year. First years had commenced college earlier than the second and third years. This had enabled the first years to find their way round more easily and Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 9 for staff to give them more attention. Students are offered a full day at the college to look around and take part in activities, some of these include tasks to assess students abilities and whether the college can meet their needs. Prospective students and their families visiting for the day said “We had a wonderful visit. I am so impressed with staff and students I am really looking forward to my next visit!” “Myself and my mother where very impressed with how we were shown round the college by the students themselves” “Positive attitude of the students. We were shown round by them very competently- a good advert for the college”. Assessments utilised reports from a range of professionals that included Educational Statement of Special Needs, social work assessment and reports from psychologists, speech and language therapist, occupational therapists and physiotherapist. The college also carries out its own range of assessments to ensure that they are well prepared to support the student when they arrive. The Annual Quality Assurance Assessment (AQAA) completed by the college details these measures: Prospectus, student information pack, Statement of Purpose and guide, Initial Assessments, Speech and Communication assessments, communication passports, school questionnaires, parent questionnaires, LSC Learner Schedules, ILPs (Individual learning plans), Care Plans, Risk Assessments, termly targets, nine term assessments, accreditation documentation, personal care pen portraits, Skills for Life pen portraits, powerpoint presentations for annual review meetings. This includes an Equality and Diversity evaluation assessment to enable the college to meet individuals’ needs and to audit for fairness of access. This is used to develop and review Individual Learning Plans (ILP) used across the educational and care setting and is in place for the 1st term, along with risk assessments. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students are well supported through individually tailored support plans that promote independence and allow informed decision-making. EVIDENCE: Individual plans are regularly up-dated and revised as goals have been attained. This leads to care plans that are dynamic and evolving documents that encourage significant personal development for students. Developing individual plans that promote choice and encourage personal development is a notable strength of the staff team. There are two styles of support plans one to direct staff and the other style termed “Person Centred Plans”. Staff use a variety of skills and ways to engage students in planning their care and setting goals. Students are involved through picture work and symbols and where appropriate, are encouraged to take ownership of their personal files. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 11 Risk taking is well managed and a good balance is achieved between promoting independence and ensuring the well-being and safety of students. The college is not risk adverse but instead will carefully consider each potential risk and weigh up the benefit to the resident engaging in the identified activity. Risk assessments demonstrate step-by-step planning to allow activities to take place, enabling students to gain value and enjoyment from taking part. These are regularly up-dated and monitored to ensure that risk to students is minimised. Students are given a number of different ways to have a say and influence the day-to-day running of the college. For example a weekly activities meeting takes place for students to plan and organise the evening and weekend, and a Student Council is involved in any new development or policy. The colleges AQAA describes these measures: All staff are aware of the ethos and good practice of promoting student advocacy. The college has now made links with the advocacy service, Young People First based in West Cumbria and last year all students and staff received training from the group in order to develop good practice at the college. In addition volunteers from the student body attend regular meetings away from the college to discuss aspects of advocacy. There is a high quality speech and communication support programme available at the college whereby a range of AAC strategies are utilised by students to enable them to contribute to discussion about their college experience in a proactive and meaningful manner. Communication passports are sent to all new students prior to the start of their course and this incorporates views on what they would like to learn and do during their time at college. In addition person centred planning work is undertaken and presented in powerpoint format during the students annual review meeting. The college needs to understand and consider the impact of the Mental Capacity Act on decision-making for its students and seek training in this area. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 12 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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Students are offered a stimulating and supportive environment providing them with varied opportunities for developing new skills and promoting social and personal relationships. EVIDENCE: A major thrust of the college’s work is to assist individuals to become more independent, and informed decision-making is a large part of the student and staff activity, crossing both educational and social areas of the college. This drive to promote independence skills, in conjunction with education colleagues, has resulted in students accessing the local community to a much greater extent. The managers described how the college is now actively seeking links with the wider community to provide activities and social contacts rather than trying to arrange these at the college. A good example of this being a number of students joining a local slimming and exercise class, Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 13 and a student composing a song that was aired and recorded at a local radio station. The colleges AQAA describes the opportunities available: Many of the learners come to college with prior achievements in Duke of Edinburgh Award Scheme or sporting bodies such as the Special Olympics. In response to that, Duke of Edinburgh will be operated at the college from September 2007 and links with sporting bodies developed to enable students to maintain and build on their achievements in these areas. Our already excellent work experience is being developed to incorporate evening and weekend work with a view to supporting students gain paid employment during this period. The first learner to do this begins work on Sunday 15th September 2007. In addition to this, through employment skills sessions on the formal curriculum and supported by the extended curriculum, we will be developing links with various volunteer services to build the students capacity to access this independently and carry these skills through to holiday periods when the student return home. It is anticipated that the college will provide regular feedback with regard to work experience to parents and Connexions to support a higher number of students accessing meaningful occupation certainly over the long summer holiday period. The college volunteer co-coordinator was spoken to and students described how much they enjoyed their experiences of volunteer working. This has included work with National Parks, youth clubs, Primary schools and Animal sanctuaries. A local volunteer bureau said of this work “dedicated staff at Lindeth, the work is exemplary, well done, long may your wonderful links with the local community continue”. Students personal development is assisted by: The college is now proactive in raising student awareness of equality and diversity issues and we have used our community partner, Impact Training to deliver diversity days for the students. The college has utilised a range of external agencies to support the additional needs of learners, eg Relate Counselling and Family Planning Guidance for relationship issues. (AQAA extract) The college is good at promoting healthy eating and lifestyles choices. The menus examined were varied and wholesome and the cook described an example of working closely with one student with an eating disorder that had been very successful. The atmosphere observed at lunch-time and breaks was lively and friendly, with plenty of conversation. Students are involved in menu planning, shopping, cooking and cleaning up after each meal as part of promoting new skills and learning about responsibilities. In some cases this is incorporated into gaining a qualification in catering. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 14 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health needs of students is carefully monitored and well-managed by the college. EVIDENCE: All students are registered with the local GP practice, as is the norm for students, and revert to a GP of their choice when out of college term time. Dentist and optician appointments usually take place in the student’s home area. The AQAA states and was this was verified during Inspection that: The college maintains strong and successful relationships with a number of specialist services to ensure the personal, physical, mental, emotional and sexual health of all the students, i.e. GP practice, continence nurse, RELATE, MS support and counselling, clinical psychology, Adult Protection Team, Learning Disability Team, Connexions and Social Services. All students are registered with the local GP service and effective liaison exists with the college. There are high levels of support for personal care practices and students are treated with dignity and respect to maintain their privacy. The college has a Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 15 robust system of administering medication and this is supported by policies and procedures, risk assessments and staff training. Facilities provided by the college ensure students have the choice to complete personal care in the way in which they prefer or require. Hazard assessments are undertaken to ensure the safety of the students when undertaking personal care routines. The college has good working relationships with the Community Mental Health Team, who provide advice on anger management, counselling and the services of a psychologist. The college also has on its staff team an occupational therapist and a speech therapist. All healthcare appointments and checks are recorded. Personal Care pen portraits and booklets have been introduced and are now used by staff to support the students. The college has worked hard to ensure its liaison with the GP is more effective and consistent and has achieved this. As reported by the Practice Nurse who states “ We have conferred together and have worked out a new system which appears to be working much better, to the satisfaction of all. We have no concerns currently.” The home has policies and procedures in place to ensure the safe handling of medicines including a self-medication procedure and risk assessment. Selfmedication is an area identified by the Student Services Manager to develop further as there is the potential for students to gain more independence, learning and skills in this area. All staff on rota for administering medication have received Boots medication training. The college sought the advice of the CSCI pharmacy Inspector in drawing up policies around self-medication and in the use of homeopathic medicine. The college carries out assessments to test the students understanding and compliance with instructions to ensure the students safe handling of these medicines. This area has been further strengthened by allocating medication responsibility to a Senior Residential support worker, and a dedicated room has been set aside just to house medicines and records. It was recommended that student photographs be added to the records to reduce the potential for errors. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The college has satisfactory measures in place to safeguard the well-being of students. EVIDENCE: The newly appointed Student Services Manager has been instrumental in supporting the colleges development in managing POVA procedures and has enabled the college to develop effective links with the local Adult Protection Team and Learning Disability Team. A systematic incident recording and reporting system is now in place and social workers are in close contact with the Student Support Manager in the event of allegations being made. The college is now much more effective in managing and documenting complaints raised in relation to students or staff. All students stated in feedback surveys that they knew who to complain to and would feel comfortable doing this. The college has policies and procedures on complaints that are issued by the registered provider, Craegmoor Healthcare. Students are issued with appropriate formats of the complaints procedure and are given individual support to understand when and how they can complain. This takes place in individual tutorials. The college’s student committee can take up issues, and the college also uses Craegmoor’s Home Analysis survey, which seeks views on a regular basis from students and family members. These systems allowed students, and others to Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 17 openly discuss issues and raise concerns. This is reflected in the low number of complaints that reach a formal stage. The college staff group is well trained to handle aggressive outbursts and on appropriate use of diversion techniques. Staff reported that because they are trained in de-escalation techniques the number of incidents of aggression was extremely low. The emphasis of the training was to avoid and defuse situations, and these areas are addressed in training on challenging behaviours. This ensures that students demonstrating this type of behaviour are understood and their rights and best interests are protected by the appropriate actions of staff. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 18 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, 28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The college environment is safe but in need of up-dating to comfortably accommodate students needs individually and collectively. EVIDENCE: For a number of years, and commented upon in the last two Inspection reports, it is evident that the fabric and maintenance of the building has not had any substantial funding for sometime. The buildings require painting and woodwork needs replacing, and generally the college is looking run down. This is a pity when the quality of care and commitment of staff is so high. Craegmoor have agreed to invest in a major programme of refurbishment and up-grading. A project manager has been designated from the parent company, Craegmoor, to oversee a comprehensive programme of up-grading of the college environment. This should address a number of requirements for improving the building made on past inspections. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 19 A visiting relative commented, “Only one fault some of the décor, carpets etc seemed a bit grubby and well worn!”. The college has just had a Fire Risk assessment and a number of doors and door seals had been identified as needing to be replaced urgently. The college must inform CSCI when this has been done. The communal areas were also looking shabby and not really in keeping with the tastes of younger people. Again a programme of refurbishments is planned and students will be consulted. The grounds were also looking overgrown, and the college should seek to employ a groundsman as the size of the gardens is far to big for current staff to keep on top of. Work has recently been carried out to make some areas of the college more accessible, to comply with the Disability Discrimination Act. For example one of the smaller houses has had its kitchen partly adapted by adding ramps and by lowering work surfaces in the kitchen. The college needs to carry out a further assessment to ensure that they have done all that is reasonably possible to facilitate students with disabilities by removing barriers to learning and social interaction. The kitchen for example now allows for a student using a wheelchair to prepare food but the cooker is still not accessible. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 20 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): 32,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels continue to improve and this along with a management reorganisation has strengthened the provision of care offered to students. EVIDENCE: There are highly effective systems in place to support staff and, in addition, there are robust performance management, appraisal and observation procedures in place to ensure a high quality of provision is maintained. All staff are appropriately qualified for their roles. Residential Support workers (RSWs) are quickly gaining qualifications to equip them to meet the demands of their role. The college has a good track record of training staff and frequency of supervision has improved with a rolling programme of individual supervisions and annual appraisals. RSWs are now being enrolled on the higher care qualification, NVQ level 3 as this focuses on promoting independence, and is much more relevant to the needs of students. Over the past academic year the college has adopted procedures set down by Craegmoor Healthcare to ensure equal opportunity for all staff, these include induction and mandatory training. The Quality Manager role has also been Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 21 crucial in maintaining and monitoring robust induction and training programmes for all staff. Two new Senior Residential Support Worker positions have been created at the college to further develop and strengthen the management of the extended curriculum team and support the already considerable progress being made in this area, reported upon at the last Inspection. Craegmoor Healthcare have supported the college by facilitating the employment of agency staff to support existing staff working during the extended curriculum. This has had significant, positive impact on the development of provision and has enabled managers to manage and not work as part of a staff rota. As a result Residential Support Workers have made good progress in raising standards and this was commented upon in the Ofsted Inspection in February 2007. All staff have received training provided by Young People First advocacy group. This has enabled them to reflect on and develop their practice to ensure their approach meets the needs of young adults with learning difficulties. A peer observation system has been in place from May 2007 in order to identify and share good practice and further work will be undertaken to consolidate this. This is backed up by a mentoring role provided by seniors for staff who may need extra support. From September 2006 a new middle management tier, with line managerial responsibilities, was created at the college. This has ensured a systematic structure for supporting staff is in place. All positions are subject to rigorous recruitment procedures and enhanced CRB clearance. CSCI is contacted in the event of requesting to employ a person on POVA first. All students are aware of staff names and their roles. Where agency staff are used they are checked to ensure they are of a high quality and are regular to the college to ensure consistency of support for the students. CRB numbers are collected along with proof of qualifications for agency staff. The following documents were checked to ensure compliance: Staff applications, interview notes, CRB, POVA, POCA documents, references, induction documents, training records, observation data, appraisal and supervision documents, quality cycle forms and Craegmoor Healthcare policies and procedures. The college demonstrates that they are proactive and have a very good understanding of equality and diversity throughout the recruitment, induction and training process. These processes reflect the service’s understanding of the strands of diversity. The college now has more employees from ethnic minority groups and there is a more balanced gender ratio of staff working in all roles at the college where previously there has been an imbalance of more females. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38,39, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The new management team are clear about their roles and responsibilities and have been highly effective in raising professional standards at the college. EVIDENCE: The Principal of the College, Anglea Winrow gives strong leadership and communicates a clear sense of direction, to both staff and students. She has a sound understanding and application of ‘best practice’ operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. Working within these systems the Principal demonstrates effective financial planning and budgetary control skill and the college provides value for money. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 23 A full time, permanent appointment has been made to the position of Student Services Manager and the post holder is appropriately qualified as a Level 4 Registered Care Manager. The post holder will become Registered Home Manager at the college subject to a successful CSCI interview that is due to be held imminently. There have been highly effective changes in the staffing structure at the college and the College Management Team is strong and clear about the ways in which the college needs to develop. There are now two managers who are effective in supporting the development of the care and social aspects (extended curriculum). The latter also ensures that evenings and weekends are well managed as there is always now a senior person on duty. The Quality Manager’s role covers all aspects of the college, from ensuring it is clean and hygienic through to audits on care and education. The Quality assurance cycle examines the following to identify action plans: senior management meeting minutes, college management meeting minutes, health and safety meeting minutes, risk assessments, Craegmoor Audits, Fire Audits, Ofsted reports, CSCI reports, LSC audits, policies and procedures, parent feedback, staff qualifications, induction programmes, training records, staff appraisal, performance management, learner programmes and support documentation, Boots medication system, learner achievement data, community links, and links with external multidisciplinary agencies. The college had its Investors In People Award renewed after a recent reassessment, the report stating that “The assessor was satisfied beyond any doubt that Lindeth College continues to meet the requirements”. Particularly singling out the colleges Development Plan 2006-09 and audit systems in bringing about positive outcomes. Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 4 2 3 3 4 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 2 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 3 4 x x 3 x Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA9 Good Practice Recommendations The college needs to understand and consider the impact of the Mental Capacity Act on decision-making for its students and seek training in this area. Student photographs should be added to the medication records to reduce the potential for errors. The college should seek to employ a groundsman as the size of the gardens is far to big for current staff to keep on top of. The college needs to carry out a further assessment to ensure that they have done all that is reasonably possible to facilitate students with disabilities by removing barriers to learning and social interaction. The kitchen for example now allows for a student using a wheelchair to prepare food but the cooker is still not accessible. 2 3 YA20 YA24 4 YA24 Lindeth College DS0000022699.V348413.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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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