Care Home: Linkage Cluster 2

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What the care home does well Students and their families are given enough information that is easy to read so that they know what they will get from the home. New people are able to visit the home and stay overnight to help them to decide if the home is right for them or not. Relatives are very involved in the home and are made to feel welcome, making sure that family can keep in contact. People are helped to eat a healthy diet.Each person has a health action plan which helps to make sure that their health needs are met.Peoples medicines are looked after well and staff help them to take their medicines safely.Everybody`s concerns and worries are listened to and staff make sure they take action to sort problems out quickly. The staff and managers know that they need to make sure people are protected from harm and what to do if someone isharmed. The managers make sure that staff employed are safe to work with the people that live in the home and they are protected from harm.The staff are very caring and treat people with respect and dignity. What has improved since the last inspection? There has been moreredecoration, new furniture and other things bought for the houses, to give the students a comfortable, homely environment. Staff do waking shifts during the night, so they are available 24 hours. 58% of the staff group have achieved a National Vocational Qualification at level 2 or above; the remainder are working towards this award. An ex student has been recruited to a paid post, as a learner representative. This person will help learners in meetings and is working with learners and the college to introduce a buddying systemfor new learners. Learners are now able to choose when they want support services within the college for example, psychology input, or A Quiet Place. What the care home could do better: The service continues to provide an excellent service; no requirements were made at this visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Linkage Cluster 2 Ferriby Lane 234 Scartho Road Grimsby DN33 2EB The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Wilma Crawford Date: 2 4 0 2 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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 Care Homes for Adults (18-65 years) Page 2 of 34 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 34 Information about the care home Name of care home: Address: Linkage Cluster 2 Ferriby Lane 234 Scartho Road Grimsby DN33 2EB 01472241044 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Linkage Community Trust Name of registered manager (if applicable) Paul Steven Rowson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 16 0 care home 16 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category 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 category: Learning disability Code LD, maximum number of places: 16 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Linkage cluster 2 comprises of two houses. Since the last inspection visit the house known as 25, Scartho road has been sold. The five students living there in term time,have been accommodated throughout the remaining Linkage houses. Each of the houses offer accommodation on ground and first floor. They have gardens to front and rear and are in keeping with other properties on the road. They are on a main bus route to Grimsby and close to local shops and amenities. The Gables provides accommodation for 7 individuals. On the ground floor there is a domestic style kitchen, utility room, dining room, two lounges and a toilet. Upstairs there are three double bedrooms rooms, two single bedrooms, bathroom with toilet and shower room with toilet. Ferriby provides accommodation for 9 individuals. On the ground floor there is one single bedroom, a large lounge, a large dining room, kitchen, utility room and a self contained flat with two single bedrooms an office, kitchenette land bathroom with toilet. Upstairs there are two double bedrooms, three single bedrooms, one bathroom, one separate toilet and two shower rooms both with toilet. All the houses have furniture and fitting that are domestic in style. Information is made available to students in the service users guide and statement of purpose. Care Homes for Adults (18-65 years) Page 5 of 34 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 6 of 34 How we did our inspection: This is what the inspector did when they were at the care home We observed the people who live at the home. We also talked to the staff. Care Homes for Adults (18-65 years) Page 7 of 34 We looked at some of the (policies and procedures) in the home. Policies are rules about how to do things. Procedures tell people how to follow the rules. What the care home does well Care Homes for Adults (18-65 years) Page 8 of 34 Students and their families are given enough information that is easy to read so that they know what they will get from the home. New people are able to visit the home and stay overnight to help them to decide if the home is right for them or not. Relatives are very involved in the home and are made to feel welcome, making sure that family can keep in contact. People are helped to eat a healthy diet. Care Homes for Adults (18-65 years) Page 9 of 34 Each person has a health action plan which helps to make sure that their health needs are met. Peoples medicines are looked after well and staff help them to take their medicines safely. Everybodys concerns and worries are listened to and staff make sure they take action to sort problems out quickly. The staff and managers know that they need to make sure people are protected from harm and what to do if someone is Care Homes for Adults (18-65 years) Page 10 of 34 harmed. The managers make sure that staff employed are safe to work with the people that live in the home and they are protected from harm. The staff are very caring and treat people with respect and dignity. What has got better from the last inspection There has been more Care Homes for Adults (18-65 years) Page 11 of 34 redecoration, new furniture and other things bought for the houses, to give the students a comfortable, homely environment. Staff do waking shifts during the night, so they are available 24 hours. 58 of the staff group have achieved a National Vocational Qualification at level 2 or above; the remainder are working towards this award. An ex student has been recruited to a paid post, as a learner representative. This person will help learners in meetings and is working with learners and the college to introduce a buddying system Care Homes for Adults (18-65 years) Page 12 of 34 for new learners. Learners are now able to choose when they want support services within the college for example, psychology input, or A Quiet Place. What the care home could do better The service continues to provide an excellent service; no requirements were made at this visit. Care Homes for Adults (18-65 years) Page 13 of 34 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 Wilma Crawford St Nicholas Building St Nicholas Street Newcastle upon Tyne Tyne and Wear NE1 1NB 01912333300 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 can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 14 of 34 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 15 of 34 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. People accessing this service undergo a thorough assessment prior to admission and are provided with the necessary information to enable them to make an informed choice. Evidence: Students are assessed for their placement at linkage by the Linkage Transition team. The team provide parents with a copy of the document Information for Parents which covers all aspects of college life including development, health and welfare, consent forms, finance, college and student charter etc. The assessment process is ongoing and can often determine the placements of the students in the following years. The assessment also includes the students social worker from their home area, school, educational psychologist, medical professionals and the connexions service. Any potential restrictions/limitations are discussed and agreed at this time and any students whose needs cannot be met, by the college will not be offered a p Students and their families are given detailed information about linkage so that they are able to make a choice about whether to go there or not. The information provided is available in appropriate formats. The Transition team visit the student at home/school and students come to one of the houses for a 3 or 5 - day residential placement for Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: assessment. Students, relatives and staff spoken to confirmed this process and said that they were very involved in the process and had a chance to look around before making a decision as to whether the college was right for them. Care Homes for Adults (18-65 years) Page 17 of 34 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. People are empowered to make decisions and are consulted on in all aspects of their lives. Evidence: Students social, emotional; communication and independence skills are developed and maintained by the implementation of the 24-hour curriculum. These may include things such as; cooking skills, monetary skills, washing, ironing, and independent travel. Students are enabled to be as independent as possible and this was confirmed by talking to staff, students and families, who stated that the colleges main aim was to promote independence. Students spoken to confirmed that they are encouraged to participate in the development of their own care plan. Each student writes a pen picture about himself or herself, which is included in their care plan. Care plans were found to be detailed and comprehensive and had been developed to cover all aspects of the students assessed needs, including a decision making record. Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: Additional reference information about specific health conditions or other conditions that may be relevant to the individual are also included. Samples of care plans were examined as part of the inspection process found that they had been regularly evaluated and updated to reflect any changes identified. In addition to this key workers go through care plans with students and there are monthly programme review meetings. Risk assessments were in place for any areas that posed a risk to students and measures put in place to minimise the risks, i.e. personal safety, road safety and leisure activities. Students are actively encouraged to be involved in the development and review of risk assessments. All students had a key worker and were able to tell the inspector who this was and explain what their specific role was. Key workers play an active role in ensuring that students are familiar with the content of their care plan and any changes are made in consultation with the individual. Students confirmed that they meet with their key worker on a weekly basis where they can share their views on specific matters. There was evidence within care plans to show that where students disagreed with specific goals, a process of discussion and consultation had taken place, followed by a decision as to whether the goal would continue or not and the rationale behind this. Students said that their key workers helped them with their timetables and supported them with their goals. They said that they regularly talked to them about their progress and achievements. There is an active learner council, supported by an advocacy worker, house meetings once a week and leisure meetings. Students were able to explain how they decided as a group what the menu would be for the week, activities, outings and allocation of domestic tasks e.g. grocery shopping and assisting with meal preperation. An ex student has been recruited to a paid post, as a learner representative. The representative will represent learners in meetings and is working with learners and the college to introduce a buddying system for new learners. Students are also involved in the staff recruitment process. Care Homes for Adults (18-65 years) Page 19 of 34 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 have extensive opportunities for leisure activities, are supported to maintain relationships and have their nutritional needs well met Evidence: The students are involved in weekly meetings in order to plan the weekly menus. Students are able to invite friends and family to their accommodation and often arrange parties or other social gatherings to spend time with their friends. Many have their own mobile phones, are computer literate and have access to computers. They regularly use texting and e mail to keep in touch with their friends and families. The weekly house meetings are also used to plan individual activities, discuss any issues within the house, choose their representative for the student council etc. Further support is offered by staff supporting individuals social, emotional, communication and independence skills, through the implementation of a 24 - hour curriculum and skill delivery plans. Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: Students also have the opportunity to meet up at college and other social activities which they engage in e.g. Duke of Edinburgh Award Scheme, youth club, discos, bowling, cinema, swimming. Pursuit of personal hobbies, meals out, shopping and culture week, where they have the opportunity to be involved in residential trips, for example, to London and Paris. Additional support workers are available in the evening to promote these activities. Attention is paid to students specific dietary needs as well as personal likes and dislikes, whilst maintaining a healthy diet. The students also decide who should be involved in the shopping and preperation of the meals and a rota is set up from this. Individuals are encouraged to be involved in meal preparation in order to further develop their independence skills, with the necessary support from staff. Students spoken with were able to give examples of food from the menu and how individuals who did not like or had an allergy to certain foods were accommodated. All of the students spoken with said that they had more than adequate opportunities to eat meals and foods of their own choosing, without compromising others preferences or dietary needs. Parents and students commented on the high quality and nutritious diet provided. Decisions made are recorded in individuals care plans and the rationale leading up to this. The learner council takes an active role in college life, including the staff recruitment process and is supported by an independent advocacy service. Members of the council are supported to feedback information and issues raised, to their peer group. An ex student has been recruited by the college to a paid post, as a learner representative. This person will help learners in meetings and is working with learners and the college to introduce a buddying system for new learners. Students have the opportunity to secure work placements, many based on their personal aspirations and the type of employment they wish to access in the future. Transport is available in the form of minibuses, people carriers and company cars to support people to access activities. However the emphasis is on the use of public transport and towards independent travel. Care Homes for Adults (18-65 years) Page 21 of 34 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. Students physical and emotional needs are met, by the provision of a wide range of healthcare professionals and outside agencies Evidence: Linkage has robust medication policies and procedures that include receipt, storage, administration and disposal of medication. Students who wish to self medicate are encouraged to work toward this with a graduating self-medication programme. The individual would be assessed and a risk assessment undertaken, prior to any programme being introduced. Facilities would then be made available for students to lock their medication away. Regular audits are then carried out to ensure that the individual is taking their medication appropriately. The medication system was examined and medicines were found to be stored appropriately with well maintained records in place. The GP regularly reviews students for their medication and audits of the medication systems in the houses are completed on a regular basis. The local pharmacist also regularly reviews the medication systems, in addition to this. Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: Students are enabled to visit the GP, audiologist, and dentist and attend any outpatient appointments; otherwise relatives can facilitate this when students go home. Students have Health Action Plans and Vulnerable In Patient cards, which contain medical and other information about the individual, that professionals may need if they are admitted to hospital for treatment. Records examined confirmed that students had access to a wide range of health professionals e.g. psychiatrist and psychologist, speech and language therapist and visual impairment specialist. These professionals can be accessed externally via their G.P. or through the college, who also provide a range of professionals and services for students. Services include psychology, physiotherapy, art therapy, behaviour therapy, speech and language therapy and a Quiet Place. Students are now also able to refer themselves for professional input, as can staff if they feel that this is needed for any individual. At certain times students may experience difficult situations which they may need additional support to manage effectively. Within the college they are able to access a resource known A Quiet Place. This resource offers a six week intervention programme which focuses on improving the learner’s emotional intelligence skills and developing their awareness of how stress can affect them physically. They also receive a hand massage or foot spa which gives the students the opportunity to manage their stress levels more effectively. A log cabin has been built to offer students some where to go for time out away from the main college Care Homes for Adults (18-65 years) Page 23 of 34 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. Students are consulted about all aspects of their college lives and are safeguarded from harm Evidence: All people spoken with including relatives, staff and students were aware of how to make a complaint. Linkage has a complaints policy/procedure which is available in symbols, audiocassette and DVD. Each student has a copy of this. (kept in care plan) and those spoken to confirmed this. Surveys returned confirmed that people are aware of this procedure. There have been no complaints or safeguarding referrals made in the last 12 months. Minor issues were dealt with through the house meetings and minutes were seen to evidence this. More serious issues were taken to the learner council and a mechanism is in place for responding to these areas of concern and/or complaint. All students and staff spoken with were confident that any complaint or minor issue would be addressed. The risk of abuse to people is minimised through robust protection procedures being in place. Everyone spoken with said they felt safe and protected from harm. Linkage has a Protection of Vulnerable Adults and Child Protection procedure, which identifies a key person within the college for all referrals made. A new policy has been introduced in relation to text and cyber bullying as many of the Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: students have their own mobile phones and computers or access to one. When this was raised with students by the inspector, they were not only aware of the policy, but had a good understanding of what bullying was and what they could do to stop it. Staff spoken to were clear about their responsibilities within the POVA /complaints procedures. Examination of records demonstrated that they have received safeguarding training and training on the Deprivation of Liberties and the Mental Capacity Act. All students have responsibility for their personal allowances Care Homes for Adults (18-65 years) Page 25 of 34 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are provided with a safe environment that is clean, comfortable and well decorated Evidence: Linkage cluster 2 now consists of two properties Ferriby Lane and Gables. The other property Scartho has been sold and the students previously accommodated there have been moved to other residential houses within the organisation. Each property is two storey with its own private garden and parking. The accommodation in each house provides homely domestic style settings which were found to be clean and well maintained. There are both double and single bedrooms available. Students are fully consulted about sharing a room and their wishes are respected and recorded in their decision making record. Bedrooms were found to be personalised. There has been ongoing improvement and redecoration of the houses, including purchase of some new carpets, curtains, blinds, and outside lighting. New wide screen televisions and wi fit games consoles have also been purchased for each of the houses. There is an annual maintenance plan which prioritises work ensuring that properties are Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: maintained to a high standard. Students are encouraged to take responsibility through the use of an agreed cleaning rota to ensure that high levels of cleanliness are maintained. Feedback from the 2009 Residential Learner Survey showed that 100 of learners thought that the house they lived in was either good or very good. Students said that they are consulted and involved in improvements to the environment, offering their views on colours, fabrics and equipment. The long-term plan developed to reduce the double rooms in the building, remains in place. The organisation is looking at seeking alternative sources of income to improve this further. Care Homes for Adults (18-65 years) Page 27 of 34 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. People are supported by a skilled team of staff, who are well supervised and are available in sufficient numbers to meet individuals needs Evidence: People in this service are cared for by staff, that is extremely competent, skilled and knowledgeable in the area of learning disabilities. Support levels are provided in line with assessed needs of individuals. Within Cluster 2 there are two designated teams of staff. The Registered Manager has responsibility for both houses and is supported by a Deputy Manager, Independence Tutors and Support Workers. Further support staff is provided based on the individual needs of the students, in addition to this. The organisation has introduced waking night staff to replace sleep ins. These are covered by the staff team in the house and is considered to have improved the level of support for learners and the responsiveness of staff working during the night. The Ofsted report of 2008 noted that staff development and training programmes are excellent Staff are required to complete mandatory training and specific training as required, to support individual needs. A full induction is given upon commencement of employment. Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: Linkage has a comprehensive induction pack, which staff work through over a number of weeks. This looks at care practices, expectations of staff and covers mandatory training. Staff spoken with confirmed this training had taken place, and individual training files were available to evidence this. A new Learning Disability Qualification Induction has been introduced. Currently 58 of staff hold an National Vocational qualification at level 2 or above and a further 42 are working towards this qualification. Staff receive regular recorded supervision and an annual appraisal, from which a training development plan is made. A wide range of training is provided by linkage and included mandatory training, HIV/Aids, POVA and child protection, diabetes, aspergers, autism, makaton, competence to drive the mini bus, administration of medication, epilepsy, religion and culture, equality and diversity, mental capacity act, confidentiality, whistle blowing, every child matters, principles of care, managing challenging behaviour and human rights. Training is provided through a range of external training, internal training and funding for specific developmental training requests. The manager and residential services managers oversee the recruitment procedure, an application form, two written references a police check and a protection of vulnerable adults and children checks are undertaken prior to a person starting employment. The risk of harm to people is minimised due to the stringent procedures in place. Two staff files seen were found to be complete and up to date. Care Homes for Adults (18-65 years) Page 29 of 34 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. People using the service are safeguarded and strong management promotes independence and choices Evidence: The Registered Manager of this service is an excellent individual with a genuine regard and philosophy of caring for people with learning disabilities, where person centred care is of paramount importance, and the needs of individuals are considered and reflected upon in detail. He has achieved the Registered Managers Award, an Assessors Award and has completed NVQ at level 4. Further qualifications he has achieved include: a BTEC GNVQ Intermediate and Advanced Health and Social Care, Certificate in Education, City and Guilds 7307 Teaching certificates stages 1 & 2 and has completed British Sign Language (BSL) Level 1. He has considerable experience of working with younger adults with learning disabilities. The Manager continually strives to improve the service and competently and conscientiously supports his capable staff team. He sets high standards, which his team Care Homes for Adults (18-65 years) Page 30 of 34 Evidence: work to. He competently manages two houses (the third has closed) which supports students at programme level 2 and also is closely involved in supporting students with autism and behavioural difficulties. There is clear management structure in place and a deputy is in post to support the manager and the further progression of the service. Staff spoken to described the Manager as always there for you, Very on the ball with files and checks and always says thanks He never asks anything of you that he is not prepared to do himself he sets very high standards for the benefit of the students. We have taken these standards on board and are proud of what has been achieved. Students said that he was very kind always listened to you a good laugh, and very fair. The health and safety of people in the service is taken seriously. There are designated fire officers and maintenance staff who are responsible for minimising risk of harm to people. Weekly fire drills take place and a fire risk assessment has been completed. Pictorial formats of the fire procedure are displayed throughout the home. Mandatory training is completed by all staff and staff records evidenced that moving and handling, fire safety, food hygiene and infection control had been completed. Examination of a sample of certificates and maintenance checks corresponded to the information given in the Annual Quality Assurance document; emergency lighting, fire safety equipment and portable appliance testing. Linkage has a corporate Health and Safety policy and procedures to ensure the safety of students, staff and visitors. Students also undertake a safe learner induction which covers; fire, accidents and staff support so that they are aware of the correct procedures that need to be followed. All areas are risk assessed, this includes both environmental and task/activities. They have been awarded the 3 Star British Safety Council Award. A Corporate Quality Monitoring system (EFQM) and a College Quality Manager who co ordinates and leads on quality issues are available within the organisation. An annual plan is produced that provides the framework for QA activity including surveys, audits and appraisals. The Responsible Individual carries out monthly Regulation 26 visits and the Manager ensures that regular systems checks are also carried out. A monthly analysis of accidents is also completed. Staff files showed that they receive regular supervision and appraisals Care Homes for Adults (18-65 years) Page 31 of 34 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 32 of 34 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 Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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