Care Home: Linkage Cluster 3

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What the care home does well Linkage Community Trust provides an excellent service for young adults with a learning disability and other needs. It is well managed at all levels from the directors to the support workers. The primary aim of the college is to enable the young people to develop as much independence as possible, whilst helping them to develop their confidence. They provide a wide range of educational college courses and training in life skills, and were recently awarded an outstanding rating by Ofsted. Policies and procedures (rules) that are regularly reviewed and changed in order to promote students rights and bestinterests and ensure that the staff have the information to do their jobs properly. Students are actively promoted as individuals in their own rifght and Linkage ensures that they are listened to and have a say in how they lead their lives. There is an active student/learner council and regular student meetings. Students are at the heart of the organisation and their views/wishes are taken into account by the use of questionnaires, learner council meetings and by managers and staff that make sure they are involved. Students are supported to gain skills while at the same time, making sure they are safe. The college has a learner council, which has a representative from each house, and is supported by an external advocacy service. Personal allowances have recently been increased as a result of this being brought up by the learners council. Students have an in depth assessment prior to coming to college. Individual care plans are detailed and comprehensive and are developed with students. Students and their families are givendetailed information about Linkage , so that they are able to make a choice about whether to go their or not. Information is available in different suitable formats.Staff are well trained and supported ensuring they have the necessary skills to meet the students` individual needs. Staffing levels are determined on the individual needs of the students in the houses at any time ensuring that they are enough staff available at all times meet the needs of students. Comments from relatives included; `The service provides an ideal environment for the learner to live their own independent life, towards their own wishes and hopes for the future.` What has improved since the last inspection? Ongoing refurbishment and redecoration of the accommodation has been made, providing the students with a comfortable, homely environment. 62.5% 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. The representative will represent learners in meetings and is working with learners and the college to introduce a buddying system for new learners.Learners are now able to self refer to support services within the college for example, psychology input, or `A Quiet Place`. This service offers a six week intervention programme which focuses on improving the learners 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 learners the opportunity to manage their stress levels more effectively. What the care home could do better: The service continues to provide an excellent service to the students accommodated there. Although the two properties making up Cluster 3, provides a good standard of accommodation and continuing maintenance and refurbishment of the properties has been completed. The organisation have been unable to develop or reprovide the property as much as they would have liked to. This has had an effect on the progress of the continuing reduction of the number of single rooms available. No requirements were made at this visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Linkage Cluster 3 20 Pelham Road Grimsby DN34 4SU 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 2 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 3 20 Pelham Road Grimsby DN34 4SU 01472241044 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Linkage Community Trust Name of registered manager (if applicable) Mrs Kerry Ann Pidgen Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 14 0 care home 14 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 14 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: 14 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Linkage cluster 3 comprises two houses both situated in residential areas of Grimsby. 20 Pelham Road is close to Grimsby town centre and 16 Devonshire Avenue is close to Peoples Park. Both houses are in keeping with surrounding properties are two storey and have garden areas. Pelham Road provides accommodation for 8 people. The house is domestic in style and provides a choice of single and double bedrooms, for those people wanting to share. There are ample communal areas, kitchen facilities, bathroom and shower rooms, utility and toilet facilities. There has been continual refurbishment and improvement of the house since the last visit. Extensive redecoration, replacement of furnishings and soft furnishings has been completed, providing students with a well presented, comfortable environment. Devonshire Avenue provides accommodation tfor 6 people. The house has been well maintained and the environment continued to be improved. Accommodation is provided in two double and two single rooms, with a lounge, dining room, kitchen, utility and shower and bathroom facilities for students use. The environment presents as being, clean, comfortable and homely. There is a pictorial guide of each of the houses as well as a statement of purpose and learners guide, which is made available to students and their families. 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 The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by the Care Quality Commission (CQC) since the last key inspection of the home on 8th May 2007, including information gathered during a site visit to the home. The site visit was unannounced and took place over five hours. The Registered Manager is currently on maternity leave and her post is being covered by two of the Registered Managers from other residential homes taking on additional responsibilities during this time. These were available throughout the inspection process. Care Homes for Adults (18-65 years) Page 7 of 34 The main method of inspection used was called case tracking which involved selecting three people living in the home and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The premises were looked at and the records of three people living in the home and two staff were inspected. Three staff and four people living in the home were also spoken with. The comments and views of people spoken with are included within this report. An AQAA (Annual Quality Assurance Assessment ) document asking for information about home was sent out before this visit and information from this was included as part of the inspection process of this service. Surveys were sent out, completed and returned by 5 staff members, 11 people living in the home and four relatives. The comments from these are also included in the report. Fees are paid by the learning skills council to Linkage for a package of education, support and accommodation based on each students individual assessed needs. The fees are detailed on individual contracts, which gives information about about their contract as provided by the learning and skills council, who fund students, accessing Linkage college provision. Care Homes for Adults (18-65 years) Page 8 of 34 Devonshire Avenue and Pelham Road are two properties which make up a group or cluster of several residential facilities provided by Linkage Community Trust, for learners accessing the college. Learners are provided with accommodation, identified care needs and any other support they may require. In addition to this the staff of Cluster 3, offer continuity and further support with educational and development objectives. Devonshire and Pelham currently accommodates students at programme level three. What the care home does well Linkage Community Trust provides an excellent service for young adults with a learning disability and other needs. It is well managed at all levels from the directors to the support workers. The primary aim of the college is to enable the young people to develop as much independence as possible, whilst helping them to develop their confidence. They provide a wide range of educational college courses and training in life skills, and were recently awarded an outstanding rating by Ofsted. Policies and procedures (rules) that are regularly reviewed and changed in order to promote students rights and best Care Homes for Adults (18-65 years) Page 9 of 34 interests and ensure that the staff have the information to do their jobs properly. Students are actively promoted as individuals in their own rifght and Linkage ensures that they are listened to and have a say in how they lead their lives. There is an active student/learner council and regular student meetings. Students are at the heart of the organisation and their views/wishes are taken into account by the use of questionnaires, learner council meetings and by managers and staff that make sure they are involved. Students are supported to gain skills while at the same time, making sure they are safe. The college has a learner council, which has a representative from each house, and is supported by an external advocacy service. Personal allowances have recently been increased as a result of this being brought up by the learners council. Students have an in depth assessment prior to coming to college. Individual care plans are detailed and comprehensive and are developed with students. Students and their families are givendetailed information about Linkage , so that they are able to make a choice about whether to go their or not. Information is available in different suitable formats. Care Homes for Adults (18-65 years) Page 10 of 34 Staff are well trained and supported ensuring they have the necessary skills to meet the students individual needs. Staffing levels are determined on the individual needs of the students in the houses at any time ensuring that they are enough staff available at all times meet the needs of students. Comments from relatives included; The service provides an ideal environment for the learner to live their own independent life, towards their own wishes and hopes for the future. What has got better from the last inspection Ongoing refurbishment and redecoration of the accommodation has been made, providing the students with a comfortable, homely environment. 62.5 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. The representative will represent learners in meetings and is working with learners and the college to introduce a buddying system for new learners. Care Homes for Adults (18-65 years) Page 11 of 34 Learners are now able to self refer to support services within the college for example, psychology input, or A Quiet Place. This service offers a six week intervention programme which focuses on improving the learners 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 learners the opportunity to manage their stress levels more effectively. What the care home could do better The service continues to provide an excellent service to the students accommodated there. Although the two properties making up Cluster 3, provides a good standard of accommodation and continuing maintenance and refurbishment of the properties has been completed. The organisation have been unable to develop or reprovide the property as much as they would have liked to. This has had an effect on the progress of the continuing reduction of the number of single rooms available. No requirements were made at this visit. Care Homes for Adults (18-65 years) Page 12 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 13 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 14 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 transitions team. The Transition 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. Initially the Transition team visits the student at their home or school. The student then visits one of the houses providing assessment beds for a three to five days stay, for a residential assessment. The assessment process also includes the student social worker from their home area, their school, educational psychologist, medical professionals and the connextions service. Any potential restrictions/limitations are discussed and agreed at this time and any Care Homes for Adults (18-65 years) Page 15 of 34 Evidence: students whose needs cannot be met will not be offered a place at college. The students currently living at Pelham Road are programme level 2 and those at Devonshire are programme level 3. Each house has a document showing a pictorial tour of the two properties, as well as a learners guide and statement of purpose, which are made available to the students and their families. Discussion with students confirmed that they had visited the college and been involved in the assessment process prior to being offered a place. They had also had an opportunity to visit the house. Care Homes for Adults (18-65 years) Page 16 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 all aspects of their lives Evidence: Each student has their own individual care plan, which is detailed and comprehensive. The students are involved in writing a pen picture about themselves, which is included in the care plan. Students spoken with confirmed that that they are encouraged to participate in the development and review of their own care plans. Samples of care plans examined during the inspection process were found to have been developed to cover all aspects of the students assessed needs and were constantly reviewed. They were also found to be up to date with current information. The students are encouraged to be as independent as possible, which is supported through the care plan processes. Discussions with staff and students confirmed this, giving examples of personal achievements and goals that were being worked towards, for Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: example becoming independent with road safety. Care plans are also linked to the educational programme within the college and contain planned goals and skill delivery plans, based on individuals needs and aspirations. Risk assessments were in place for all areas that may present a risk to students. These contained clear information and instructions for staff to follow in order to minimize the risk. Areas covered included; personal safety, road safety, health problems and leisure activities. Students spoken with were aware of their risk assessments and why they were in place. They are also actively encouraged to be involved in the development and review of risk assessments. There is a key worker system in place. Students explained that they could choose who they wanted as their key worker and what their role involved. This included playing an active part in ensuring students are familiar with the content of their care plans and that any changes are made in consultation with the individual. A new daily notes system has been introduced covering 24 hours. The details included in this covers a summary of all medical, activities, goals, behaviour, emotional care activities for this period of time and identifies level of support offered for all care tasks. The daily notes demonstrate that students care plans are being implemented in accordance with their assessed needs and are fully involved in all aspects of their care. Care Homes for Adults (18-65 years) Page 18 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,leisure activities and any other topics they may wish to raise. Minutes of these were available and were signed off by all attendees. 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 preparation 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 were accommodated. All of the students spoken with said that they had more than Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: adequate opportunities to eat meals and foods of their own choosing, without compromising others preferences or dietary needs as these were also accommodated. 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. They 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 (recent visits to Paris and London).Additional support workers are available in the evening to promote these activities. 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. Decisions made are recorded in individuals care plans and the rationale leading up to this. 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, how their rooms would be decorated, they are also included in staff selection. Members of the council are supported to feedback information and issues raised to their peer group. 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. A quiet Place offers a six week intervention programme which focuses on improving learners emotional intelligence skills and developing their awareness of how stress can affect them physically. They have the opportunity to have a hand massage or a foot spa, giving learners the opportunity to manage their stress levels effectively. This is in addition to quit areas available throughout the college and access to the college psychologist. Students are now able to make a self referral to this or any other professional if they feel that they would benefit from these services. Students have access to computers, which they can use to keep in touch with their friends and family. 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 Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: support people to access activities. However the emphasis is on the use of public transport and towards independent travel. Each student is issued with a code of conduct and a student charter which is discussed on entry to the home and their personal responsibilities within these. 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 well met, by the provision of a wide range of healthcare professionals and outside agencies. Evidence: Care plans examined demonstrated that students have access to a wide range of health professionals e.g. psychologist, dietician, G.P. Students are enabled to access health professionals and attend out patient appointments either with the support from staff or from their relatives, depending on their personal preferences. There are robust medication policies and procedures within the home, which include receipt, storage administration and disposal of medication. All students are encouraged to work towards a graduating self - medication programme with a goal of becoming independent in managing their medication. This process was confirmed by students in the house. During this process the campus coordinator assesses the individual prior to the start of the programme and a thorough risk assessment would be completed, including the provision of a safe, lockable facility to store their medication. Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: The medication system was examined and found medicines were appropriately stored and records complete and well maintained. The students spoken with informed the inspector that they currently had their medicines administered by the staff. The GP regularly reviews students medication and the systems within the houses are audited on a regular basis. The local pharmacist regularly reviews the medication and medication systems in addition to this. 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. The risk of abuse to people is minimised through robust protection procedures being in place, including recruitment procedures. Linkage has a Protection of Vulnerable Adults and Child Protection procedure, which identifies a key person within the college for all referrals made. Evidence: There are clear, comprehensive policies and procedures in place, available in written, audio tape, DVD and symbols. Each student has a copy of this (kept in their care plans) and they also have access to a complaints book in the house. The students spoken with confirmed this. They also explained that minor issues could also be raised at the weekly house meetings or at the learners council, where an independent advocate is available. There are also mechanisms in place for responding to these complaints. Completed surveys also demonstrated that students knew how to make a complaint. All of the students spoken with said that they felt safe in the house and able to go to someone if they wanted to raise a concern. Staff are trained in how to deal with complaints and to identify and act upon any protection issues. During training they are issued with a green card (advice leaflet on how to deal with the disclosure of abuse). Staff spoken with demonstrated a good understanding of what their role was in dealing with these issues and how they would implement procedures to deal with them. Surveys completed by staff further supported their understanding in these areas. Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: The Manager has attended training on the Mental Capacity Act and this has been cascaded down to all of the staff working in the home. There has been one complaint in the last twelve months; this was dealt with in accordance of procedures and to the complainants satisfaction. One safeguarding referral has been made during the last twelve months. This has been appropriately managed and the outcome of the invesigation is still awaited at the time of the report being written. 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. Students accessing this service are provided with a safe environment, which is cleaning comfortable, homely and well decorated. Evidence: Cluster 3, the two houses Pelham Road and Devonshire Avenue offer accomodation for up to 14 people. The two houses are two storey and offer a small homely type of accommodation for the students living there. The houses provide a lounge, dining room, kitchen, utility, shower room and bathroom, with single and double bedrooms. The properties have continued to be maintained and improved to a good standard, involving the fitting of new kitchens, bathrooms, carpets, new furnishings and general redecoration throughout.Widescreen televisions and wi fit game consules have been purchaseed for the houses. All areas of the house are well maintained, decorated to a high standard and furnished with high quality furniture and soft furnishings. Students were keen to show their bedrooms, which were found to be personalised and reflect the individuals personalities. Some were found to have bedding or posters of favorite football teams whilst others had fresh flowers and personal photographs. All of the rooms had lots of electrical equipment as may be expected in other student accommodation e.g. laptops, TVs, DVDs, hi fis etc. Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: The students are encouraged to take responsibility through the use of a cleaning Rota, with support from staff to ensure that a high level of cleanliness is maintained within the home.Risk assessments are in place to support these activities. There is an annual maintenance plan which priorities work ensuring that all Linkage properties are maintained to a high standard. In addition to this any repairs that arise are reported to the maintenance team and dealt with promptly. The manager keeps a maintenance book in which records of any action relating to maintenance are maintained, including dates of the request being made and the date of the task being completed. All areas of the home were found to be clean and free from any odors. The students are proud of the houses and described them as awesomeand cool. The long term plan to reduce the number of double rooms, remains in place. Further work has continued to look at how the accommodation can either be reprovided elsewhere or the numbers of double rooms can be further reduced. Presently the two houses are not being used to full capacitity, so the double rooms are not all being used as doubles. Those students who share rooms are fully consulted about sharing a room and their wishes are respected and recorded within their decision making record. Students currently sharing rooms said that they had been consulted and many found it an enjoyable part of what they saw as college life. 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. Students are supported by a competent, skilled staff team, who are well - supervised and available in sufficient numbers to meet individuals needs. Evidence: The staffing support levels in the house are determined by the assessed needs of each individual living there. The current staff team consists of the registered manager who is supernumerary, a deputy manager and eight independence tutors. Additional staff are brought into the house to support students with social activities or other curriculum activities, details of these individuals are available on the Rota. There is a balance of gender in the staff team offering students more choice about who they wish to support them. A key worker system is also in place, with students expressing a preference of whom they wish to have as their key worker. A training and development plan is in place for the staff team, which identifies staff training needs, with each staff member having an individual training and development action plan, which is completed on an annual basis and regularly reviewed with the home manager. All staff is required to complete a mandatory training as well as specific training relating to their role and to support individuals identified needs. A wide range of training is provided including a full induction on commencement of employment. Other training Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: includes: Makaton foundation, Health and Safety level 2, MIDAS theory, Epilepsy, HIV/AIDS, Managing Diabetes, Non Violent Crisis Intervention, Infection Control, Food Hygiene level 2, Risk Assessment, Cerebral Palsy, Independence for Independence Tutors, Fragile x Syndrome, Principles of Care and First Aid Appointed Person. An Ofsted visit made to the college in 2008 noted Staff development and training programmers are excellent. 65 of the staff team holds an NVQ at level 2, whilst the remainder are working towards this qualification. Some of the team also hold the NVQ level 3. Staff files examined demonstrated that all staff are well supported through accessing regular training and with regular supervision, at least six times a year. Recruitment procedures are in place and adhered to ensure the correct calibre of staff is sourced to meet individual needs of students. The manager and residential services manager oversees the recruitment procedure; an application form, two written references, a police check and a protection of vulnerable adults and childrens checks are undertaken prior to a person starting employment. The risk of harm is minimised due to the stringent procedures in place. Two staff files seen were found to be complete and up to date. Staff spoken with said that they felt well supported by their manager and those who were covering her post during her absence. They felt that they could approach them at any time with any ideas or concerns, but more importantly that they were listened to. The staffing arrangements have been changed; staff no longer provide a sleeping in service, they work a mixture of waking night shifts and day shifts. Independence tutors accompany students who require additional levels of support to their lessons, offering continuity. This has received a mixed response, although staff can see the benefits for students, they feel their time is more limited, for the other duties they need complete. Time has been factored into their working week to allow them time to keep their paperwork up to date. Additional support workers are also in place to assist with set curriculum based activities for the students living at the houses. Students spoken with said that they felt the staffing arrangements were good. They said that staff was always there for them to help them with any problems, help them with things that they wanted to do, help their independence and give them real choices. 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. Students accessing this service are safeguarded and strong supportive management promotes their independence and choices. Evidence: The Registered Manager has achieved the Registered Managers Award and has completed an HND in social care. They have a level 3 first line management qualification and are registered with the Care Quality Commission. They have previous experience of working in different care settings,primarily with younger adults with Learning Disabilities. The Registered Manager is curently on Maternity leave and her post is being covered by two Registered Managers from other homes taking on responsibility for one house from the cluster. The manager continually strives to support the philosophy of the organisation, where person centred care is of paramount importance, and the needs of individuals are considered and reflected upon in detail. Staff and students spoken with described them as supportive, approachable, a good listener, someone with a genuine regard for the staff and the students. Care Homes for Adults (18-65 years) Page 30 of 34 Evidence: A range of certificates were included in the Aqaa document and a sample of these were examined during the visit including; fire fighting equipment, fire alarm and electrical certificate all of which were found to be satisfactory. There is a corporate Health and Safety policy and procedures in place to ensure the safety of students, staff and visitors. All areas are risk assessed and copies of these are maintained within the home, covering all environmental and task related activities. Linkage has been awarded the three star British Safety Council Award. Similarly there is a corporate Quality Monitoring system (EFQM) which is coordinated by a College Quality Manager and who takes the lead on quality issues. This includes producing an annual plan which provides the framework for Quality Assurance activity; including surveys, audits and appraisals. An annual review document and regular newsletters are also produced as part of this. Quality assurance is further supported by monthly Regulation 26 visits by the responsible individual. A monthly analysis of accidents is produced by the manager. Staff receive regular supervision and have the opportunity to attend training and staff meetings. Students are involved in weekly meetings, a learners council with external advocates and are involved in staff recruitment. Records of all students and staff meetings were seen. 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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