Care Home: NCYPE - College Residential Services Lingfield.

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What the care home does well Young people who are considering moving into student accommodation on the college campus can be confident their needs will be properly assessed to ensure these are fully understood and can be met. They are provided with detailed information about what life will be like and opportunity to visit to enable them to make an informed decision about moving onto the campus. The young people can be confident their needs are understood and can be met. Their independence is promoted and they are encouraged and supported to make choices according to their individual needs and abilities. They also enjoy opportunities to take part in a variety of activities and a full social life. They are supported to maintain contact with family and friends and establish links with the local community. Students are encouraged to develop independent living skills and help prepare nutritious meals in line with their individual needs and choices. The health of students is promoted. They are supported by a range of on site health care professionals. Personal care is provided in a way that promotes their privacy and dignity. Safe medication systems ensure young people are protected from harm. The young people are listened to and protected from abuse. Many of the young people benefit from good student accommodation within the newly built or refurbished housing on site. Students can be confident there are sufficient staff on duty who understand their needs and are well trained and competent to support them. Students are protected from harm through robust recruitment and selection policies and procedures. They can be confident the service is managed in their best interests. Effective quality assurance systems ensure their views are taken into account when decisions are made. They are protected from harm through safe working practices. What has improved since the last inspection? A number of improvements have been made since our last visit. These include the introduction of student management plans and working files to all houses to provide a clear operational guidance to enable staff to understand how to provide appropriate support for students according to their individual needs and abilities. Changes to the environment have been made and new clubs have been introduced as a result of listening to the young people. More transport is available to assist students to access community facilities. Staff training courses are more frequent and new courses have been introduced to enhance working practice and develop knowledge and skills to ensure support for students is of a high standard. What the care home could do better: Whilst many of the young people benefit from good student accommodation within newly built or refurbished housing on site, a number of houses do not meet current standards. A requirement has not been made on this issue as agreement was reached at registration that the ongoing building plan is satisfactory. Whilst the difficulties of the current economic climate are acknowledged the momentum must be maintained. Key inspection report Care homes for adults (18-65 years) Name: Address: NCYPE - College Residential Services Lingfield. St Piers Lane Lingfield Surrey RH7 6PW     The quality rating for this care home is:   two star good 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: Ruth Burnham     Date: 1 6 0 4 2 0 1 0 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. that people have said are important to them: They reflect the things 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 29 Information about the care home Name of care home: Address: NCYPE - College Residential Services Lingfield. St Piers Lane Lingfield Surrey RH7 6PW 01342831314 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The National Centre for Young People with Epilepsy Name of registered manager (if applicable) Mrs Wendy Elizabeth Doyle Ms Joanne Eileen Lutton Type of registration: Number of places registered: care home 110 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 110. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home NCYPE Residential College provides education. personal care and accommodation for 110 students who have epilepsy and varying levels of learning disability. Many of the students have complex needs including physical disabilities and require significant levels of care and support. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 110 1 5 0 4 2 0 0 9 Brief description of the care home In addition to the educational facilities there are 12 houses on the campus where students live during term time. One of the houses provides accommodation for students who live there for 52 weeks of the year. The houses vary from new build to older houses. There is also a medical centre and good recreational facilities on site. The College is located in a rural setting close to Lingfield and local amenities. Fees vary according to levels of care and support required. Full information about fees can be obtained by application to the college. Care Homes for Adults (18-65 years) Page 5 of 29 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the Service was an unannounced Key Inspection. Two site visits were undertaken, The first visit was on 26th March 2010 at which time we visited 3 houses on the campus, spoke to a number of staff and students and examined a number of documents. We gave feedback to the residential services management team at the end of this visit. We made a short second visit on 16th April to discuss recent safeguarding issues and procedures with the residential services management team and visit the student house where accommodation and care is provided throughout the year, rather than just in term time. The inspection took into account detailed information provided by the college and any information that CQC has received about the Service since the last inspection. There are no Required Developments at the end of this Report although the environment has been given an overall judgement of adequate. This is because some Care Homes for Adults (18-65 years) Page 6 of 29 existing student accommodation does not meet current standards and is gradually being replaced as part of the ongoing building programme at the college. The quality rating for this service is 2 star. This means the young people who use this service experience good quality outcomes. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Whilst many of the young people benefit from good student accommodation within newly built or refurbished housing on site, a number of houses do not meet current standards. A requirement has not been made on this issue as agreement was reached at registration that the ongoing building plan is satisfactory. Whilst the difficulties of the current economic climate are acknowledged the momentum must be maintained. Care Homes for Adults (18-65 years) Page 8 of 29 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 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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 10 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Young people who are considering moving into houses on the college campus can be confident their needs will be properly assessed to ensure they are fully understood and can be met. They are provided with helpful information about what life will be like and opportunity to visit to enable them to make an informed decision about living there. Evidence: Young people who are considering moving to the college are provided with helpful information about what life will be like if they choose to move into the student houses on the college campus. Within the NCYPE college residential homes there are 12 individual residences. Aims and objectives for each home are reviewed annually to ensure that each home continues to meet the needs of students, the group relates well together and are students are offered appropriate learning and development opportunities. Information is provided in the college residential homes Statement of Purpose which details the individual aims and objectives of each home. Each of the houses has an Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: individual service user guide which provides students with specific information about the home that they are considering living in. Young people are able to visit and experience life in one of the residential units before they decide to move there. Open days are arranged for prospective families and professionals to visit the college and determine whether the services provided are relevant and suitable for the needs of the young person they represent. The visit includes a tour of both college and a residential environment. Up to date information about prospective students is reviewed by an admissions panel made up from members of the multi disciplinary team before assessment. These assessments identify staffing required as well as any specific equipment needs. Full detailed assessments are carried out before any young person moves in. This includes an overnight stay and in some cases outreach visits. Young people can be confident they will be placed in a house that meets their needs. Should a student need to move between houses during their time at the college and this is identified with involvement from the young person, their families and the staff teams working with them. Transition visits are planned and necessary information is shared between the two staff teams. Students we spoke to confirmed they had visited the college before moving in and they knew about the information available. Care Homes for Adults (18-65 years) Page 12 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students who live on the college campus can be confident their needs are understood and can be met. Their independence is promoted and they are encouraged and supported to make choices according to their individual needs and abilities. Effective risk management systems protect students from harm. Evidence: Students can be confident staff understand their needs and know how to provide appropriate support in line with their wishes and expectations. Once students move in, staff work with them to develop an individual student management plan detailing their needs and how they wish their needs to be met. Each student has an individual learning, care plan which identifies objectives they are working towards to enhance and improve their independence and social skills. Students are encouraged to be involved in this process. The plan is personalised to reflect the needs and wishes of the individual and provides clear guidance to staff on how to provide individualised support. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Each student has an annual review as well as regular multi disciplinary meetings to discuss progress and factors which may affect them. These reviews take account of the view of the student. Many of the young people have complex needs and cannot communicate their needs easily. Specialist support is available on site and and a range of services are available to support them with their individual needs and choices. For example, occupational therapists assist with practical support to aid and promote independence. Speech and language therapists are available to ensure communication needs are identified and strategies are in place for staff to provide appropriate support. Each student has a key worker with whom they have regular individual sessions. Their key worker listens to them and supports them to make choices. They are involved in choosing their key worker wherever possible. Students are protected from harm through effective risk management processes. Risk assessments were seen for several students, these were individual and provided guidance for staff on how to minimise risk. Risk assessments varied in quality between houses. There is a problem in some instances where these documents are pre populated and have not been personalised to take account of individual needs and abilities. This was discussed with the managers following the first visit. The issue had already been recognised and there are plans in place to remove pre populated sections to ensure all the actions recorded to minimise risk are person centred and relevant to the individual concerned. Discussion with staff during the visit confirmed that they know the student well and understand how to ensure students are protected from harm within a risk management framework that promotes choice and independence. Better training for staff in Mental Capacity and Deprivation of Liberties has led to more staff advocating for the students rights to make choices rather than making decisions for them. Students can be confident their cultural and religious needs are identified and understood. Young people at the college come from a variety of ethnic groups and religious backgrounds. Policies are in place to ensure that equality and diversity are promoted and practised. Staff are trained on values, diversity and disability awareness. The training covers respecting values and beliefs. Students have the opportunity to access places of worship and are supported to attend as required. Religious celebrations and events are acknowledged through culture evenings. Care Homes for Adults (18-65 years) Page 14 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students who live on campus enjoy a variety of activities and a full social life. They are supported to maintain contact with family and friends and establish links with the local community. They are encouraged and supported to develop independent living skills and help prepare nutritious meals in line with their individual needs and choices. Evidence: Students who we spoke to told us how happy they were at the college. They confirmed they are involved in decisions about how each house is run. Regular student meetings are held and students plan their menus. Students benefit from the excellent links the college has with the local community and students visit places in the local community such as the local gym,library, sports centre, pubs, clubs and places of worship. Increased availability of minibuses has improved the students access to college transport and they are supported to use Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: public transport where appropriate. Students enjoy a full social life and are offered many and varied activities such as trips to the cinema, bowling, night clubs, swimming and a variety of places of interest. We were able to observe a lively discussion in one of the houses during lunch when students were talking together with staff about plans for a trip to the cinema on the evening of our visit. Students told us they enjoy lots of recreational activities in the evenings and at weekends, some on campus and some in the community. The students attend college each day and are also involved in work experience placements. A selection of Evening activities are also offered on-site that cater for a wide range of needs and abilities. Discos are held in the main hall regularly. Students are asked what activities they would like and this is reviewed annually. Houses on site have a good selection of leisure equipment. Paton has a computer room for students use. Students also benefit from access to a large sports hall, gym, aqua trainer pool and soft play area on site. Many of the students participate in a residential holiday and some young people have the opportunity to attend a skiing holiday with Surrey Special Schools. . Students all have regular weekends at home and are supported to maintain regular contact with their family and friends. Parents and families are encouraged to visit at any time. They are able to meet in the privacy of their own bedrooms or in a separate family area that affords privacy. Students share the responsibility for keeping their house clean and tidy where appropriate. There is a rota in place and they are supported to develop independence skills. They are encouraged to do their own washing and clean their rooms with appropriate support from staff. Students who are able to are encouraged and supported to shop and do their own cooking and are very happy to do so. Healthy eating is actively promoted and students are supported to plan a healthy menu. Lunch is provided in most of the homes by the central kitchen however some of the houses choose to remain self catering where lunch is prepared by staff. All homes cater for their own evening meals and students are supported to be actively involved in preparing this wherever possible. A selection of nutritious recipes has been provided by the catering manager for houses to ensure a healthy and balanced diet whilst considering individual preferences. We joined students for lunch in on of the houses, some chose sandwiches and others had the hot meal which was fish and chips. Staff eat with students at lunch time which provides a friendly family atmosphere. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and health care 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health of students who live on campus is promoted. They are supported by a range of on site health care professionals. Personal care is provided in a way that promotes their privacy and dignity. Good medication systems ensure students are protected from harm. Evidence: Students who live on the campus can be confident their health and personal care needs are understood and will be met in a way that promotes their privacy and dignity. Care staff and management work as part of a multi disciplinary team to identify and meet the health and personal care needs of students. Privacy, dignity and respect is maintained when dealing with students who are unable to manage their own personal care. Young people are encouraged to choose staff to help them and same gender support is encouraged. A new medical centre has been opened since our last visit. This is a 24 hour facility and is available for use by students. Each house has a named key nurse who visits regularly to discuss any concerns with the students and advise the staff team if necessary. All students are registered with the local GP and clinics are offered at the NCYPE medical centre. Students are offered the opportunity to access the local surgery if they prefer. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Details of health care needs are recorded in student management plans. Students are encouraged to manage their own personal care with support from staff where required. Students told us they knew who to talk to about any concerns or health issues. Communication between care staff and health care professionals is good. There is Opportunity to raise any issues or concerns during multi disciplinary meetings, annual reviews and team meetings. Students are also offered additional services such as psychology, physiotherapy, occupational therapy and speech and language therapy. They are encouraged to make and attend their own clinical appointments wherever possible but are aware that they can also ask for staff support if they wish. Staff advocate for students who are unable to do this and arrange appointments if necessary. Students are protected from harm through safe handling of medication. Medication is held securely,in line with current guidance and legislation. Risk assessments are carried out and support is provided where students are assessed as not being able to manage their own medication safely. Young people who can manage their own medication are provided with lockable storage areas. Any medication changes are subject to consultation with the students and or their representative. Students can be confident staff understand their specialist needs. Care staff are required to attend training in Epilepsy Awareness, Moving and Handling, Risk Assessment and Medication training, to ensure they understand and can support the students with their individual health care needs. Students have access to Mens or womens groups and health issues can be discussed with a Key nurse allocated to each home. Care Staff are are also trained in Sexuality and relationships to enable them to support and provide appropriate guidance for students in these areas in a way which supports their privacy and dignity. Care Homes for Adults (18-65 years) Page 18 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Young people who live on the campus are listened to and protected from abuse. Evidence: Students who we spoke to during our visit knew who to talk to if they were unhappy about anything. They are encouraged to offer comment or complaint. The complaints procedure is displayed on the notice board in each of the houses. Each home holds a low level complaints book where complaints are logged. A satisfactory outcome is explored in consultation with students and any actions necessary are also recorded. The registered managers review these regularly. A copy of the complaints policy has been produced in a symbolised format to ensure it is accessible to all students. Key workers also explain the procedure and support students to make a complaint and advocate for them as necessary. In some cases, where students need additional support to complain or raise a concern the service involves the visiting independent advocate who is trained in seeking students views. The complaints procedure is also available in the Statement of Purpose and the individual service user guide. More serious complaints or complaints where the complainant is not happy with the outcome are forwarded to the college Director of Health and Social Care who ensures a full investigation is carried out and responds in writing to the complainant with the outcome within a specific time frame. It is also policy that any complainant is given Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: the details of the Commission and may also refer their concerns to us. Where we were notified of a concern about the security of student houses this was passed on to the registered managers of the service who conducted an investigation and took action to ensure students are protected and their property in the houses is secure at all times. The managers told us about 21 complaints which they have received since our last visit, all of which were resolved within 28 days. Young people who live on the campus are protected from abuse through robust policies and procedures for safeguarding adults. All staff attend a full training course in safeguarding before they start working with students. Annual refresher training is also provided. A social worker with experience in safeguarding is employed by the College who coordinates and communicates concerns to the local Surrey Safeguarding Authority. A team of additional professionals from different disciplines within NCYPE ensure there is 24 hour cover for reporting concerns. Staff from the houses know they can also raise concerns directly with Surrey County Council and the Care Quality Commission if they wish. Staff who we spoke to understood how to safeguard students from abuse and who to contact if concerns were identified. The service told us about 57 incidents which have been reported to them under their safeguarding adults procedures since our last visit. Fourteen of these were referred to Surrey County Councils safeguarding team for investigation. A recent safeguarding investigation conducted by the Surrey County Council Safeguarding Team was discussed and we were told this has now been closed. There is one ongoing investigation. We discussed safeguarding procedures with the residential services management team. They told us that reporting procedures are being reviewed to ensure there are no unnecessary delays in alerting appropriate external Agencies where concerns arise and to ensure the registered managers are also informed of all incidents. The service informs us of all incidents promptly in line with current regulations. There are occasions when staff need to intervene physically to ensure the safety of students. There are clear individual restraint procedures in place and all incidents are logged. All staff receive training in safe and appropriate physical interventions. The service told us about 26 incidents where restraint has been used to protect students and others on the campus. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Many of the young people benefit from good student accommodation within newly built or refurbished housing on site. However a number of houses do not meet current standards. The Commission has agreed the gradual phasing out of less suitable accommodation as the building programme progresses. Evidence: Students who live on campus are accommodated in 12 houses, all these homes are situated within the college grounds and within walking distance to the college where all young people attend. NCYPE uses approx 80 acres and is set in countryside affording a safe place for young people to independently access different areas if appropriate. Four houses were seen during this visit. The service endeavours to match students to an appropriate house where their needs can be catered for. During this visit we looked at Red Cross, Tucker House, Paton and Furzewood. The quality of accommodation in these houses varies. The service is aware that not all houses meet current standards and was registered on the understanding that accommodation, which fell short of minimum standards would be phased out. Plans to achieve this are underway however the current economic difficulties has delayed progress. The Management were reminded that momentum must be maintained to ensure all students are provided with accommodation to the required Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: standard within a reasonable time frame. Williams House, the latest new build student accommodation on the campus, is firmly established. It houses 24 young people,in 4 separate wings all with their own en suite facilities. Changes have been made since it opened to ensure it continues to meet the needs of the students. The service told us that environmental issues identified since this accommodation opened have been noted and will be taken into account for the next new build project. Staff teams work hard to ensure each house offers as homely an atmosphere as possible. Houses have been adapted where possible to create new areas of leisure such as computer areas. Of the four houses seen during this visit the least suitable was Red cross. Here students sleep in a large room which has been divided into bedroom cubicles. Dividing walls finish just above head height affording little privacy for the occupants. Further concerns were noted where a glass pane in a roof has not been repaired effectively and damaged guttering disturbs students at night when it rains. These concerns were drawn to the attention of the registered managers and we were told that this house will be taken out of use at the end of this academic year. Tucker house has been redesigned and meets the required standards. We were also told that Furzewood is earmarked for closure to make way for the next new accommodation block. Each house has its own laundry facilities and kitchen. Those seen during the visit were well equipped and well maintained. Care Homes for Adults (18-65 years) Page 22 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students can be confident there are sufficient staff on duty who understand their needs and are well trained and competent to support them. Students are protected from harm through robust recruitment and selection procedures. Evidence: Students who we spoke to told us staff were kind and supportive. All interactions observed between staff and students during our visits were supportive, respectful, good humoured and friendly. Students are protected from harm through robust recruitment procedures. The service manages recruitment and selection effectively through the College HR department. Individual staff files evidence sound selection and vetting processes. These include detailed application forms, Criminal Record Bureau checks, proof of identity and 2 written references. Ongoing recruitment takes place to ensure there are always sufficient staff to meet students needs. Potential candidates are required to spend the evening on one of the houses to meet the young people, prior to interview. They are assessed for their skills with particular ability levels and to see if they can demonstrate effective communication with the students and staff. The views of the young people who meet them are taken into Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: account. Formal interviews take place, questions have been reviewed and changed to improve this aspect of the recruitment process. If agency staff are needed, specific skills are identified and sought, the use of the same regular individuals ensures students receive consistent support. House managers are responsible to ensure the students individual needs are met and that there are adequate numbers of staff on each shift. Students can be confident staff who support them are trained to understand their needs before starting work in the houses. Before starting work with students staff are required to attend a 5 day induction course to cover the mandatory courses and to provide an overview of the service that is offered. This programme has been reviewed within the past year and a new programme developed which supports all new starters. New staff are supported in the work environment through regular supervision and mentoring. They are required to satisfactorily demonstrate skills and knowledge in line with the Skills for Care Common Induction Standards. They receive a 1, 3 and 6 month appraisal. In order to pass the 6 month probation period staff must demonstrate good practice, have completed the induction training Programme and booklet and have a satisfactory appraisal. A grading structure is in place to ensure staff meet the required competency level. A Literacy threshold has been introduced to ensure staff employed are competent. Half termly supervisions are carried out and documented for all staff and an annual appraisal is also undertaken. An NVQ programme is offered to all staff, including levels 3, 4 and RMA. Both in house and external management courses are offered. All staff are encouraged to seek training opportunities to aid their personal development. The managers told us that staff turnover for has reduced and is in line with the national average. Regular team meetings are held to ensure staff are up to date with the support students need. Thorough handovers are undertaken between shifts to ensure all relevant information is passed on and each students needs are met and any changes are understood. Care Homes for Adults (18-65 years) Page 24 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Young people who live on campus can be confident the houses and service are managed in their best interests. Effective quality assurance systems ensure their views are taken into account when decisions are made. Students are protected from harm through safe working practices. Evidence: Students can be confident that residential services on the campus are managed in their best interests, taking account of their views and expectations. There are 2 registered managers for the 12 houses who are qualified and experienced in the role. Each home has a dedicated staff team comprising of a house manager, assistant managers and support workers. Good communication between managers ensures students who live on campus are protected and enjoy a good quality of life. The conduct and management of each home is reviewed during monthly inspection visits. It was clear throughout the inspection that the houses are run in the best interests of the students. They are involved as far as possible in decision making processes Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: through regular house meetings where students meet as a group and share ideas about how the house is run. The minutes are available to all. There are effective quality assurance systems in place. The College holds regular Student council meetings where nominated young people represent the views of others. They invite various members of the organisation to discuss any issues that they feel strongly about. An independent advocate visits the organisation once a month and spends time with the young people listening to their views and opinions. She provides a report on the visit including any actions required. Formal annual reviews are held and the young people are asked for their views and opinions by the Chairperson about the house and college. The meeting is documented and sent to the relevant professionals. Some houses use student questionnaires to gain the young peoples views however these are not suitable for some of the young people with complex disabilities, questionnaires are sent to the person advocating for them instead. Visits from various members of the organisation including the chief executive are undertaken. Unannounced monthly visits are also carried out and the person completing the visit seeks the opinion of the young people, observes practice, choices and interactions. Students are protected from harm through safe working practices. Staff are required to attend all induction training courses which include moving and handling, first aid, infection control, health and safety, basic food hygiene and fire safety. Regular safety checks are carried out on all equipment and installations. Regular health and safety inspections are carried out on each house. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R 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 27 of 29 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 Requirement 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 Requirement 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 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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