Care Home: Toynton College (Cluster One)

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What the care home does well .Students like living at the home. They live in a house, which is clean and comfortable. They are able to make their bedrooms homely with their own personal belongings such as ornaments and photos if they wish. Students can take part in a range of social and leisure activities if they wish. Students said there were lots to do.Students’ health care and wellbeing is checked through regular appointments with a range of health professionals. Students told us they liked the meals and we saw that they have a choice.The staff know how to look after them. They work together so that they can help the student living in the home. They ensure that the students are helped to have interesting lives and activities. Students said they felt safe and liked living in the home.The home is well managed What has improved since the last inspection? The home has been made nicer to live in. Some bedrooms have been redecorated with the students involved in choosing the colours and how they wanted it done. There is a new lounge with computers. Information and care plans are more person focused and clearer. This has included a new service user’s guide which is easier to read.The range of activities has improved to give more individual choice to each person. They now focus on what the students want to do. What the care home could do better: They need to consider making more bedrooms single and making the new lounge more homely. Key inspection report Care homes for adults (18-65 years) Name: Address: Toynton College (Cluster One) Toynton College and the Bungalow Toynton Campus Toynton Hall Toynton All Saints Spilsby PE23 5AE 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: Tobias Payne Date: 0 7 0 9 2 0 0 9 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) 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. 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: Toynton College (Cluster One) Toynton College and the Bungalow Toynton Campus Toynton Hall Toynton All Saints Spilsby PE23 5AE 01790752499 01790754058 sean.knott@linkage.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Linkage Community Trust Name of registered manager (if applicable) Mr Sean Knott Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 29 0 care home 29 learning disability Additional conditions: A maximum of two service users aged 15 may be accommodated at Toynton Hall College only, for a period of up to five days in total, for assessment purposes only. These service users to be accommodated in room numbers six and eight only. College students who are under 18 years of age and who are currently being supported by staff who are under 21 years, on a 1:1 basis, will continue to be so until such times that the student no longer requires this, or the staff member reaches 21 years of age. All new staff working unsupervised with students will be over 21 years old. The category LD applies to service users aged 15 and over. The home is registered to provide personal care for service users of both sexes whose primary needs fall in the following categories:- Learning Disabilities, not falling within any other category (LD) (29) Care Homes for Adults (18-65 years) Page 4 of 34 The maximum number of service users to be accommodated is 29. The number of service users aged 15 and those aged 16 and 17 years, does not exceed a total of 11 at Toynton College (Cluster One) and this is conditional on there being no service users over the age of 25 years of age at the home. Date of last inspection 1 3 0 9 2 0 0 6 A bit about the care home Toynton College is one of a number of homes run by Linkage. It is in a village in Lincolnshire. Students live in the main building or in the single storey Bungalow in the large grounds of the main college. The home is comfortable and homely. There is a kitchen, dining room and 2 sitting rooms. Care Homes for Adults (18-65 years) Page 5 of 34 20 young men and women live in the home. Everyone is given information telling him or her what they can expect if they live there. They have mini buses. This means that the people who live at the home can get around easily. There are 9 single bedrooms and 7 doubles. They can decorate them to suit their needs with a choice of 3 colours. Care Homes for Adults (18-65 years) Page 6 of 34 Some information and photographs are on display in the home showing the different things that happen. Care Homes for Adults (18-65 years) Page 7 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 8 of 34 How we did our inspection: This is what we did when we were at the home. Throughout this report the terms we and us refer to the Care Quality Commission (CQC). Before the visit the manager had completed a questionnaire. This gave us some important information about their own assessment of how well they are meeting standards and how they plan to improve the service. We spent time with the students who lived there. We talked to two of the people who live at the home. Care Homes for Adults (18-65 years) Page 9 of 34 We talked to the staff who were helping them. We followed the care of 2 people and checked their records. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell student how to follow the rules. General discussion was held with the manager about the outcomes at the end of the inspection. Care Homes for Adults (18-65 years) Page 10 of 34 What the care home does well. Students like living at the home. They live in a house, which is clean and comfortable. They are able to make their bedrooms homely with their own personal belongings such as ornaments and photos if they wish. Students can take part in a range of social and leisure activities if they wish. Students said there were lots to do. Care Homes for Adults (18-65 years) Page 11 of 34 Students’ health care and wellbeing is checked through regular appointments with a range of health professionals. Students told us they liked the meals and we saw that they have a choice. The staff know how to look after them. They work together so that they can help the student living in the home. They ensure that the students are helped to have interesting lives and activities. Students said they felt safe and liked living in the home. Care Homes for Adults (18-65 years) Page 12 of 34 The home is well managed What has got better from the last inspection The home has been made nicer to live in. Some bedrooms have been redecorated with the students involved in choosing the colours and how they wanted it done. There is a new lounge with computers. Information and care plans are more person focused and clearer. This has included a new service user’s guide which is easier to read. Care Homes for Adults (18-65 years) Page 13 of 34 The range of activities has improved to give more individual choice to each person. They now focus on what the students want to do. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 14 of 34 If you want to speak to the inspector please contact If you want to speak to the inspector please contact Tobias Payne at the Care Quality Commission East Midlands Citygate Gallowgate Newcastle upon Tyne NE1 4PA Tel. 03000 616161 Email enquiries@cqc.org.uk 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 15 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 16 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: Students 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 living at this home receive clear and detailed information to suit their needs to enable them or their relatives and or advocates to make an informed choice as to whether or not they wish to live in this home. Where a person is referred to the home careful and sensitive assessments take place for each person being admitted to the home to ensure that it meets their needs. Evidence: There was a statement of purpose and a new easy read service users guide with photographs and pictures available. Both documents were in words and in an easy read format with pictures. The manager agreed to ensure that our new name and contact details were in all the relevant information. The manager told us that the college had just opened following a summer break and many of the students in the Main Hall were new to the college and in the process of settling in. The manager told us that where a referral was received each person would be invited with their parents for a 3 day assessment where they would initially stay in one of their assessment beds. During this period they would receive a detailed assessment which could include assessments from their child psychologist, educational therapist and Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: speech and language therapist. Once it had been agreed that the service can meet their needs arrangements would be made for them to come and meet the team at which they would outline how Linkage works and how the service operates. The manager told us that the emphasis was to ensure that there was a smooth transition to the home and support was given to both the person and their family to enable this to happen. During this process the manager told us information was obtained from the person their family and other students connected with their care and support. Written confirmation would be sent to confirm the home could meet their needs based on this assessment. It was clear to us that considerable time and effort was made to ensure any admission went well. We spoke with 2 new students who commented this is a fab place, I was nervous when I first came here but I have settled in and like the freedom. We also saw a letter from a local school sent in June 2009 which was very positive and commented I would like to thank you for all the support you have given in settling one of our students into Toynton College. The liaison between yourself and staff was brilliant. Thank you all the meetings and ensuring such a smooth transition for one of our young students with complex needs. Care Homes for Adults (18-65 years) Page 18 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: Students 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. There is detailed care planning which includes risk assessments. Students enjoy choices about what activities they want to get involved and have a varied social programme. Students are encouraged to make decisions for themselves and be independent with the support and guidance of staff. Evidence: Each person had a care plan. The records included, personal information, their likes and dislikes, photograph, daily support plan, communication record, my health action plan and a detailed initial assessment. From this a care plan had been produced which was clear and detailed. The care plan outlined the delivery of care needs, goals and action plan to achieve goal. Each aspect of care and support and their daily routine was very detailed and specific to each person and included weight records as well as nutrition and healthy living programme. There was evidence of review dates and the care plan was reviewed every 6 weeks with the involvement of each person. Care plans were individual and the daily records well written, factual and dated and cross referenced with the care plan. During the inspection visit we saw staff offered and respected choices and were Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: flexible in their approach with good clear communication skills towards the students. The manager told us that staff had received training about the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and a capacity assessment was included. This concerned protecting each persons rights and choices. We saw staff throughout our visit talking and communicating with the students in a kind, calm and sensitive approach respecting their views and opinions. Choice and decision making was clearly shown in the care plans. The students were given choice concerning their interests, activities and lifestyle. Staff received training to assist and support them. The care records were very detailed, person focused and reviewed regularly. Each person had a key worker and personal tutor during their stay. This information enabled staff to understand and support each person. There were also very detailed risk assessments covering transport, activities and where required cooking or working in the kitchen. All entries were dated with signatures from staff. The manager told us that the new students were sampling the wide range of courses at the college so that they could choose which they wanted to do in the future. The college has a learners council where students can raise any concerns. A representative of a Lincolnshire advocacy service visits the site every week and is involved in this council. The manager told us that they have a weekly meeting at which issues such as activities and meals are discussed. During the visit the students we spoke with talked about how they are supported to make decisions and choices about things like holidays, meals and activities. One person told us I was involved in choosing my key worker and she is beginning to get to know me. Staff we spoke with told us of the support they gave to enable the students make choices about the decisions they made each day concerning what clothes to wear, what they want to eat and where they want to go. They also talked about how they help the students to maintain and develop their independence with, for example, cooking skills. There is a large kitchen and a smaller domestic style kitchen available for the students to use with the support and guidance from staff. Care Homes for Adults (18-65 years) Page 20 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: Students 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 involved in meaningful and appropriate activities, which include educational and recreational activities. They enjoy varied and nutritious meals which within their capabilities they are involved in. Evidence: Each person was in the process of deciding upon and being involved in drawing up with their key worker an individual timetable, which provided a combination of educational, vocational and leisure activities. Linkage had a philosophy of a 24 hour curriculum to enable the skills gained from college to be transferred into the home. There were very close links to enable this to happen between the educational and care staff. Students are encouraged and supported to gain a wide range of skills whilst at the college. These included on site gardening, information and computer literacy, art and media studies, photography, communication with emphasis on MAKATON and performing arts. Out of college activities included bowling, visits to the cinema, swimming, visits to the theatre, golf, local walks, nature walks, games evenings as well as evening classes and the opportunity to study for a Duke of Edinburgh award. There were also a wide range of Care Homes for Adults (18-65 years) Page 21 of 34 Evidence: home and community based activities. There were photographs in the home of the activities the students had chosen to go on. The manager told us of past trips had included Florida, a skiing trip in Andorra and some students had been to pop concerts. Students we spoke with told us this place is cool and there is so much to do and lots of choice. The manager also told us that there was a weekly residents meeting at which the students were asked for suggestions, so that they could choose their favorite meals. During the day students ate in the main canteen. We noted that following an inspection by East Lindsey District Council they were awarded an Excellent award in recognition of their catering standards in 2009. Both the Main Hall and The Bungalow have domestic kitchens, and students are supported to cook their own evening meals and involved in menu planning. All students we spoke with told us they liked the food, it was good, and that their preferences were catered for. Each care plan contained detailed information about likes, dislikes and any special diets and fresh fruit and vegetables were available. Care Homes for Adults (18-65 years) Page 22 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: Students 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 benefit from being fully involved in identifying their own needs and choices. Clear care plans, created from assessments of need help to ensure that students health and welfare needs are fully met. Medication is safely given by staff who know what they are doing. Evidence: Care plans had information about each persons health needs and where required specialist services were available on site including a registered nurse. Linkage encourage students to maintain their own dentist and optician arrangements from where they have lived. As part of the assessment process a report is obtained from each persons local doctor and they have a health check when starting at the college. The college encourages and supports the students to self medicate. However as most of the students were new and settling in this was not taking place on the day our inspection visit. Each student would be assessed as to their competence before self medication would take place. We saw staff throughout our inspection visit show a person focused approach to care, using a flexible, sensitive and relaxed approach. Each person had a detailed Health Action Plan, a nationally recognised health check assessment. There were also clear plans and risk management strategies in place for supporting students with behavioural needs. Each person had a nutritional assessment and their weight was monitored regularly. Care Homes for Adults (18-65 years) Page 23 of 34 Evidence: The manager told us that staff were responsible for giving out medication and monitoring that students did this safely. They only did this after they had been assessed as competent to administer medication by the registered nurse. They would then have 2 weeks of practice under supervision. We saw that records were well maintained with receipt and disposal records. The manager also carried out monthly audits and reports of findings and action required were kept. The service receives regular pharmacy inspections the last being on the 11/6/2009. The report commented continues to maintain a good standard. All satisfactory. Care Homes for Adults (18-65 years) Page 24 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: Students 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. Complaints received were treated properly. Staff are recruited correctly to ensure that the students were protected from abuse. Staff have a good knowledge of the adult protection procedures. Evidence: Each person had a pictorial complaints procedure and a DVD was also available describing what they should do if they had any complaints or concerns. The complaints policy was also referred to in the easy read service users guide. The AQAA showed us they had received 1 complaint over the last year which they had investigated using their complaints procedure. We had received no complaints about the service. We had been aware of 2 safeguarding adults issues which had been investigated by Lincolnshire County Council with no concerns arising as a result. The home had an adult and child protection policy and all staff as part of their induction received abuse training. The home also had a copy of Lincolnshire County Councils adult and child protection procedures. This is covered during the induction training for new staff and in addition each person is given a green card about abuse recognition and a safeguarding children and vulnerable adults leaflet. We spoke with 2 members of staff who knew about abuse and what they should do if they suspected abuse was taking place. There are procedures available on individual care plans regarding physical intervention to Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: make sure students are protected properly and detailed records are kept in order to support the students with their finances. During our visit no person we spoke with living in the home or staff had any concerns about the home. Care Homes for Adults (18-65 years) Page 26 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: Students 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 live in clean, safe, and comfortable accommodation suited to their needs. Evidence: The home had a maintenance programme. The manager told us that each student is encouraged and supported to take responsibility where they live with a cleaning rota to maintain the levels of cleanliness. Students are also encouraged to personalise their bedrooms. Since the last inspection they have reviewed the layout of the home and removed offices and teaching rooms not connected with the hall out of the building to other areas on the site. This has made the main building more homely. They now have a separate medication room and a second lounge/computer room. Students were offered a choice of 3 colours to decorate their rooms. Communal spaces included 2 lounges and a dining room. There was a laundry with domestic machines and the students were encouraged and supported to do their own washing. We discussed with the manager our observation that a number of students had to share accommodation and some of the windows did not have window restrictors on the first floor. We were told that a programme of window repair was in progress. Students we spoke with told us they liked their rooms. 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: Students 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. There is a safely recruited, well trained, established, supported staff team available who have the skills to meet the varying needs of the students living in the home. Evidence: Each person living in the home had a key worker responsible for care support and a personal tutor responsible for their education. The manager told us he ensured that staff had the skills to support the particular needs of the the students. Where the students had particular needs he would arrange for specific training to ensure that staff had the knowledge to care and support the person. We saw recruitment records for the most recent member of staff recruited over the last year. These records showed they had been safely recruited with a check by the Criminal Records Bureau, application form, 2 references and proof of identity. Linkage also ensures that representatives of the students living in the home are involved in the interview process for staff and managers. The manager told us that each person is asked whether they wish to be involved in interviewing staff. The manager told us he would arrange to meet with the person and together they would decide on the questions they wish to ask. Once recruited each new member of staff had a supported induction programme. Records we saw confirmed this took place. Thereafter a more detailed induction programme would take place over 6 weeks to nationally recognised standards. The manager told us that they have an annual training programme and encouraged the staff to work towards a national Vocational Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: qualification in care. Records we saw showed that 75 of staff had obtained a an NVQ level 2. Training over the year had covered equality and diversity (each person receives a detailed leaflet in addition to the training), fire safety, first aid, health and safety, moving and handling, protecting vulnerable adults, risk assessment, medication administration and MAKATON communication. The manager had also received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. We spoke with 2 members of staff who told us I received a very professional and friendly interview, I received a thorough induction during which I was supported and shadowed by a member of staff until I felt confident to work on my own, It was rather daunting but I found everyone friendly and keen to help and answer any of my questions and I have learnt so much and there is plenty of training provided. Staff told us they receive supervision and that they are supported to talk about their individual needs. Records confirmed this. There was an equality and diversity policy and during our inspection we saw no equality and diversity or communication issues. The staff felt they could meet the needs of the students living in the home and felt they had sufficient time. During our inspection visit we saw staff taking particular time to communicate to the the students in a calm, kind, friendly and sensitive manner. 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: Students 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 and staff benefit from the positive leadership of the management team. Management record systems show that students health, welfare, safety and choices are promoted. The management team ensures that the students living in the home with the support of the staff have the opportunity to voice their views and opinions. Evidence: Since the last inspection we registered a new manager for the home in July 2009. This person had many years of experience in learning disability and was studying to obtain a management qualification. Staff had confidence in him and spoke of the supervision and support received during which their practice and performance was discussed. Throughout our visit we saw a very relaxed and happy atmosphere in the home and staff showed knowledge about the needs of the students living in the home. Linkage have very well established systems in place to monitor quality and seeking the views of the students. Regular detailed annual questionnaires are sent out to obtain their views of the service. We looked at the results of the last survey in 2008. These were analysed by the manager and showed that the majority of comments were very positive Care Homes for Adults (18-65 years) Page 30 of 34 Evidence: about their experience in the home. The views of the students are also obtained through weekly house meetings, a Learners Council, personal tutorials and one to one key worker sessions. Regular monthly visits were also made by the responsible individual for Linkage who was present at this inspection. These were also comprehensive and looked at aspects in the home and also the views of a sample of students. An action plan was provided as a result of these visits where issues arose and these would be followed up to see that the issues had been addressed. In addition the Learning Skills Council made regular external audits. Linkage also had a 3 year development plan, quality improvement and operational plan. Students we spoke with told us Sean is great, I like it here and find staff helpful and I know I can discuss things with my key worker if I have any worries. Staff told us we work well together and the manager is very supportive and I can discuss issues with him. We found records up to date and available throughout our visit. The service was once again awarded Investors in Students award a nationally recognised standard in recognition of their commitment to staff development. The home had a comprehensive and detailed health and safety policy together with detailed risk assessments covering all aspects of daily living activities. Linkage have a health and safety manager responsible for this and each student carries out a Safe Learner Induction Checklist which covers fire prevention, accidents and staff support, so that they know what to do in an emergency. The manager also has a managing safety qualification. We did observe that a number of windows could pose a hazard as they did not have restrictors to windows on the first floor to prevent falls. We had no other concerns. 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 1 24 Consideration should be made to make the new lounge/computer room more homely by providing curtains rather than blinds Windows on the first floor should be assessed about the risk posed to students living in the rooms and suitable methods provided to reduce and prevent the possibility of students falling from open windows. 2 24 3 25 Consideration should be made to provide more single bedded accommodation to meet individual needs and lifestyles. 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. 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 34 of 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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