Care Home: Toynton College (Cluster Three)

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What the care home does well The 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. They said there were lots to do.They have weekly meetings when all the students who live in the home can get together to talk about any changes they may like and raise any matters of concern. Their health care and wellbeing is checked through regular appointments with a range of health professionals. They 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 students living in the home. They ensure that the students are helped to have interesting lives and activities.They said they felt safe and liked living in the home.The home is well managed. What has improved since the last inspection? One of the homes has had a large conservatory built since the last visit, which students have their meals in. Students have the choice of colour in their rooms. Those rooms which needed decoration have been done. Students are encouraged to read and work with carers on their care plans. What the care home could do better: Training for some staff needs to be better so that they can protect peoples rights. Key inspection report Care homes for adults (18-65 years) Name: Address: Toynton College (Cluster Three) Donnas Cottage Toynton College Toynton All Saints Spilsby Lincs 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: Douglas Tunmore Date: 0 3 1 1 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 37 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 37 Information about the care home Name of care home: Address: Toynton College (Cluster Three) Donnas Cottage Toynton College Toynton All Saints Spilsby Lincs PE23 5AE 01790754053 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : mykey.rockall@linkage.org.uk Linkage Community Trust care home 16 Number of places (if applicable): Under 65 Over 65 16 0 learning disability Additional conditions: College students who are under 18 years of age and who are currently being supported by staff who are under the age of 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. Linkage Cluster 3 may accommodate a maximum of 6 service users aged 16-17 years of age, conditional on there being no service users over the age of 25 years of age at the home. The category LD applies to service users aged 16 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) (16) The maximum number of service users to be accommodated is 16. Care Homes for Adults (18-65 years) Page 4 of 37 Date of last inspection A bit about the care home Donnas Cottage and Dunsford are two homes run by Linkage. It is in a village in Lincolnshire. Students live in the homes which are two storey houses with parking to the front and gardens to the rear. Dunsford also has a conservatory. The homes can accommodate 16 students. Everyone is given information telling them what they can expect if they live there. Mini buses are available for students use. Care Homes for Adults (18-65 years) Page 5 of 37 The students fees are funded by the Learning Skill Council LSC and also on occasion by Local Authority Social Services Departments. Care Homes for Adults (18-65 years) Page 6 of 37 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 7 of 37 How we did our inspection: This is what the inspector did when they were at the care home *** The quality rating for this service is 3 stars, which means that people get good quality outcomes. 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 Page 8 of 37 Care Homes for Adults (18-65 years) improve the service. We spent time with the students who lived there. We talked to two of the people who live at the home. We talked to the staff who were helping them. We followed the care of 2 people and checked their records. Care Homes for Adults (18-65 years) Page 9 of 37 We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people 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 37 What the care home does well The 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. They said there were lots to do. Care Homes for Adults (18-65 years) Page 11 of 37 They have weekly meetings when all the students who live in the home can get together to talk about any changes they may like and raise any matters of concern. Their health care and wellbeing is checked through regular appointments with a range of health professionals. They 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 students living in the home. They ensure that the students are helped to have interesting lives and activities. Care Homes for Adults (18-65 years) Page 12 of 37 They said they felt safe and liked living in the home. The home is well managed. Care Homes for Adults (18-65 years) Page 13 of 37 What has got better from the last inspection One of the homes has had a large conservatory built since the last visit, which students have their meals in. Students have the choice of colour in their rooms. Those rooms which needed decoration have been done. Students are encouraged to read and work with carers on their care plans. Care Homes for Adults (18-65 years) Page 14 of 37 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 15 of 37 If you want to speak to the inspector please contact Douglas Tunmore Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA Tel: 03000 616161 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 16 of 37 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 17 of 37 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: We were told that, a full assessment of the students needs are gathered prior to entry and prospective students have the opportunity to test drive the home in a residential assessment stay. As a specialist residential college we operate a program designed to help students develop their independent living skills and student needs are continually being assessed. We looked at the care plans of two students at Donnas Cottage who are new to the college. We found that prospective students had been invited to the college with their relatives or advocates before they were admitted to have a look around. The manager told us that when a referral is received each person would be invited with their parents or advocates for a three day assessment where they would initially stay in one of the homes. During this period they would receive a detailed assessment which Care Homes for Adults (18-65 years) Page 18 of 37 Evidence: could include assessments from their child psychologist, educational therapist and 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 who would outline how Linkage works and how the service operates. The manager told us that the assessment process is undertaken in a sensitive manner to ensure that prospective students and their families are fully involved in this process, ensuring a smooth move into the home by the student. Care plans of students showed that information was obtained from the person, their family and other people connected with their care and support. Written confirmation would be sent to confirm the home could meet their needs based on this assessment. We spoke with two students who said when we came here the staff were nice to us, both said that they liked living in the home. Students surveys showed that the majority were asked if they wished to move into this home and that they had enough information before they moved in. One said that he wasnt asked if he wanted to move to this home and he didnt get any information. All staff surveys showed that they felt that they were given up to date information about the needs of students that they care for. From information seen in care plans and comments made by students, some who have complex needs it appears that considerable time and effort was made to ensure that the admission went well. Care Homes for Adults (18-65 years) Page 19 of 37 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 are encouraged to make decisions for themselves and be independent with the support and guidance of staff. Care plans accurately describe students needs. Evidence: We were informed that, we have excellent care plans which reflect individual personal goals. The care plan is reviewed every six weeks with the student taking an active role alongside staff. Each student has a key worker of their choice and is allocated a personal tutor who assist with decisions regarding all aspects of their lives. Students attend weekly meetings as well as annual reviews where they are encouraged to make a contribution of choice. We were told by the manager that all students have a care plan. We found that care plans contained personal information, their likes and dislikes, photograph, daily support plan, communication record, my health action plan and a detailed initial assessment. 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 Care Homes for Adults (18-65 years) Page 20 of 37 Evidence: 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. We found that care plans were reviewed every six weeks with the full involvement, where possible, of each student. Care plans were individual and the daily records were clear and identified the needs of students. During this visit the inspector observed interaction between students and staff in which students were actively encouraged to make their own decisions and were asked what the likely outcome would be from their actions. Staff were seen to engage students as equals and were flexible in their approach with good clear communication skills towards the students. We looked at care plans and found that there was no evidence that new laws relating to the capacity of students in what decisions they were able or unable to make had been recorded. The manager told us that there is a CD, which is used in conjunction with a questionnaire for staff to undertake. She confirmed that there were students who lacked capacity and that care plans now need to record this and assess the risks involved. We saw staff throughout our visit, talking and communicating with the students in a kind, calm and sensitive manner respecting their views and opinions. We saw that 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. We found that care plans had detailed risk assessments covering transport, activities and where required cooking or working in the kitchen. All entries were dated with signatures from staff and students who are actively involved in their care plans. We were told by the manager that there is a wide range of courses at the college so that students 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. We were told by a member of staff of the support they gave to students to enable them to make choices about the decisions they made each day, so as to improve their confidence and independence. Students surveys show us that four felt that they make decisions about what they do each day, two felt that they didnt and felt that they usually made the decision what they did each day. We were told by two students that they are involved in their care plans and that they sign them. They also confirmed that they have meetings with staff and decide what meals they want and what activities they are going to do next week. Staff surveys show that the majority of staff feel that they have the support, experience Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: and knowledge to meet the differing needs of students who live in this home. Two felt that they usually did. Staff also felt that they usually share information about those students they support. Care Homes for Adults (18-65 years) Page 22 of 37 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students 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: We were told that, we promote independence through our twenty four hour curriculum and offer wide and varied leisure programs and the development of key skills such as travel, budgeting, self managed medication and cooking skills. We encourage social inclusion and community participation. We have a Personal Health and Social Education lecturer. We looked at students care plans which showed that students are 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 twenty four hour curriculum to enable the skills gained from college to be transfered into the home. There are very close links to enable this to happen between the educational and care Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: staff. We were told that 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 theater, golf, local walks, nature walks, games evenings as well as evening classes. We were told by two students that they go bowling, swimming and on Fridays go to the local public house for the Karaoke. They also confirmed that in college they do drama, computing skills, yoga and literacy and numerous skills. One student has a boyfriend and has visited him at his house for lunch. We were told by a member of staff that they meet with students every Sunday so that they can choose their activities for the coming week. He confirmed that they go on holidays which, included trips to Center Parks, a holiday for some in Florida, Andorra skiing,, Disney land and Slovenia to attend a special festival for people with special needs. Both houses have domestic kitchens and students are supported to cook their own evening meals and are involved in menu planning. One resident who is a vegetarian has his own cooker and cooking pans due to his cultural beliefs. A student returned from college with an iced cake which he had made. This he explained was for everybody after tea. Observations made at the lunch time meal was that all students had a choice and they said that they enjoyed the meals at the home. Care plans showed us that students preferences were catered for. Each care plan contained detailed information about likes, dislikes and any special diets and fresh fruit and vegetables were available. Comments made in students surveys were, Every time the staff are nice to me, they are all kind to me and care for me well. It helps me get more independent so I will be able to care for myself. Another comment was, I like the food. I also like the activities at night and at weekend. Care Homes for Adults (18-65 years) Page 24 of 37 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and welfare needs of students living in the home are fully met. Medication procedures keep people safe. Evidence: We were told that, We have excellent care plans which state personal health care support that is required. We have a thorough medication policy and system which includes a self medication programme. Mandatory training is given to all staff. We have quarterly pharmacy visits and our medication paperwork is now more user friendly. Loss and bereavement and Manual Handling training is available for residential and staff if required. All students are registered with the local general practitioner. The college also employs a nurse to look after and advise on the health care needs of students. The nurse also undertakes training for staff on the safe handling of medication. We looked at care plans and found that students are fully involved in identifying their own needs and choices. Care plans are created from assessments of need to help ensure that students health and welfare needs are fully met. Those care plans seen 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 Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: they have lived. Other services that are available are; Psychology, Psychiatry and Speech and language therapy, which is available through the Linkage Clinical Services Team. We were told by one member of staff that students can have a choice of male of female key worker to help with their personal needs. He said that they try and maintain and improve students independence and be mindful of their privacy. Observations made throughout this visit demonstrated a person centered approach to care, being flexible and sensitive to the needs of students. Each student had a detailed Health Action Plan and a nationally recognised health check assessment. We saw that there were also clear plans and risk management strategies in place for supporting people with behavioural needs. Each person had a nutritional assessment and their weight was monitored regularly. The manager told us that staff were responsible for giving out medication safely. We looked at medication sheets and found that an accurate record was kept. The pharmacist visited on the 05/09/2009 and no issues were recorded relating to the administration of medication. We were told that no students self medicate at the time of this visit. Care Homes for Adults (18-65 years) Page 26 of 37 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students have confidence that staff will take complaints seriously and feel safe living at the home. Evidence: We were told that, we listen and act upon any concern or complaint that our students may make in accordance with our detailed policy and procedure which has been agreed with the statutory agencies and is reinforced through our staff training program. We also have a student friendly policy on DVD format within each house. All staff are issued with a green card abuse advice and Safeguarding Children and Vulnerable Adults leaflet as part of their initial induction. All existing staff were reissued with these as they were updated. Complaints received were treated properly. We looked at three Staff personnel files and found that staff are recruited correctly to ensure that students are protected from abuse. One member of staff demonstrated a good knowledge of the adult protection procedures and knew what kinds of abuse there are. 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 service users guide. We had received no complaints about the service. However, two complaints had been made about the home and these were seen to have been addressed within the time limit of twenty eight days. Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: The provider has 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 one member of staff who confirmed that he had undertaken training regarding adult and child protection as part of his induction. The manager told us that staff had to physically get involved with two students needing to be separated. On another occasion a student was sent home for a short period to reflect on a threat he had made to another student. We looked at students care plans and found that records were up to date regarding peoples welfare. The manager also confirmed that CQC as well as The Adult Social Care Team had been informed of these safeguarding adults issues. Two students told us that they liked living in their home and felt safe. One said that staff do not shout at us. Another student had stated that he refuses to move from this home. Student surveys showed that half knew how to make a complaint and half didnt. All surveys showed that students knew who to speak to if they were unhappy. During this visit no person living in the home or staff had any concerns about the home. Care Homes for Adults (18-65 years) Page 28 of 37 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students live in clean, safe, and comfortable accommodation suited to their needs. Evidence: We were told that, Our students all live in a homely, comfortable and safe environment and both of the houses are of a good standard. The homes are kept clean and hygienic. Students are encouraged to personalise their own rooms and have lockable facilities and a key to their own room if desired. We found that both homes had a maintenance programme. We were told by the manager 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. One student showed the inspector his home and his bedroom, they were found to be clean and comfortably furnished. Dunsford has had a conservatory built on the back of the home giving more room for students who take their meals there. We looked at both homes and found that they were clean and had no unpleasant odours. Students that we spoke to told us they liked their rooms. Student surveys showed that three felt that the home was always fresh and clean, with two saying that the home is usually clean and two say the home is sometimes clean. Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: Care Homes for Adults (18-65 years) Page 30 of 37 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. There are robust recruitments practices that ensure the safety of students. There is a supportive staff team available who have skills to meet the varying needs of people in the homes. Evidence: We were told that, Staffing arrangements provide stability for students ensuring that they are well supported. Staff are trained to be competent in their work in order to fully support the students. We have an effective recruitment policy and staff are supported to work efficiently within the organisation. Staff are given a full comprehensive induction and the opportunity to work shadow when they join us.More students are involved in the interview process. We were told by a member of staff that each student living in the home had a key worker responsible for care support and a personal tutor responsible for their education. The manager told us training is made available to all staff to ensure that they had the skills to support the particular needs of the students. Where the people had particular needs she would arrange for specific training to ensure that staff had the knowledge to care and support the student. Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: We saw recruitment records for three staff members. These records showed there had been a robust recruitment process with a check by the Criminal Records Bureau, application form, two references and proof of identity. One staff member confirmed that he had undertaken all the checks required and had a formal interview. Linkage also ensures that representatives of the students living in the homes are encouraged to be involved in the interview process for staff and managers. We were told that Once recruited each new member of staff had a supported induction programme. Records that we saw confirmed this took place. Thereafter a more detailed induction programme would take place over six 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 qualification in care. A member of staff told us that he had an NVQ level 3. He also said that other training over the two years he had worked here had covered equality and diversity (each person receives a detailed leaflet in addition to the training), fire safety, health and safety, moving and handling, protecting vulnerable adults, risk assessment, medication administration and Makatan communication. The manager had also received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff told us they receive supervision and that they are supported to talk about their individual needs. Records confirmed this. The staff felt they could meet the needs of the people 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 people in a calm, kind, friendly and sensitive manner. Care Homes for Adults (18-65 years) Page 32 of 37 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students and staff benefit from the positive leadership of the management team. Health and safety systems are in place to ensure that students are safe. Students and their relatives have the opportunity to voice their views and opinions. Evidence: We were told that, the homes are both well organised and managed with quality monitoring systems in place. Health and safety procedures ensure that the students are kept safe. The registered manager has many years of experience in learning disability and is well qualified and competent to lead this care team. Staff were complimentary about her leadership and the support that they receive from her. One member of staff told us about the 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 people living in the home. We looked at the Linkage systems, which monitor quality and seeking the views of the Care Homes for Adults (18-65 years) Page 33 of 37 Evidence: students and their relatives. Regular detailed annual questionnaires are sent out to obtain their views of the service. We looked at the results of the last survey in 2009. These were analysed by the manager and showed that the majority of comments were very positive 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 are also made by the responsible individual for Linkage who visited this home during this inspection. In addition the Learning Skills Council made regular external audits. Linkage also had a three year development plan, quality improvement and operational plan. Staff surveys told us that they were happy working for this organisation. Comments made were; since working at Linkage in 2007, I have had every opportunity to become a valid member of staff, I have been made to feel welcome and have had all the relevant training to make me better at my job. My manager addresses any concerns I have and always sorted them out for me. Surveys also showed that staff felt that the manager regularly gives them enough support and meets them to discus how they are working. Four students surveys tell us that the care staff and manager listen and act on they say. Two surveys say that usually they listen and act on what they say and two told us they sometimes do. 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. Care Homes for Adults (18-65 years) Page 34 of 37 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 35 of 37 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 7 It is recommended that support plans include reference to the Mental Capacity Act, 2005 and the effects it has upon peoples lives. This is to ensure that their rights and choices are protected. Care Homes for Adults (18-65 years) Page 36 of 37 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). 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