Inspection on 25/04/07 for Ashdale

This inspection was carried out on 25th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Ashdale 14 Beresford Park Sunderland SR2 7JU Lead Inspector Andrea Goodall Unannounced Inspection 25th April 2007 10:00 Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashdale Address 14 Beresford Park Sunderland SR2 7JU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 515 4656 Tyne and Wear Autistic Society Post Vacant (awaiting completion of application) Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: The small care home at Ashdale is a family house that provides 4 places for young adults with Autistic Spectrum Disorder. It is owned and operated by the Tyne & Wear Autistic Society (TWAS), which operates several care and educational services for children and adults in Sunderland. The house is a detached two-storey property in a desirable residential area near the City centre. It is sited on a private road with gated access. The home is only intended for use by young adults who are physically fit and mobile. However it has ramped access at the front entrance for any visitors who may have mobility needs. The ground floor comprises a large lounge with a split level area. There is a family sized kitchen/diner, utility room, shower room with WC, and staff office (that will double as a staff sleep-in room). On the first floor there are 4 good sized bedrooms and two bathrooms. The home is near to the City centre shops, pubs and sports centres. Residents also have use of a family-sized vehicle for transport to other facilities. The weekly fee is from £1480.77 to £1826.92. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is about the first inspection of this new home. The home was only told about the visit a couple of days before, and this was to make sure that the people who live here were going to be at home. Before the inspection we looked at information from TWAS about the home. We sent a questionnaire to relatives for their views, and one was received back. During the visit the inspector talked with the people who live here, looked at their bedrooms with them, and joined them for an evening meal. The inspector also talked with the manager and staff about this new home and looked at care records, training records and safety records. In this report the people who live here are sometimes called ‘residents’, and the Tyne & Wear Autistic Society is called TWAS. What the service does well: TWAS made sure that the four people who live here all had the same skills so they can learn to be more independent together. Before they moved here TWAS made sure that it would be a good place for them to live and that it could support them in the right way. People who live here can make their own choices, like activities and meals. The home helps people to make their own decisions about what they would like to do in the future. All of the residents said that Ashdale was the “best” home that they had lived in. One person said, “It’s brilliant. I’ve learnt to do loads of things for myself.” Another resident said they can really relax here “because it’s not noisy”. Residents said that there are lots of different activities that they enjoy. The people here choose all their own meals and staff help them to make their meals. People said that their house is a very nice place to live. They said, “It’s really good” and “I like it very much.” Everyone has a big bedroom and their own key so they can keep it private. There are plenty of bathrooms for everyone to use. There is a big lounge and a big family kitchen. All of the house is nicely decorated. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 6 Staff have lots of experience and training so they are the right people to work here. Staff said they like to help the residents to learn to do things for themselves. Residents said that staff are “great”. The manager and TWAS makes sure that the home is run in the right way for the people who live here. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have information about TWAS but not about the specific service provided at Ashdale, which may impact on their decisions about using this service. Comprehensive assessment and admissions procedures ensure that only those residents whose needs can be met are offered a placement at the home. EVIDENCE: The home has a Statement of Purpose that gives detailed information about TWAS services, and the aims and objectives of the home. These are given to parents of residents and to professionals involved in the residents’ care. There is also a Service Users Guide that is kept in the office, although it can be accessed by residents if supported by staff. However, this information is about TWAS services and does not give any specific information about the new service at Ashdale. (The manager confirmed that the Service Users Guide is being redeveloped.) Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 9 TWAS has clear written guidelines about referral and assessment to its services and, before they move here, residents’ needs are assessed by social and health care professionals. Relatives and TWAS staff are fully included in making a decision about whether the home could meet people’s needs. People who are new to TWAS services have at least a one-week trial stay at a TWAS home as part of the assessment process. Three of the young people who live here were already living in other TWAS small homes. The fourth resident was already receiving an educational service from the TWAS College. In this way all four residents had already been involved in on-going assessments and reviews. The home provides a specialist service for people with Autistic Spectrum Disorder and staff are trained in this area of need. TWAS identified that all four residents have compatible skills and would benefit from moving to this new home together where they have opportunities to improve their independent living skills. Prior to moving here the four young people had opportunities to visit the house while it was being refurbished and to choose their own bedroom. TWAS provides residents with a Licence Agreement, which explains their rights and what to expect from the service. This is available in 2 forms – one is written in complex language, and the other is a simplified version in pictorial format. However the people who live here have good literacy skills but benefit from plain language, so neither format currently matches their skills. The residents’ copies of their Licence Agreements are currently kept in their care files, which means that residents usually only access these with staff support. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear care planning means that residents are supported towards achieving their goals, but care plans do not demonstrate whether or how residents are involved. People have good opportunities to make their own choices. However some limitations on lifestyle are not adequately assessed within a risk assessment to show the reasons for this. EVIDENCE: Care planning systems are in place to ensure that staff work consistently to support individual people towards a small number of short-term independent living goals (‘smart targets’). When these are achieved, more smart targets are set. In this way, Ashdale is actively promoting people’s maximum potential. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 11 Staff stated that residents have been involved in their own care planning. However, at this time there is no demonstration on the care plans of how residents are included. Care files also include good information about people’s cultural and religious beliefs and whether or not they need support to pursue these. The people who live here have good verbal communication skills and are very able to express their likes and dislikes. They make their own choices and decisions, such as appearance, menus, leisure activities, and holiday destination. The home has a Participation of Service Users policy that supports residents’ rights to be involved and included in making decisions about the home. Residents have a meeting about every month where they can make suggestions and reach group decisions about the house. Residents are also fully involved in carrying out the household tasks within their home. There are risk assessment records in place about activities that people carry out that might incur an element of risk. As the service at Ashdale is focussed on promoting independent living skills, the risk assessments are around activities such as food preparation, cooking and road safety. It is good practice that risk assessment records are also sent for information to parents and the relevant Social Workers. Recently all TWAS small homes have been fitted with a new door security system, which is linked into the homes’ fire alarm systems. This allows the main entrance doors to be locked at all times for security, but the lock releases in the event of the fire alarm system being activated. In this way resident and staff can exit the house in the event of a fire without having to first unlock a door. However this system also means that people cannot access or exit their house without a fob (electronic swipe key). At the time of this visit none of the people who live here had their own fob. In this way residents have to rely staff to let them in or out of their home. There is an easy to read Access to Information statement in each person’s file, which is kept in the office. This tells the residents that their records belong to them and that only people who have a right to see their records can do so. TWAS also has a clear Confidentiality Policy home for staff to understand their responsibilities in making sure that any information about the people who live here is confidential at all times. As all residents’ records are kept in the office, a resident would probably only access their own care file with staff support, in order to protect the confidentiality of other people’s records. In this way residents do not have Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 12 independent access to their own records. In discussions some residents said they would be happy to have some of their own care records in their bedrooms for easy reference. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people here are fully supported towards their maximum personal development. Residents can take part in fulfilling, purposeful daytime occupations. Residents can choose from a good range of suitable activities. Residents have good support keep in contact with family members and have many opportunities to meet others at social and leisure events. Residents have clear information about their rights and responsibilities. Residents enjoy nutritious, healthy meals so that their choices and dietary needs are met. EVIDENCE: The service at Ashdale has been specifically set up to support the personal development of the four residents to maximise their independent living skills (potentially towards semi-independent living in the future). Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 14 It was clear from discussions with residents that Ashdale has improved the quality of their lives. Most residents previously shared homes with people whose needs sometimes challenged the service. All of the residents said that Ashdale was the “best” home that they had lived in. One person said, “It’s brilliant. I’ve learnt to do loads of things for myself.” Another resident described how they can really relax here “because it’s not noisy”. Another resident said, “I am very happy because no-one is is being noisy or walking in front of the television.” During discussions staff described how they are now very clear about their role in encouraging and promoting people to gain their own skills. Staff said, “It’s been quite hard to take a step back. But we are here to enable people to do things for themselves and to help them to learn to manage their own needs. ” At this time one person is working at Beamish Museum library one day each week. Another resident had recently been working alongside TWAS decorators (however due to changes in the maintenance operations this was no longer possible). Some residents expressed desires for future paid employment, and staff support that aim. In the meantime, all the residents attend day services provided by Tyne & Wear Autistic Society and one person has an education-funded placement at college. These include vocational courses at the nearby Thornbeck College, such as IT, arts & crafts, and sports sessions such as swimming. Residents also have opportunities to gain practical skills at the TWAS Workshop where they make garden furniture, greetings cards and jewellery, which is sold in the TWAS shop (on a not-for-profit basis). This provides residents with tangible, purposeful outcomes to their daytime occupations. The home is a family residence and is indistinguishable form other similar properties in the area. It is a short distance from the city centre so residents have a good range of shops and leisure resources nearby. The people who live here make good use of local facilities in the community including shops, sports centres, pubs, and post office. Residents are able to keep in contact with their relatives whenever they wish by telephone, and one person has their own mobile ’phone. Residents have short breaks with their families or are visited by their relatives. Residents described a huge range of leisure activities that they enjoy in the evenings and at week-ends. These include cinema, theatre, swimming, sports, line dancing, shopping, walking, and cycling. Residents do have opportunities to meet other people at social settings such as pubs and disco’s but the nature of Autism Spectrum Disorder can makes it difficult for people to form social relationships. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 15 The people who live here are all involved in menu planning but can choose alternative options from whatever is in the cupboards if they decide to. All are involved in grocery shopping at a large supermarket. All prepare meals, snacks and drinks (with supervision from staff only where necessary). The large family kitchen/diner provides a very pleasant area for residents and staff to dine together, and mealtimes are a social occasion where residents can talk abut their day and discuss their choices of activity for that evening. Meals are nutritious, healthy and suit the age and preferences of the young people who live here. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive the right support to access care services where necessary so that their health and welfare is well met. Residents do not yet receive adequate support to manage their own medication. EVIDENCE: The four young people who live here are physically fit and are able to manage their own personal care needs, with only occasional prompts to support this. The staff team comprises female support staff and a male manager so that both female and male residents have access to gender-appropriate guidance or support in case they ever require this. The residents are registered with a local GP practice, and have access to community dental, optician and chiropody services as and when required. In Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 17 this way the home ensures that residents health care needs are met by appropriate health care services. At this time all medication is managed by staff. It is delivered to the home in blister-packs by a pharmacy, and is kept securely stored. However from discussions with staff there is clearly the potential for some residents to manage all or part of their medication independently, but this is an area that has not yet been risk assessed. Senior staff have had training in the administration of medication. However there is not a list of the staff who are designated as responsible for managing medication. An over-the-counter antiseptic cream had been purchased and used for one resident which was stored in the medication cupboard, perhaps for future use. However as it was not marked with the resident’s name so it might be mistakenly used by others. The people who live here are young and physically fit. Nevertheless, TWAS has comprehensive procedures regarding the death of a service user. Clearly healthcare professionals and relatives would make decisions about the care of a resident in such an event. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have good information so they know how to make a complaint. Staff are trained in safeguarding adults so residents are protected from abuse. EVIDENCE: The home has a clear Complaints Procedure that is easy to read for the people who live here. This is currently kept in their care files in the office. Staff ask residents for their comments at Residents’ Meetings. All of the people who live here can express their dissatisfaction with a situation. There is regular contact between the home staff and relatives, and the views of relatives are requested at annual reviews and through questionnaires. In this way residents and their relatives have opportunities to comment on any concerns or complaints. There have been no complaints about this service. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 19 As with all care services for adults in the City of Sunderland, TWAS has adopted the MAPPVA (Multi-Agency Panel for the Protection of Vulnerable Adults) policy and procedures. These are robust procedures for dealing with suspected abuse. Most staff have had training in MAPPVA procedures so they would know what to do in the event of suspected abuse. All new staff will also receive this training. Residents are supported to manage their personal allowances in their own individual savings accounts. Smaller amounts of money can be stored at the home for access by residents whenever they want. All records of residents’ personal allowances were in good order, with receipts kept for any transactions made by residents. It is very good practice that one resident is now managing all aspects of her own finances, including completing her own finance records. Two other residents are also working towards this independent living skill. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live in very good quality accommodation that is comfortable, homely and safe. EVIDENCE: Ashdale is a family-house that has been refurbished to provide a homely, comfortable home for the 4 people who live here. It is a desirable property in a pleasant residential area near the city centre. All areas of the home are decorated and furnished to an excellent standard, and in keeping with the age and interests of the residents. TWAS has its own maintenance team that visits the home on a weekly basis to carry out fire tests and to address any minor repairs. In this way these items can be addressed quickly. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 21 During this visit the residents showed the inspector their bedrooms. These were spacious, warm and comfortable. Bedrooms were very individual in style and colour scheme. People had lots of their own possessions in their bedrooms, and since they have moved in they have added new things such as shelves. One person showed me the stencilling that he had done himself to the walls of his bedroom. The four people who live here have their own bedroom keys so that they can keep their rooms private. It was clear that residents can choose to spend time in their own bedrooms, or the spacious, comfortable lounge or the dining area in the kitchen whenever they want. There was a good sense of ownership of the house and residents were clearly very relaxed and comfortable in their home. When asked for their views of their new house, the people here had many positive comments. For example, “It’s really good” and “I like it very much.” No-one could think of anything that would improve the quality of the house. The house has two bathrooms on the first floor, one of which also has a shower. There is another shower/toilet room on the ground floor and a separate toilet. In this way there are a good range of bathing and toilet facilities for the 4 people. Residents manage their own laundry, with guidance from staff if they need this. There is a small but well-equipped utility room on the ground floor. The people who live here are fully involved in cleaning their own rooms and take turns to clean communal areas. All staff have training in Infection Control and support the people who live here to keep their house very clean and hygienic. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are competent and qualified so residents receive an effective service. The Provider uses robust recruitment practices to ensure that residents are safeguarded from unsuitable staff. Staff have good training and supervision opportunities so that they are well supported to meet residents’ needs. EVIDENCE: All the staff are provided with job descriptions that clearly outline their role and responsibilities. All of the current staff worked at other TWAS homes before transferring to this new home when it opened last year. Some staff had previously provided support for residents when they lived at their former homes so were already familiar with their needs. This helped staff and residents to have a smooth transition from their previous homes to Ashdale. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 23 Staff commented that their role at this service is much more focussed on supporting the residents towards improved independent lifestyles and skills. Staff were very enthusiastic about the improvement in residents’ well-being since moving here as they no longer had to share houses with people whose greater needs took up all most of staffs’ time and attention. Staff felt that each of the people who live here now get their fair share of staff time, so that they are supported to learn greater independent living skills. There are at least two staff on duty at the times that the four residents are at home. At this time the staff team is led by the manager and a deputy manager who are also both responsible for a six place home opposite Ashdale. The staff team currently consists of 3 senior support staff, and 2 vacant support staff posts (which are being covered by other TWAS staff). New appointments have been made but clearances are awaited. TWAS operates a robust recruitment and selection process that ensures all necessary checks and clearances are received before a new member of staff starts to work at the home. The manager receives information from TWAS HR department that lets him know when clearances have been received. Residents have the chance to meet applicant staff during a ‘trial’ visit (usually in the evening) to see if they have suitable personalities and values to support young people with Autistic Spectrum Disorder. The manager stated that it would be helpful if he had the chance to have sight of the person’s application form before the trial visit takes place so that he has some understanding of their background. TWAS promotes a comprehensive equality and diversity policy for all those involved in its services, that includes equal opportunities for its staff. All staff receive Autism Focus training, which is specific training to support them to understand the needs of the people with autism. All new staff will undertake induction/foundation training before starting NVQ training. There is an individual learning plan for each member of staff that identifies any training that they need and a record of all training courses attended by each staff. It is evident that TWAS is committed to staff training so that residents receive support from a well-trained, competent staff group. Two of the senior staff have achieved NVQ level 3 (a care qualification) and the other is working towards this. Staff on duty said that they have “brilliant” training opportunities with TWAS. Staff are clearly enthusiastic and committed to progressing their training and career development within the organisation. Staff positively described proposals for TWAS to become a training agency for Autism-specific induction/foundation training where senior staff would act as mentors to new staff. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 24 The manager and deputy manager provide individual supervision sessions for each member of staff. The supervision records include good details and appropriate agenda items for discussion between the staff member and their line manager. Records examined demonstrated that the home is on target to achieve at least 6 supervision sessions for each staff member within a year. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and staff benefit from a well managed, well organised service. Systems, procedures and practices promote the safety and welfare so residents are safe. Recording systems are in good order and accessible by all staff so residents receive consistent quality care. TWAS have demonstrated its sound financial viability so residents will continue to benefit from this service. EVIDENCE: Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 26 The manager has several years experience of working in care settings with younger adults with autism, and has been registered as a manager for other TWAS homes for the past couple of years. He has attained NVQ level 4 and the Registered Managers Award, which are suitable qualifications for a manager of a care home. He is also currently undertaking a certificate in Autism Spectrum Disorder, which demonstrates his commitment to updating his skills and competence in this specialised area of care. The manager is also responsible for the day to day management of a similar small home that is opposite Ashdale. He is supported in the management of both services by a deputy manager and senior support staff. His hours are supernumerary to the staff rota to allow him the time to deal with the many managerial, supervisory and administrative tasks involved in running the two homes. There are clear lines of accountability and management support within the TWAS organisation. In this way the residents, and staff, benefit from a well managed service. During this visit it was clear that the people who live here have very good relationships with staff, and there is a calm, friendly and supportive atmosphere in the house. One resident said “Staff are great.” Another person named all the staff as the ‘best things’ about the home. TWAS operates a comprehensive quality assurance process. This includes monthly visits on behalf of the Provider by an external consultant who seeks the views of residents and staff, and reports back to the organisation and CSCI on their findings. The four people who live here are able to express their views about the service. They are also encouraged to make comment at monthly Residents’ Meetings. They are invited to their annual review meetings along with their relatives and representatives. The home has only been operating for a few months but it is anticipated that TWAS will continue to use formal methods to collect and collate the views of residents and their representatives. Staff have access to all procedures and this ensures that residents receive a well organised and consistent service. At this time some policies and procedures are being redeveloped as part of the organisations continuous review of its services. Staff training records demonstrate that all staff receive statutory training in all health & safety matters, and there are up-to-date records of health & safety checks in the house. Weekly health & safety audits of the building are carried out by the TWAS maintenance team. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 27 Satisfactory financial clearances were received in respect of TWAS during the registration process last year that demonstrated its on-going business viability. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 4 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 4 12 4 13 3 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 4 3 3 3 3 3 Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 29 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4, 5 Requirement Timescale for action 01/08/07 2 YA6 15 3 YA9 13(4) 4 YA20 12(2) 13(2) The Statement of Purpose and Service Users Guide must include details of the facilities and services that are specifically provided in Ashdale. This is to ensure that residents and prospective service users have clear information about what Ashdale is like. Support plans must demonstrate 01/09/07 how each resident is involved and included in their care planning. This is to show that residents have access to and agree with their care plans. There must be risk assessment 01/08/07 in place for each resident whose access into and exit from their house is restricted by the new security door system. This will ensure that residents are individually assessed for their capability to manage their own front door fob. There must be a list of staff who 01/08/07 are designated as responsible for the administration of medication; and over-the-counter antiseptic creams must be marked with the person’s name to prevent the DS0000068282.V334451.R02.S.doc Version 5.2 Ashdale Page 30 potential for prevent crosscontamination. This is to ensure that medication is managed in the right way. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA5 YA5 YA10 YA20 Good Practice Recommendations Consideration could be given to redeveloping the pictorial Residents’ Agreement into plain language that would suit the literacy skills of the people who live here. Each resident should be offered the choice of keeping their copy of the Residents’ Agreement and Service Users Guide in their own room for easy reference. Consideration could be given to offering each resident the choice of keeping their own care plans in their own rooms for easy access. Each resident should be assessed for their capabilities towards managing their own medication, and the home could now begin planning how people can be supported to work towards this. Ashdale DS0000068282.V334451.R02.S.doc Version 5.2 Page 31 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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