Inspection on 13/07/06 for Autism Initiatives

This inspection was carried out on 13th July 2006.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Autism Initiatives 11/06/09

Autism Initiatives 26/07/07

Autism Initiatives 25/01/06

Autism Initiatives 31/05/05

Autism Initiatives 23/08/04

Autism Initiatives 24/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Autism Initiatives 90 All Hallows Road Bispham Blackpool Lancashire FY2 0AY Lead Inspector Christopher Bond Unannounced Inspection 13th July 2006 09:30 Autism Initiatives DS0000009968.V299530.R01.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 Autism Initiatives DS0000009968.V299530.R01.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. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Autism Initiatives Address 90 All Hallows Road Bispham Blackpool Lancashire FY2 0AY 01253 592284 01253 592284 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) Autism Initiatives Miss Jeanette Kenworthy Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: The home is registered for six adults who have Autism and Learning Disabilities. It is situated in the Bispham area of Blackpool, within walking distance of Bispham Village. The home is in a residential area with shops and other community resources in the close vicinity. Regular bus services into Blackpool run from close by, and public transport to a number of locations runs from the village. The house itself is situated next to All Hallows church and the exterior is completed in the similar stone fascia as the church. The house is set back from the road and has a parking area to the front. The grounds are tidy and well maintained and offer a good deal of privacy for the people who live there. There are six registered single rooms within the home. There are also two main bathrooms and a separate shower facility on the first floor. One of the bedrooms is situated on the ground floor and has en-suite facilities. At the time of this visit, (13/07/06) the information given to the Commission showed that the fees for care at the home are from £1,235.00 to £2,100.00 per week. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place over a total of 5 hours. A tour of the home included bedrooms, lounge and dining areas, and bathrooms. All areas were clean, hygienic and pleasantly furnished. Administration records were also examined. Everyone was very friendly, welcoming and co-operative throughout the visit. What the service does well: What has improved since the last inspection? What they could do better: There did not seem to be a coherent policy of renewal regarding the decoration of the home. The registered provider needs to work with the Housing Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 6 Association to develop a regular, planned maintenance and re -decoration programme which includes dates and timescales for completion. Parts of the house were in need of redecoration. Because of this the care staff had previously undertaken redecoration work themselves to maintain the appearance of the home. This could pose a safety risk, as the care staff are not trained to do this. The registered manager was aware that she needed to complete her NVQ 4 training in Management and Care. She has enrolled for this course and hopes to achieve this in the near future. There is still a need for at least half the care staff to achieve a nationally recognised qualification in care. (National Vocational Qualification level 2 or 3). Again, some of the staff have enrolled and hope to become qualified in the near future. There is a need to develop the sensory room. This has fallen into disrepair and would be a valuable addition to the specialist services provided by the home. This type of facility provides sensory stimulation (lights, touch pads, soothing music, soft furnishings etc). 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. Autism Initiatives DS0000009968.V299530.R01.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 Autism Initiatives DS0000009968.V299530.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thorough admittance procedures and careful assessment ensures that the home can meet people’s needs. Written information provided to prospective residents is good enabling an informed decision about admission to the home to be made. EVIDENCE: The home’s Statement of Purpose and Service Users Guide is a set of written information that tells people about the care service that is offered, who the manager and staff are, and what the resident can expect if he or she decides to live at the home. This has been reviewed and updated. Each resident had been given a copy of this information. Each of the residents had been assessed before coming to live at the home so that a decision could be made as to whether the home could care for them properly and address their specific needs. One person had been admitted to the home in the past 12 months. The manager said that another vacancy would be created at the home in the near future and the Director of Services and the Speech and Language Therapist had done a detailed assessment of a new resident. This person’s parents had visited to talk to the care staff and a home visit had been planned. The process Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 9 was well planned and the new resident would not be admitted until a great deal of preparatory work had been done. Autism Initiatives DS0000009968.V299530.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good planning is helping the residents to enjoy fuller lives. Good communication training helps the staff to promote individual choice and help decision -making. The residents are supported to take controlled risks to help their development. EVIDENCE: All of the residents had a plan of care, which held important information about their needs and abilities. All of the plans held individual goals where the residents could achieve set tasks that would help enhance their lives and develop skills. These individual support plans helped the staff to work methodically towards assisting the residents to achieve the set goals. The plans were reviewed monthly and residents-evaluated every three months to make sure that each resident had achievable goals set. There was lots of evidence to show that the plans were in regular use. All of the residents within the home had difficulties in communicating and it was essential that the support workers knew the residents well and were able Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 11 to help them make decisions that affected their lives. One of the local authority social workers was able to confirm that the senior staff had supported one of the residents for a number of years, were able to advocate on his behalf and had received communication training. There was a lot of work being done towards using pictures to improve the review process. One of the relatives of a resident was spoken to. She said, “We are always invited to reviews and the staff at the home always inform us when there are any changes. We trust the home and we know that he’s happy there.” Risk taking is important when people are undertaking new challenges. It is important that risk taking is assessed correctly to ensure that residents are not put in any danger, and that the risks can be controlled. Each resident had risk assessments on their files to show that every effort was being made to minimise danger and to control risks. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given the opportunity to use community facilities and resources to ensure community participation and widen their experiences. Family contact is encouraged and promoted to maintain valuable relationships. EVIDENCE: There were some good examples of the residents using the facilities and enjoying activities that are available to everyone in the community such as going to the cinema, going to restaurants, enjoying sports facilities and going for walks. It is important that people are encouraged to use these facilities and are not stopped because they have a disability. It was also clear that the staff were used to helping the residents to use community facilities. One of the staff said, “The residents are well supported and can regularly enjoy resources in the community. The staffing here is really good.” One of the residents relatives agreed with this saying, “ There’s a very good staff ratio which means that people can get out and do things that they like doing.” Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 13 Parents and relatives were regularly invited into the home to ‘open houses’ where they can meet the manager and staff and talk to other parents. There were other social events such as barbecues and parties. Visitors were welcomed and encouraged to participate in the daily routines of the home. The menu’s that were available showed that people were enjoying a good healthy diet. The residents were also being encouraged to prepare meals and to become involved in activities in the kitchen. This helped to increase individual skills and help build confidence and competences. The residents’ likes and dislikes were recorded on file to ensure that they were not given food that they disliked. It was pleasing to see that all of the residents were able to choose individual holidays with good staff support. Photographs were available to show how the residents were enjoying new challenges and experiences through carefully chosen holidays. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Well- trained staff handle medication safely. The health needs of the residents are attended to properly by medical professionals and appointments recorded for good continuity. EVIDENCE: There was lots of information in each of the care plans to show that everyone was receiving adequate health support from other agencies such as the GP, opticians, dentist, chiropodist, community nurse and LD nurse support. Visits to the doctor’s surgery were recorded properly. There had been some training for the staff about how to give medication properly. There was evidence in staff files to show that this had occurred and the senior carer confirmed this. Only the senior staff gave out medication and all had received training in the past 12 months. All the medication was stored safely and there were policies and procedures to help staff. None of the residents controlled their own medication. It is recommended that the manager contact the local community pharmacist to provide the home with a medication audit and advice. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Residents are protected by robust safeguarding procedures. EVIDENCE: There was a good complaints procedure and the care staff were skilled in advocating for the residents and ensuring that the service was dealing properly with their needs. Information was available in the home about the local advocacy service and the manager showed that she was aware of when an independent advocate was required to represent someone and help to voice their opinion and protect their rights. Autism Initiatives had a service user abuse protection officer who offered help and advice to managers within the service regarding protection issues. Regular training was available to all staff regarding protection issues and abuse awareness. Care staff files held evidence of this and the area manager of the service confirmed that regular training took place. The home had good protection procedures and policies. This meant that the residents were safer. The manager was aware of the procedure to follow should an allegation of abuse be made. There was a copy of the Blackpool Vulnerable Adult policies and Procedures in the home for staff to refer to for information. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean and hygienic environment and bedrooms were personalised. This means that residents will feel at home with their belongings around them. EVIDENCE: This was a pleasant home which was clean and hygienic. All of the bedrooms had personal possessions such as photographs, soft toys, music collections, and memento’s around. This made each room personal and homely. The residents had been involved in decorating their own rooms in colours of their choice. The soft furnishings were of good quality and the carpets had recently been replaced. The bathrooms had recently been refurbished and re-tiled. They looked far more homely and it was nice to see matching suites. The home was maintained and repairs were dealt with by the housing association that owned the house. There did not, however, appear to be a coherent and planned redecoration programme. Some of the communal areas Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 17 were getting a little ‘tired’. The care staff had previously helped to decorate these areas to maintain the appearance of the home and to ensure that it was a nice place to live. This is not their responsibility and could be dangerous. The manager had frequently difficulties in getting the housing association to deal with redecoration issues. There seemed to be no indication from the housing association when work was due to be completed and whether or not this was a regular, planned maintenance programme with dates and timescales, and within a planned budget. This is something that needs to be sorted out between the housing association and the caring organisation and not left for the manager to sort out at a local level. The house had a ‘relaxation’ room where the residents could spend time alone if they wished. This had been a sensory room where the residents could develop their sensory awareness through stimulation. Some of the equipment was still around but was not used, or had fallen into disrepair. The caring organisation should consider re-establishing this valuable resource and provide the funding to do this. There were garden areas to the sides of the house that were being used frequently due to the good weather. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good recruitment practices meant that residents were protected from unsuitable staff working in the home. Staff were trained and competent to do their jobs. Residents were well supported by a large staff team. EVIDENCE: The residents were well supported by a competent staff team. Both the manager and the area manager spoke of their commitment to providing good staffing ratios. Training records showed that appropriate and frequent training was taking place. This training included medication awareness, abuse awareness, communication awareness, valuing people, and positive intervention. This was supplemented by core safety training such as health and safety, fire safety, first aid, food hygiene and moving and handling. There was a need to ensure that all the staff files were organised properly. Some of the information was hard to find and a lot of it was loose which means that there is a potential to be misplaced. Staff records showed that new carers had been properly checked before starting their jobs. This helped to make sure that the residents were safer. There was a good induction process to help ensure that new care staff were Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 19 competent before commencing their role. Records showed that care staff were being supervised properly and regularly. This one-to-one support showed that care staff were valued, and encouraged to do their jobs properly and efficiently. Some staff had achieved a national qualification in care (National Vocational Qualification level 2 or 3). Others would be commencing this training shortly which would bring the total amount of trained staff to well over 50 . This means that the staff are well trained to perform caring tasks. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by a competent manager and there are quality systems in place to make sure that they are protected. EVIDENCE: The manager had registered to complete a nationally recognised qualification in management and care (National Vocational Qualification level 4). The home was being run competently and professionally with the interests of the residents at heart. She ran the home well and had the respect of all of the care staff that were spoken to. Care staff had been trained in ensuring the safety of residents. This included learning how to move people safely and ensuring that food was prepared and served hygienically. Good records were being kept of safety checks within the home. These showed that tradesmen were checking the lift, electric and gas Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 21 equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. It was clear that the residents’ financial issues were being protected. There were systems in place to ensure that their money was being handled properly and the management team regularly made checks. Finances were also audited by the caring organisation. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 3 X X 3 3 Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA24 Regulation 23 Requirement The home should have a planned maintenance and renewal programme for the fabric and decoration of the premises, with records kept. Timescale for action 30/09/06 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 YA32 YA37 YA20 YA29 Good Practice Recommendations 50 of care staff should have achieved NVQ level 2. The Registered Manager should hold an NVQ 4 qualification in Management and Care. The Registered Manager should contact the local community pharmacist in order that an audit is completed regarding the storage and administration of medication. Consideration should be given to re-furnishing the relaxation room and adding appropriate sensory equipment. This would help the residents to develop their sensory awareness and improve their quality of life. Autism Initiatives DS0000009968.V299530.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 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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