CARE HOME ADULTS 18-65
Autism Initiatives 90 All Hallows Road Bispham Blackpool Lancashire FY2 0AY Lead Inspector
Christopher Bond Unannounced Inspection 25th January 2006 10:00 Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 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.V283617.R01.S.doc Version 5.1 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.V283617.R01.S.doc Version 5.1 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.V283617.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 31st May 2005 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 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. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over two hours. There was one resident at home at the time of the inspection. The manager of the home was spoken to along with three of the care staff. A tour of the home was undertaken. Care records and staff records were looked at. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on one person living at the home. All records relating to this person are inspected along with the rooms they occupy in the home. What the service does well: What has improved since the last inspection?
Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 6 There have been several training courses since the last inspection. Regular training helps the staff to be more successful in their role. New ‘support plans’ are being introduced to help the residents to develop their lives and skills through achieving goals. 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. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 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.V283617.R01.S.doc Version 5.1 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): 2, 3, and 4 A good assessment and positive caring help new residents to settle well. EVIDENCE: One person had been come to live at the home since the last inspection. Unfortunately the normal procedures for admitting someone could not be followed because the gentleman had to be admitted quite quickly. He did not get the chance for the usual introductory visits because he came from another part of the country. A good assessment was completed so that the staff within the home had the information to help them care for this person. It was a difficult time for the manager, staff and the resident because of the challenges presented. It was clear that after an initial unsettling period the gentleman had settled in well, due to successful strategies and positive caring. It was clear that the home was meeting his needs and they had been complemented by the gentleman’s family because of the successful work that they had done with him. The service had an emergency admittance procedure to help the manager and staff through this period. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 9 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, 8 and 9 A plan of care is developed with the residents, which ensure their wishes, goals and aspirations are well planned and constantly reviewed to support positive outcomes. EVIDENCE: All of the residents had an Individual Plan to help ensure that their wishes, goals and aspirations were recognised and developed. Each plan was reviewed regularly and changes were made to reflect the development of the residents. The care staff spoke of how they worked with the plans and how they found them useful in developing the residents’ lives. New ‘support plans’ were in the process of being introduced by the organisation, which were an improvement on the current individual plans. All of the residents had autism. The manager and staff had developed successful strategies to help people air their views and to participate in the daily activities of the home. By looking at the plans it was clear that carefully selected risks were taken to help people develop their skills and competences.
Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 10 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, 14, 16 and 17 Residents are given opportunities to use community facilities and resources to ensure community participation and widen their experiences. EVIDENCE: There was information about what people did during the day within the individual plans. Residents were helped to enjoy the facilities and resources within the community. The care staff spoke of the range of facilities that they used. These were mainly used on a 1:1 basis, ensuring that the people who lived at the home had the care and attention that they needed. All of the residents were offered individual holidays every year. Residents were encouraged to become involved in choosing and booking their holidays. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 11 There were plans to develop the sensory room within the home. This is a facility mainly for those with autistic spectrum disorders and helps develop the senses through touch, sight, sound and smell. The manager confirmed that a healthy and nutritious diet was important for the residents. There was evidence in Individual Plans of what peoples likes and dislikes were regarding mealtimes. It was clear that care was taken with regard to the amount of food that residents ate and strategies had to be in place to help the residents make the correct choice about the amount of food they ate, and at what times it was eaten. The gentleman who had been most recently admitted to the home was not accessing day services. The manager and staff were in the process of ensuring structure and routine whilst he was settling in to his new home. This was being achieved gradually through his support plan and included his own personal interests. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 12 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): EVIDENCE: This section was not assessed during this inspection. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: This section was not assessed during this inspection. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 14 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 and 30. Residents live in a homely, safe, comfortable environment. EVIDENCE: The manager gave the inspector a tour of the home. All of the bedrooms were personalised and pictures and items that were important to the people who lived there. The bedrooms, lounge, hallway and dining room were all very well decorated and the house looked comfortable and homely. Everywhere was very clean and there was a domestic on duty at the time of the inspection. All of the rooms smelled fresh and clean. It was nice to see that care was taken to ensure that everywhere was clean, safe and homely. It was unfortunate that work had not started to renovate the bathroom areas. A housing association was responsible for the upkeep of these areas. There is a need to ensure that when people have a bath that it is a nice, relaxing experience. The bathrooms were quite bleak and poorly decorated. Surroundings are important when people are relaxing. The home was attractively set in its own grounds and there were areas where the residents could enjoy the gardens around the house.
Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 15 The laundry area had been refurbished and a small sink had been added to ensure that staff had somewhere to wash their hands when dealing with soiled washing. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 16 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 EVIDENCE: A staff meeting was about to be held as the inspection was taking place. These meetings were regular and were important to ensure that all of the staff have good, up- to- date information about the residents and the home. The care staff said that they often met individually with the manager or assistant manager to discuss their role and responsibilities. This helped to ensure that they had the information to do their jobs better. 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). Care staff were recruited properly and there was lots of information about the staff and their skills on file. Proper checks had been done on each person before they were employed (Criminal Records Bureau checks and Protection of Vulnerable Adult checks). There had been several training events for the staff since the last inspection. This helped to ensure that they had the correct skills to do their jobs properly.
Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 17 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 and 42. The home benefits from being managed in an organised and competent manner. EVIDENCE: The home was managed professionally and competently. There were no concerns regarding any aspect of the way the home was run. The registered manager was aware that she needed to complete her NVQ 4 training in Management and care and hopes to achieve this in the near future. The care staff had received training in Health and Safety issues. Good records were being kept of safety checks within the home. These showed that tradesmen were checking the electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 18 Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 19 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 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 X 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 3 X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 2 X 3 X X 3 X Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA32 YA37 YA27 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 bathroom areas of the home should be modernised and redecorated. Autism Initiatives DS0000009968.V283617.R01.S.doc Version 5.1 Page 21 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
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