CARE HOME ADULTS 18-65
Autism Initiatives 90 All Hallows Road Bispham Blackpool FY2 0AY Lead Inspector
Chris Bond Unannounced 31st May 2005 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 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 Stationary 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 F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 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 LD Learning disability (6) registration, with number of places Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: There are no conditions of registration. Date of last inspection 23 August 2004 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 F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 2.00pm and took place over 2.5 hours. The Inspector spoke to two staff members, and the manager. Five of the residents were out of the home and one resident chose not to speak to the inspector. Staff and care records were examined. A full tour of the premises was undertaken with the manager. What the service does well: What has improved since the last inspection?
Residents enjoy improved health facilities due to a change in the practice that they attend. Well person clinics are attended regularly and specialist services for those with asthma and epilepsy are accessed. The input of the practice support team means that communication issues are being addressed to a greater degree. Many people who have autism struggle to communicate so this is a very important improvement as it enables residents to communicate better. Speech therapy and picture- based communication are being used to a greater degree. The house looks more homely now that there are new carpets down and most of the home has been redecorated. It was particularly pleasing to see that the beds are now free standing, giving residents the freedom to move their rooms round as they wished. The residents’ bedrooms reflected their personality and were comfortable, safe and well decorated. The lounge area had also been redecorated and the television was no longer encased in a wooden surround for protection. This meant that the lounge did not look ‘institutionalised’, which was better for the residents.
Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 6 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 F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3 and 4 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: This home had not had a new resident for a number of years although a resident was due to leave the home the day after this inspection. This would create a vacancy within the home. The registered manager was able to outline the procedure that would be followed to fill this vacancy. This would be taken over a period of time and include pre admission visits. The registered manager acknowledged the importance of ensuring that other residents were involved in the admission procedure as much as possible, along with the person and their parents/ carers. The home had an illustrated Service User Guide already prepared for the new resident, which held all of the information required. Assessments for the other residents within the home were very thorough. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 standard(s) 6, 7 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: Individual Plans were thorough and were reviewed on a regular basis to reflect the residents changing needs and aspirations. Risk assessments formed part of the plan and residents were supported to take risks as part of their role within the community. Care staff received training in risk assessment. When decisions were made that affected the house, the residents participated in this process via resident meetings and there were minutes available to confirm this. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13 and 17. Residents are given opportunities to use community facilities and resources to ensure community participation and widen their experiences. EVIDENCE: All of the residents attended the day centre run by Autism Initiatives on Bristol Avenue in Blackpool and had a day off (known as a ‘Key Worker Day’) where community facilities and resources were enjoyed. One resident had begun a course at the local college. The registered manager said that there were few resources available that were ‘autism specific’ or geared towards the particular communication challenges that form part of autism. There were plans to develop one resident’s ability to use local facilities by investing in a ‘motability’ car so that he could travel further a field. All the residents enjoyed bowling, walking, picnics, and visiting the local shops. Another resident still enjoyed skiing on a local dry-ski slope.
Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 11 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 standard(s) 19 and 20 Residents health care is taken seriously and needs are closely monitored ensuring health issues are met. EVIDENCE: Since the last inspection all of the residents have moved to another GP practice in the local area. Since doing this it was felt by the registered manager that more specific health services could now be accessed. These services included specialist asthma and epilepsy services as well as Well Person check ups. Records of the residents were examined and they contained the information required in relation to health care and all needs are being met. Comprehensive medication policies are in place and records showed good practices are observed. None of the residents were able to administer their own medication. All of the Seniors had been given training in medication issues and had sole responsibility for dealing with medication within the home. There were no concerns regarding the administration within the home. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 12 There had been contributions from the Practice Support Team regarding improving communication for residents, and speech therapy had been part of this process. Whilst the inspection was taking place one resident was at home who chose not to speak to the inspector. It was clear that the support worker treated this resident with respect, and communicated well with her. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. EVIDENCE: The home has a detailed and illustrated complaints procedure, which is made available to all residents on admission and displayed in the Statement of Purpose and Service User Guide. There have been no complaints since the last inspection. The home has a procedure in place for dealing with allegations of abuse. The registered manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 28 & 30 Recent work had significantly improved the appearance of the home creating a comfortable and safe environment for those living there. EVIDENCE: A tour of the home was undertaken. It was pleasing to see that all of the residents now had beds that were free standing rather than fixed to the floor. This would mean that service users have the freedom to move their bedroom furniture around as they wished. All of the bedrooms, as well as other areas of the home had new carpeting and several areas had been redecorated. The house looked far more ‘homely’ now. The residents’ bedrooms reflected their personality and were comfortable, safe and well decorated. The lounge area had also been redecorated and the television was no longer encased in a wooden surround for protection. This meant that the lounge did not look ‘institutionalised’, which was better for the residents. Along with a spacious lounge there was a ‘relaxation’ room with specialist equipment such as bubble lamps and projectors. This room was fairly run down and finance was being sought to improve this facility and to redecorate the
Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 15 room. The home has a dining area and a large kitchen that were accessible to residents and well decorated. It must be added that the owners of the house, Eavesbrook Housing Association have an agreement to redecorate the home on a regular basis. It was confirmed that this had not been taking place. It remains to be seen whether or not their responsibilities are realised in ensuring that the bathroom areas are redecorated and refurbished. These areas still remain a little ‘shabby’ in comparison to the rest of the home. The home was exceptionally clean throughout and there were no unpleasant smells in any part of the building. The laundry area needed a small basin where staff could wash their hands after handling soiled laundry. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 Better support and training for staff means that they are more able to do their jobs correctly, which benefits the residents of the home. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. EVIDENCE: The home had employed five new support workers over the past 12 months and Autism Initiatives have ensured that Criminal Records Bureau and Protection of Vulnerable Adult checks had taken place as part of their normal recruitment procedure. Much more control had been given to the registered manager in the interviewing and recruitment of staff and she had found that competent and capable support workers were now being employed which, in turn, improved the service for residents. There is still a need to ensure that 50 of care staff are trained up to NVQ level two. There have been difficulties in getting support workers on to NVQ courses after Preston College pulled out of NVQ 2 training. Several training events had taken place since the service was last inspected. New staff had gone through an induction programme. Core training in food
Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 17 hygiene, fire awareness; health and safety and infection control had taken place, which made the home safer for service users. Positive Intervention training had taken place in order to provide a better facility for a resident who challenged the service. A new supervision policy meant that support workers were supervised on a regular basis. Staff meetings were monthly and minutes were produced for these meetings. Improved support for staff meant that they were more competent and able to do their jobs successfully. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 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. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Autism Initiatives Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x x x F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 20 no 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 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 32 30 37 Good Practice Recommendations 50 of care staff should have achieved NVQ level 2 by 2005. A hand wash -basin should be fitted within the laundry in order that care staff can wash their hands after handling soiled washing. The Registered Manager should hold an NVQ 4 qualification in Management and Care by 2005. Autism Initiatives F57 F09 S9968 Autism Initiatives V231234 310505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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