Inspection on 12/01/06 for Autism Initiatives Respite Services

This inspection was carried out on 12th January 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 Respite... 18/04/08

Autism Initiatives Respite... 15/08/07

Autism Initiatives Respite... 13/07/06

Autism Initiatives Respite... 09/05/05

Autism Initiatives Respite... 13/01/05

Autism Initiatives Respite... 31/08/04

Similar services:

Clover House

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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 Respite Services 8 & 10 Barnsbury Road Walton Liverpool Merseyside L4 9TS Lead Inspector Karen Barry Unannounced Inspection 12th January 2006 02:00 Autism Initiatives Respite Services DS0000025222.V282087.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 Respite Services DS0000025222.V282087.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 Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Autism Initiatives Respite Services Address 8 & 10 Barnsbury Road Walton Liverpool Merseyside L4 9TS 0151 226 8604 0151 226 8604 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) www.peterhouseschool.org Autism Initiatives Jenny Lloyd Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the person to be accommodated will be 17 - 65 years 9th May 2005 Date of last inspection Brief Description of the Service: 8 and 10 Barnsbury Road offers respite care for service users with Autistic Spectrum Disorder. No. 8 provides accommodation for 2 service users whilst No. 10 provides accommodation for 3 service users. The houses are adjoining semi-detached two storey properties. Each house offers single bedrooms a shared bathroom kitchen dining and lounge areas. The staff office doubles up as a sleep-in room within No. 8. A large garden area at the rear of the adjoining properties is available. Local amenities include a sports centre and leisure facilities, entertainment complexes, various shops and access to public transport. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The staff had not been told that the inspector would be visiting the home. Therefore when the inspector arrived only one member of staff was present as the service users where out pursuing pre-arranged activities independently or with support from other staff members. Initially time was spent examining and discussing polices & care practices with the deputy manager, followed by a tour of the both houses. When service users and staff members returned later in the day observations of interactions and further discussions took place. Feedback was given to the deputy manager in relation to the 1 requirement and 1 recommendation which have been made at the end of this report prior to the inspector leaving. What the service does well: 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. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 6 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 Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 7 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): 1,2,3,4 & 5 Service users needs are properly assessed prior to being admitted to the home, ensuring staff members have an opportunity to plan & prepare for meeting their individual needs appropriately. EVIDENCE: The inspector is aware that information about the home is provided in different formats, suitable to the different needs of the service users. It has been reported that arrangements are underway to make DVD so that prospective service users can see what’s on offer before visiting the home. Pre-admission assessment documentation seen within care files appears extremely comprehensive ensuring an appropriate skill mix of staff are allocated to meet the individual services users identified needs. Records seen confirmed that family, friends and other health care professionals known to the service user are involved in both the assessment and ongoing care of the service user which helps to provide a consistent approach to support and care required. Contracts are drawn up between the funding authority and Autism initiatives and service users. Each of the service users files seen contained a copy of the term and conditions relating to staying at the home. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 8 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): 6,7,8,9 & 10 Where possible service user’s are involved in the care planning and risk assessment process ensuring independent lifestyles are promoted and identified needs are met appropriately. EVIDENCE: The inspector discussed the needs of a number of service users with the deputy manager and examined 3 service users files. Written documentation seen confirmed that comprehensive care plans and risk assessments where in place. All plans seen where reviewed on a regular basis with support staff and multidisciplinary healthcare teams to ensure they fully reflect the changing needs and goals of the service users. Relevant information relating to services users health and social well being had been recorded upon daily records to aid the care planning and review process used within the home. Observation of interactions indicates that the staff use their knowledge and experience of the individual care plans to promote appropriate levels of independence for the service users whilst addressing any issues of risk and protection. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 9 Risk assessments examined where clear and demonstrated why service users rights might need to be limited in order to safeguard the health and safety of both service users and staff members. The deputy manager informed the inspector that plans are underway to incorporate some new paperwork in order to develop a brief pen picture of each service user to assist any agency staff in gaining essential information required whenever they are needed to assist within the home. The involvement of NHS and other healthcare professional agencies was clearly demonstrated within service user care plans and via discussion with staff members. Family, friends and support networks continue to play an important part of the service users lives throughout their respite periods depending of course on the reason why the admission was requested. Autism Initiatives Respite Services DS0000025222.V282087.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): 11,12,13,14,15,16 & 17 Staff at the home recognise the importance of family links, friendships and support networks and do their utmost to enable the service users to maintaining them, whilst ensuring carers receive suitable breaks from their overall caring responsibilities. A variety of daily routines are promoted and maintained to ensure they reflect the individual chioces and needs of the service users. Care planning process’ used ensure service users independent lifestyle are always promoted. EVIDENCE: Records indicate that social activities are determined by the service users physical, cognitive and emotions skills and aspirations. Care records examined demonstrated that services users are provided with a range of learning opportunities and social activities, in accordance with their abilities, this provides them with various opportunities for personal growth and development. A variety of photographs where seen which demonstrated Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 11 service users involvement and development via social and educational opportunities. Support is provided as and when necessary to assist service users in pursuing or attending work or educational opportunities in order to develop their communication, social, emotional and daily living skills as set out within their care plans. The overall aim of the service provided at Barnsbury Road is to enable relatives/friends to have some respite from their role as a main carer. However if appropriate, care staff support service users to maintain family links and friendships throughout their stay. During discussion staff within the home demonstrate how each of the service user’s individuals needs are identified and met. The standard of record keeping in all areas examined was good, and staff clearly demonstrated their specialist knowledge of the service users and their conditions. When appropriate service users are encourage to assist in shopping preparing and cooking of their own meals with support / supervision of staff members. Alternatively staff prepare and cook meals in accordance with service users preferences or dietary requirements. Records are kept of all meals served and those seen indicate that a varied balanced diet is promoted to aid good physical health. Autism Initiatives Respite Services DS0000025222.V282087.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): 18,19,20 & 21 Service users physical and mental health needs appear to be met appropriately in a sensitive and flexible manner. Medication and health issues appear to be handled appropriately within Barnsbury Rd. EVIDENCE: Information regarding the levels of support each service users needed around personal care was well written enabling staff to provide guidance and assistance as necessary. Records confirmed that service users, their representative and other healthcare professionals are consulted, to ensure their personal and healthcare needs are met correctly. Polices and procedure used for the receipt, storage, disposal, and documentation of medications within the home appeared to be being followed by staff members appropriately. The inspector was able to confirm that polices and procedures are in place to guide staff in their approach to the changing needs and events that can occur due to ageing, illness and death of service users in their care. Discussion with staff members demonstrated they understood these polices and that there Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 13 have been occasions when they had supported service users in dealing with the effects ageing, illness and death of service users family members. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 14 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): 22 & 23 Accessible polices and procedures are in place to safe guard residents. Staff appear to have sufficient knowledge and insight regarding their roles and responsibilities to protect the service users from abuse and neglect. EVIDENCE: The company’s complaints procedure has been produced in two booklets referred to as the “who to Talk to” and “what to do” These are designed to assist service users and their representatives to express their views and any issues / concerns, ensuring they are heard and acted upon in an appropriate manner. Staff members receive training from a Service user Protection officer employed by the company and have access to Liverpool’s interagency guidelines regarding Protection of Vulnerable Adults. Risk assessment documentation examined during the inspection and fixtures and fittings seen confirm that staff are very aware of the need to protect service users from abuse neglect and self harm. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 15 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 & 30 The standard of the environment differs between the two properties improvements are required within No. 10 to ensure all service users have an attractive and homely place to stay. EVIDENCE: All areas of both properties were examined, and although the overall standard of décor was bright and clean a number of areas within No 10 require attention to ensure comfort and safety is maintained. CCTV cameras fitted to the front and rear exits of the building do not intrude upon the daily lives of the service users. Maintenance issues highlighted during inspection are as follows; Within No10. • Stair carpet must be replaced as present covering and rods are very hard and have been identified by staff members as increasing the risk of injury to service users. Radiator covers in sitting room & hallway damaged by service user requires repairing or replacing. DS0000025222.V282087.R01.S.doc Version 5.1 Page 16 • Autism Initiatives Respite Services Within No 8 • Dryer requires repairing or replacing. Staff on duty informed the inspector that where possible the staff undertake general maintenance and redecoration work themselves this regularly includes touching up paintwork and shampooing carpets etc. Other work is undertaken professionally via requests and reports to the company’s estate department. A number of regulation 26 forms recently submitted indicate that problems have occurred ensuring return slip (acknowledgement slips) and updates are feed back to the house staff in relation to when work is due to be undertaken. Bedrooms are individualised as far as possible during service users respite periods. Staff confirmed that fixtures and fittings are adjusted as necessary to reduce risks of injury and damage occurring. It was noted that two of the present service users bedrooms required very minimal furniture and fittings in order to aid their safety. This was supported by risk assessment documentation seen within their care files. Various restrictors where seen within the kitchens areas of both properties indicating that serious consideration has been given to the effects some behaviours associated with Autism can have upon services users health and well being. A condition referred to as PICA involves a behaviour whereby service users pick up or snatch food and often swallow it whole which could lead to death by asphyxiation. Having restrictors upon various food storage areas significantly reduces such risks as staff are able to monitor closely when food is served and eaten by service users. Both houses can and will provide specialist forms of equipment, fixtures and fittings depending upon service users identified needs. The inspector was shown examples of such during the tour, these included; • • • • Shatter proof Perspex window covers, Built in protected TV, Built in speaker systems within bedroom ceiling. Rubber buffers upon wall corners. Slots within kitchen door where noted and a member of staff explained how these had previously been used to enable a half door block to be in place to enable service users to observe cooking task, being undertaken whilst providing staff with safety and security to undertake such tasks without forcible interactions being encountered. Policies and procedures are available for infection control, and on the day of the inspection the home was clean and tidy. Each house has its own laundry Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 17 equipment, this includes an industrial washing machine which undertakes sluicing facilities. All cleaning products used within the home where found to be stored within locked cupboards and relevant COSHH information is available to staff members. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 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 &36 Service users appear to benefit from a good skill mix of suitably qualified and experienced staff members, who strive to provide a consistent approach to care and support. Staff members appear to be well supported with appropriate supervision and training being provided, and all staff met where able to demonstrated a clear understanding of their roles. EVIDENCE: Staff members need to undertake a range of training sessions before they receive a permanent contract with Autism Initiatives. Mandatory & specialist training includes: • • • • • • • • • • Fire prevention and awareness Health and safety Food hygiene First aid Epilepsy awareness, Adult protection, Mental health & autism spectrum disorders, Infection control and Moving & handling. Administration of medication and use of rectal suppositories DS0000025222.V282087.R01.S.doc Version 5.1 Page 19 Autism Initiatives Respite Services Supervision and training throughout employment is ongoing to ensure that the changing care needs of the services users and staff are always met. All staff are encouraged to pursue National Vocational Qualification training to at least level 2 in care with the support of an external NVQ assessor. During this inspection it was not possible to fully examine staff selection and recruitment procedures, as these are generally undertaken by senior management and the company’s personal department, however the previous report (9th May 2005) confirmed that Enhanced Criminal Records Bureau (CRB), Protection of Vulnerable Adults (POVA) checks, and reference checks are completed prior to any staff being employed. It was reported that staff members from Barnsbury road do when necessary move onto alternative settings within Autism Initiatives in order to provide service users with continuity of care and support. However on the whole the staff group appears relatively stable. Staff who spoke with the inspector indicated that they felt valued and supported and that they gained a great deal of job satisfaction within their roles. Six-month inductions are given to all staff alongside regular supervisions and appraisals. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 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, 38,39,40, 41 & 42 Service users and their carers appear to benefit from the good standard of flexible services provided by Barnsbury Rd. The health, safety and welfare of both service uses and staff appears to be promoted and safe guarded. EVIDENCE: 8 & 10 Barnsbury Rd recently merged to provide one unit rather than 2 separate units observations and interactions indicate that the amalgamation has been completed smoothly. The proposed manager has obtained an National Vocational Qualification (NVQ) level 3 in care and is in the process of doing her NVQ level 4 managers award. An application to be registered with the commission is presently being processed. Staff spoken to during the inspection confirmed that they were happy and comfortable with the way in which the home was being managed and although communicating directly with most of the service users was difficult Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 21 observations of body language and interactions indicated they are happy with the way the home and the staff works to support them. A variety of safety certificates such as fire, gas, electric and risk assessments were confirmed as being in date and valid during the inspection. Quality assurance is undertaken by the company’s audit process and includes the submitting of regulatory 26 forms to CSCI on a month basis. Observations and documentation also confirmed that staff members communicate closely with service users at regular intervals to ensure house rules, routines and facilities are influenced by the service users own views. Policies and procedures are regularly reviewed, and are relevant to the service offered and provided within Barnsbury Rd. Fire procedures have been produced for service users using ‘Makaton’ and ‘sign-a-long’ formats, enhancing their knowledge and understanding of the process’s to follow in such events. Records are stored within safe facilities in accordance with the Data Protection Act 1998. However further storage should be provided to aid suitable maintenance and access to staff training materials provided within the houses. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 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 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 2 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 3 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 4 3 3 3 3 3 3 3 3 x Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 23 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 YA28 Regulation 23 Requirement The registered person must ensure that outstanding repair and maintenance work is completed to ensure all service users have access to safe and comfortable communal areas. Timescale for action 01/04/06 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 Refer to Standard YA34 Good Practice Recommendations It is strongly recommended that the senior member of staff on duty have access to all records that must be held in the home to ensure they are accessible for the purpose of inspection which can occur at any time. Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Autism Initiatives Respite Services DS0000025222.V282087.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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