Inspection on 13/07/06 for Autism Initiatives Respite Services

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 Adequate. 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 8 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... 12/01/06

Autism Initiatives Respite... 09/05/05

Autism Initiatives Respite... 13/01/05

Autism Initiatives Respite... 31/08/04

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 Respite Services 8 & 10 Barnsbury Road Walton Liverpool Merseyside L4 9TS Lead Inspector Debbie Corcoran Unannounced Inspection 13th July 2006 10:00 Autism Initiatives Respite Services DS0000025222.V295301.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 Respite Services DS0000025222.V295301.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 Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 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 Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the person to be accommodated will be 17 - 65 years 12th January 2006 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.V295301.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on an unannounced basis over a period of approximately 31/2 hours. During the visit there was only one service user staying at the home and this person was spoken with to obtain their views on the home. Two members of the staff team were on duty and both were spoken with. Service user plans, health and safety records and other relevant records were examined in some detail. A tour of the home was carried out and all areas were checked. What the service does well: What has improved since the last inspection? A small number of repairs / areas for maintenance were identified at the last inspection and these have been addressed. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 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 Respite Services DS0000025222.V295301.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 Respite Services DS0000025222.V295301.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): 2 Service user’s needs are assessed before they stay at the home so as to ensure their needs can be met at the home. EVIDENCE: New service users are only admitted to the home for a stay following an assessment of their needs. These assessments are carried out so as to ensure that the service user’s needs can be met at the home. Assessment information was examined for two service users. This showed that a member of staff at Autism Initiatives had carried out a fairly comprehensive and detailed assessment of needs for one of the service users concerned. The assessment of needs for one of the other service users was not particularly detailed or informative. The assessment tool and information relate specifically to the service user’s needs in relation to living with autism. There was no evidence that the home is attaining Community Care assessments as carried out by Social Services. These should be attained whenever possible and it is recommended that the home include this in their assessment and pre admissions procedures. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 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, 9 Service users have a care plan which clearly reflects their needs. Care plans are not being reviewed and updated. Risks to service users safety and well being are assessed and plans are put in place to manage these. EVIDENCE: Service users have a care plan which describes how to support them during their stay at the home. Care plans were examined for four of the service users. For three of the service users the care plans were detailed and included information as to how to support the service users with their personal care, physical care, health care and emotional and psychological needs. Care plans also include information as to how to support the service users to develop their social and daily living skills. There was no evidence that care plans are being reviewed or updated and some of the information in the care plans was not signed and dated, this needs to be addressed. One of the service users who is new to the service did not have a care plan. The manager must ensure that a care plan is in place as soon as possible when a service users starts to use the service. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 10 It is recommended that all information relating to the service users is reviewed and information which is no longer required by staff (on a regular basis) should be archived. Service users are encouraged to make decisions about their daily lives for the duration of their stay. Care plans are descriptive about the service users preferences and daily routines and service users are offered the opportunity to plan their stay. Risk assessments are carried out for each of the service users. These identify potential hazards to the service users safety and well being and include detailed guidelines as to how to then manage the risk or prevent the risk from occurring. The risk assessments cover different aspects of the persons support. For example support with communication and community access. The risk assessments are comprehensive and are reviewed regularly. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 11 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): 12, 13, 15, 16, 17 Service users are supported in appropriate activities for the duration of their stay. Service users are encouraged to maintain relationships during their stay. Service users are offered a good choice of healthy food and staff are aware of the service needs with their diet and eating. EVIDENCE: Each of the service users has a care plan and these include information on activities which the person likes to be involved with and includes information on the persons cultural needs. At the start of their stay each of the service users has the opportunity to discuss what activities they would like to be involved in for the duration of their stay and staff then plan for these to take place whenever possible. A daily record is maintained for each of the service users and this includes information on what activities the person has had the opportunity to be involved in. These showed that the service users are supported to be involved in a variety of community activities for the duration of their stay. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 12 Service user’s records include information on the people who are important to the service user and contact details for relatives, friends and relevant others. In assessing the diet and meals available to service users menu records were examined, one of the service users was spoken with and the availability and storage of food was checked. This indicated that service users have the choice of a variety of healthy well balanced meals. Information on the service user’s likes, dislikes and needs with their food and meals is recorded in the service user’s plan. The home has two kitchen areas and service users have access to both of these. One of these areas was checked and found to be well stocked with food, snacks and facilities for service users to make hot and cold drinks. Opened food was not being date labelled as to when opened, this can pose a risk to food safety and must be addressed. Food must be stored safely and staff should receive training or refresher training in food hygiene. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 13 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 Service users are supported with their physical and emotional well being for the duration of their stay. Medication is handled and administered appropriately. EVIDENCE: Service users have a care plan which includes a good level of information on how to meet the person’s personal and health care needs. Staff ensure the health care needs of the service users are met for the duration of their stay. Arrangements are made for service users to visit a G.Ps or district nurse when this is required. Care plans provide detailed information to staff on how to support the service users with their emotional well being. Polices and procedure used for the receipt, storage, disposal, and documentation of medications within the home are being followed appropriately. Medication storage and records were checked. These were appropriate. It is recommended that the home uses medication administration records which are provided by a pharmacist as opposed to hand written by staff. This would not be feasible for service users on short term respite but would be more appropriate for service users who reside at the home on a temporary basis. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 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 Policies, procedures and practices are in place which aim to protect service users against abuse or neglect and systems are in place for dealing with complaints and allegations of abuse. EVIDENCE: The home has a complaints procedure which is time scaled appropriately. The home has a ‘service user protection document’. This provides a guideline for staff on how to deal with a potential adult abuse allegation. The home should also have a procedure which links in with the Local Authority adult protection procedures in terms of notifying relevant authorities. Autism Initiatives do have such a policy. The manager should ensure a copy of this is available at the home. Staff have been provided with adult protection training. The home has further policies and procedures aimed at protecting service users including the management of service users money and financial affairs and a physical intervention policy. A record of key events is maintained for example incident reports, accident reports, service user’s monies and medication administration records. Incident and accident reports were checked and found to be undated. These records need to be maintained appropriately. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 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, 30 The home is clean and generally presented to a satisfactory standard although there is room for improvement in a number of areas. EVIDENCE: A tour of the premises was carried out which included all areas. The home is split in to two separate houses each with it’s own front door. One of the houses can accommodate 3 service users and the other accommodates 2 service users. There is no access through from one to the other. This can present as a difficulty for staff who have to sleep in a sitting room when there are no service users staying in one of the properties. Some areas of the home have been adapted specifically for the safety of one of the service users. As this person no longer uses the service these adaptations should be removed as they are not conducive to creating a homely environment. A number of further areas of work include; the radiator in one of the dinning rooms needs to be repaired, the tumble dryer needs to be repaired, a hole in the landing wall needs to be repaired, some of the paintwork around the house needs attention and one of the dinning suites needs to be replaced. Garden chairs are currently being used as dinning chairs and this is not acceptable. The home was presented as clean and hygienic and health and safety practices are adopted by staff. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 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, 36 Staff have clear roles and responsibilities and are well trained and well supported to do their job. Staffing levels are good and allow for service users to receive a significant amount of one to one support. EVIDENCE: Staff within the home and across the organisation have clear roles and responsibilities. Staffing levels are good and the staff rota indicates that service users are supported on a one to one basis. As the home provides respite care the needs of the service user group change on a regular basis and therefore staffing levels are increased as required in order to meet the needs of the service users. Staff files could not be viewed on this occasion as the manager was not available to allow access to these. Staff recruitment and selection procedures could not therefore be assessed. It is noted however that Autism Initiatives as an organisation do have a thorough staff recruitment and selection process and induction process. Both staff on duty at the time of inspection reported that they have worked at the home for approximately 3 years. Staff reported good training opportunities including training in health and safety, fire safety, food hygiene, adult protection and supporting people autism, supporting people with epilepsy and the administration of medication. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 17 Staff also reported that they have regular supervision sessions and attend team meetings approximately every 3 months. Staff sign all policies and procedures as having read and understood them and they also sign some of the guidelines for support for the service users. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 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 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, 39, 42 The home does not have a suitably experienced, qualified registered manager. Health and safety practices and checks are carried out but some of these are out of date and therefore the health and welfare of service users and staff are not fully safeguarded. EVIDENCE: The home has a designated manager, however this person is managing on a temporary basis only. The home therefore does not have a permanent manager who is registered with the Commission. The registered person should ensure that the home is visited on an unannounced basis at least once per month and provide a report on the findings of the visit to the Commission in line with Regulation 26 of the Care Home Regulations 2001. These visits should form part of the quality assurance process and should involve seeking the views of service users (and their representatives as appropriate) and staff in order to form an opinion on the standard of care provided. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 19 Staff are provided with training in health and safety topics and the home has health and safety policies and procedures. Fire safety and health and safety practices are adopted. Records of fire and health and safety checks were checked and found to be up to date with the exception of the fire alarm which should be tested more frequently. An up to date electricity safety certificate was available. However the gas safety certificate was out of date. The registered person has therefore been required to ensure that a gas safety inspection is carried out and an up to date certificate for gas safety is forwarded to the Commission. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 20 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 x 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 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 2 x x 2 x Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 21 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 YA37 Regulation 8 Requirement Timescale for action 13/10/06 2. YA24 3. YA6 4. 5. 6. 7. YA17 YA24 YA42 YA42 The registered person shall ensure that a manager is appointed to the home and an application for the registration of manager is made to the Commission. 23 The registered person shall ensure all repairs and maintenance work as identified in the report is completed. 15 Each service user must have a care plan which details how the service user’s needs in respect of their health and welfare are to be met. Care plans must be kept under review. 13 (3) Food must be stored safely and staff must be provided with training in food hygiene. 16 (2) (c ) The registered person shall ensure that dinning furniture is replaced. 23 (4)(c) Fire alarm tests must be carried (v) out at appropriate intervals. 23 The registered person shall ensure a gas safety inspection is carried out and forward a copy of a valid gas safety certificate to the Commission. 13/11/06 13/09/06 13/09/06 13/09/06 13/08/06 20/08/06 Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 22 8. YA39 26 (5) The registered person shall ensure that the home is visited at least once per month on an unannounced basis and shall supply a copy of the report following the visit to the Commission. 13/09/06 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 YA2 YA20 YA23 YA6 Good Practice Recommendations The manager should attain Community Care assessments for service users from Social Services where appropriate. For service users residing at the home on a temporary basis the manager should obtain medication administration record from a pharmacist. The manager should attain a copy of the adult abuse procedures produced by Autism Initiatives. All records should be signed and dated appropriately. Autism Initiatives Respite Services DS0000025222.V295301.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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.V295301.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!