Inspection on 09/05/05 for Autism Initiatives Respite Services

This inspection was carried out on 9th May 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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... 12/01/06

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 10 Barnsbury Road 10 Barnsbury Road Walton Liverpool L4 9TS Lead Inspector Miss Julie E King Unannounced 9 May 2005 11.30 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. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 10 Barnsbury Road Address !0 Barnsbury Road, Walton, Liverpool, L4 9TS 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) 0151 226 8604 0151 226 8604 Autism Initiatives Amanda Stirzaker PC Care Home Only 2 Category(ies) of LD Learning Disability - 2 registration, with number of places 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The age range of the persons to be accommodated will be 17-65 years Date of last inspection 13th January 2005 Brief Description of the Service: 10 Barnsbury Road offers respite care for service users with Autistic Spectrum Disorder, and takes either a single person, two male or two female service users at any one time. The house is a semi-detached two storey property, with single bedrooms and a shared bathroom. The staff office doubles up as a sleepover room. The house has a large garden that is shared with the adjoining property, number 8 Barnsbury; that also belongs to Autism Initiatives. Local amenities include a sports centre and leisure facilities, transport, public houses, entertainment complexes and various shops. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection combined a site visit to commence a proposal to register both 8 and 10 Barnsbury Road as one registration, rather than the current two. If this application is approved the new name for the service will be Barnsbury Road Respite Service. 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. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 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 standard(s) 1,2 & 3 The Homes Statements Purpose is up to date and ensures that the home stays within the category of service user agreed with the commission. Service users are given adequate information about the service before they decide to move in on a permanent basis. EVIDENCE: The service user’s pre-admission assessment documentation is robust and comprehensive; this ensures that the skill mix of the workforce in the home can facilitate the service user’s identified care needs. All service users in the home are provided with a statement of terms and conditions, plus a contact when they move in to the home on a permanent basis. Service users are able to visit the home or have overnight stays before they move in on a permanent basis. Information about the home is provided in different formats, suitable to the different needs of the service users; and currently a DVD is being made for prospective service users to ‘view’ the home before visiting. Family, friends and other health care professionals known to the service user are also involved in the assessment and ongoing care of the service user. Care staff in the home undertake special training, which is ongoing to ensure that the assessed and changing care needs of the residents are met. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 8 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 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 & 9 The individualised care plans of each service user clearly evidence how the service users needs and goals are met on a daily basis. EVIDENCE: All service users in the home have a comprehensive, individual care plan, which is formulated prior to admission to the home. The key-workers and multidisciplinary healthcare team on a regular basis review these documents. Daily health records are documented each shift for each service users, and this includes any critical incidences plus any visits from GPs, specialists, etc. Care plans are comprehensive and contain very detailed information regarding the individual needs of the service users. Documentation included a social history, behaviour guidelines/strategies, daily routines and ‘what I need’, behaviour guidelines/strategies and ‘what is important to me’ information. The guidelines from O’Brien and Lyle philosophy of care for service users with learning disabilities is incorporated in to each service users care plan. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 10 O’Brien and Lyles philosophies include: - community presence, choice, competence, respect and community participation. There was evidence of multidisciplinary healthcare involvement and if a service user has mental health problems a Care Plan Approach (CPA) document is also provided. The inspector viewed this document on one of the service users files and noted that it included a scheduled review date. Full involvement of NHS and other healthcare professional agencies was clearly evident on all service user care plans examined. Family, friends and support networks also play a large part of the current service users’ lives. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 15, 16 & 17 Service users are actively encouraged to participate as much as possible in the local community, and family and friends are fully included in the service users daily lives. EVIDENCE: Where possible, staff in the home promote opportunities for service users to develop social, emotional communication and living skills. Service users are comprehensively assessed to determine their physical and mental capabilities to enable staff and service users to socially interact as much as possible. Some service users have attended outward-bound activities, learned computer skills, and other activities within the choices and preferences of the individual service user. Service users leisure activities can be often determined by their cognitive, social and emotions skills; and what suitable leisure pursuits are available in the home or the local community. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 12 The purpose of the service provided at Barnsbury Road is to enable relatives/friends to have some respite from their role as a main carer. However, wherever possible and if appropriate, care staff support service users to maintain family links and friendships during their stay. Families who are involved with service users often communicate by telephone during the respite period and care staff keep them updated on their progress. Service users rights are respected, and the daily routines of the household promote independence, choice and freedom of movement as far as possible. Restrictions and risk assessments are completed on an individual basis, again evidencing service user involvement. This service could clearly demonstrate how each highly individual service user’s needs are identified and met. The standard of record keeping in all areas was good, and staff were able to demonstrate their specialist knowledge of the service users and their conditions. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 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 standard(s) 18, 19 20 Preferences regarding the service user’s personal support are respected, and their mental and physical needs are met. Medications are managed safely in accordance with the National Minimum Standards. EVIDENCE: No current service user in the home self medicates, and all medications for service users are administered by the named key-workers in the home. The protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). On the day of the inspection the inspector observed care staff “engaged” with service users, in a calm unhurried, supportive way. Service users preferences about how they are guided, moved, supported and transferred are complied with, and reasons for not doing so are explained and recorded. Support staff are available as needed to help the service user to wash, shave, etc; and provide support for service users regarding personal hygiene. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 14 Many of the service users frequently consult Psychiatrists, neurologists, and physicians and other specialist health care professionals. This helps ensure that the holistic care needs of the service users is provided for. Care staff in the home ensures that all service users medical appointments are met. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Barnsbury Road has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. The home’s approach to training helps protect the service users from neglect. EVIDENCE: A clear complaints policy and procedure is available for both service users and their representatives. Included in this are contact details of the local CSCI. Staff training files evidenced that protection of vulnerable adults training is commenced on induction for all staff, and continued on as long as the staff member is employed. A whistle-blowing policy and procedure was also seen. All policies at the home are up to date, or in the process of being updated to include the latest guidance on POVA. No complaints have been received either by the Commission or Barnsbury Road since the previous inspection. Two members of staff always countersign Service users finances, and a full, detailed list of any expenditures plus receipts is kept. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 The standard of the environment within Barnsbury Road is good, providing service users with an attractive and homely place to stay. EVIDENCE: On the day of this unannounced inspection some areas of the home were in process of re-decoration. All areas were examined, and the overall standard of décor and furnishings was acceptable and homely. Service users rooms are individualised as far as possible during their respite stay, and fixtures and fittings can be adjusted as necessary. CCTV cameras are fitted to the front and rear exits of the building only, but do not intrude of the daily lives of the service users. Fire and other safety certificates were in date and valid, and an ongoing plan of re-decoration was available. Policies and procedures are available for infection control, and on the day of this inspection the home was clean, tidy and well kept. An industrial washing machine is available which includes a sluice facility. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 17 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) 31, 32, 35 & 36 There is a good match of well -qualified staff offering consistency of care within 10 Barnsbury Road. The arrangements for the induction of staff are good, with the staff demonstrating a clear understanding of their roles. EVIDENCE: A random selection of staff personnel files were examined, all seen evidenced ongoing mandatory and specialist training. Six-month inductions are given to all staff along with regular supervisions and appraisals. Before new staff are given a permanent contract of employment they have to complete all mandatory training plus five modules of specialist training. This covers fire, health & safety, food hygiene, Autistic spectrum disorders, first aid, epilepsy awareness, adult protection, mental health, infection control and moving & handling. In addition to this most staff are either in process, or have completed their NVQ 2 in Care; and have the support of an external NVQ assessor. Enhanced Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, plus reference checks are completed prior to any staff being employed. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 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, 38, 39, 40, 41 & 42. This is a well run home with good leadership, and quality assurance process are in place to ensure the service user’s best interests are safeguarded and protected. EVIDENCE: 10 Barnsbury Road has proposed to merge with its sister home next door (number 8), and has asked to be amalgamated into one respite service under one new manager. The new manager is in process of doing her NVQ 4, and has already obtained her NVQ 3 in Care. All necessary certificates such as gas, electric and risk assessments were up to date. Service user specific risk assessments are also in place, with updates and reviews involving the service user seen. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 19 The inspector spoke to all staff who were on duty, and both the service users were met. The staff informed the inspector that they enjoyed their work and felt supported. Quality assurance is undertaken in-house and via the company’s own audit process. Service user’s views and involvement is sought as far as possible, and the results of audits are made available to interested parties, including the CSCI. Policies and procedures are in continuous review, and are service specific. Mandatory procedures such as fire procedures have been produced for service users using ‘Makaton’ or ‘sign-a-long’ formats. All records are kept in accordance with the Data Protection Act 1998, in a safe, limited access facility. 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 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 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 10 Barnsbury Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 21 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. Refer to Standard Good Practice Recommendations 10 Barnsbury Road F52 F02 S25222 10 Barnsbury Rd V226674 090505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Liverpool Area Office 3rd Floor, 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. 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