Inspection on 02/03/06 for Autism Plus Limited

This inspection was carried out on 2nd March 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Autism Plus Limited 22/06/06

Autism Plus Limited 16/09/05

Autism Plus Limited 21/04/05

Autism Plus Limited 16/12/04

Autism Plus Limited 08/07/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Thorne House Services For Autism St Nicholas Road Thorne Doncaster South Yorkshire DN8 4AG Lead Inspector Janet McBride Unannounced Inspection 2nd March 2006 11:00 Thorne House Services For Autism DS0000007974.V281560.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 Thorne House Services For Autism DS0000007974.V281560.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. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Thorne House Services For Autism Address St Nicholas Road Thorne Doncaster South Yorkshire DN8 4AG 01405 812128 01405 812509 dj@thsa.co.uk 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) Thorne House for Autism *** Post Vacant *** Care Home 33 Category(ies) of Learning disability (33) registration, with number of places Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th September 2005 Brief Description of the Service: Thorne house is a care home providing care and accommodation for 33 service users, for Adults with Autism. The organisation is a registered charity, and is run from central offices located at Fieldside Court in the centre of Thorne. The residential service is provided in five properties that are all in easy reach of each other in the town of Thorne. Thorne house is the main unit located in its own grounds. It is divided into five self-contained flats and in total offers places for 18 young adults. Each flat has its own front door and there is a central lobby that visitors to the units can utilise. They also have four satellite homes, Bellwood Crescent and Alexandra Road are in the heart of the community and Rusholme and Hillcrest are on St Nicholas Road both being next door to each other. Each accommodation has single bedrooms and shared communal facilities. Each operating as a domestic household, staff are allocated to specific homes and have facilities within for record storage and sleep-in rooms where appropriate. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector from the Commission for Social Care Inspection carried out this unannounced inspection at Thorne House, on the 2nd March 2006, commencing at 11:00 and finished at 16:40. This was the home third Inspection since April 2005,any standards not covered in this inspection was covered in the two previous unannounced inspections that was conducted early in the year. It may be the case that some standards will be covered twice in the inspection year 2005/2006, which is considered good practice, and consistent with a professional approach to regulation. During the Inspection we looked at chosen number of documents, sampling of records, tour of some of the premises and direct observation of staffs interaction with service users whenever possible. Any issues or concerns that were raised were discussed with the acting manager at the end of the Inspection. What the service does well: What has improved since the last inspection? Changes within the management structure, which has impacted on the progress made in relation to some previous requirements and recommendations, also more communication between senior management and staff within the organisation, and management have worked hard at addressing any issues raised, by the Commission for Social Care Inspection. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 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. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1 and 2 has been assessed on previous Inspections throughout the year and met. EVIDENCE: Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Evident that each individual service users is assisted and support by staff to make decisions and choices about all daily living needs. EVIDENCE: Discussed with two members of staff at one of the satellite homes how they ensure that service users make decisions about every day living needs. Service users abilities to make decisions could be limited to their level of understanding. Some service users had profound Autism with an inability to imagine and think laterally; also some service users did not have social skills and at times displayed unacceptable behaviour’s, therefore staff support service users to make decisions, communicate and behave appropriately at the correct level. Other service users had a higher level of ability to express wishes and make choices and staff supported this. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 10 Documentation in care plans shows that each service users has a communication file, which shows limit of communication, what methods are used and what support is needed. During interviews with staff it was very evident that there were aware of the need to support service user’s rights to make decisions, choices and how this was facilitated at the right level for individuals. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 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): 11 12 13 14 15 16 17 The organisation provides and promote communal and leisure activities for service users, and ensures some of their time is spent outside of the home giving them opportunities to mix with other people who have the same disability. EVIDENCE: Staff spoken and records examined evidenced that staff supported service users to have the opportunity to learn and use practical skills, no matter how small a task this may seem, for example one person as learned how to move laundry that requires washing to the appropriate place. Service users participated in some household task, with staff support, where able, dependent on abilities and preferences. All service users has the opportunity to attend day services, and college they are also supported to continue and participate in any activity enjoyed prior to admission. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 12 Discussions with staff and examination of records evidenced that staff supported service users to participate in the local community, according to assessed needs and within a risk management framework, one service users works within a charity shop, this has developed their employment skills. Each service user had a weekly activities chart, which was planned in advance. These were available and show that the majority of planned activities had taken place. The organisation had a fleet of vehicles to facilitate these activities and outings Parental contact was maintained and supported at an agreed level and in accordance to the needs of the individual service user. Parents were kept informed of the development of their son or daughter; they can go home for overnight, weekend stays or holidays. The majority of service users spend some of their time outside of the home, and have opportunities to mix with other people who have the same disability at disco’s and other events. Discussions with management and staff evidenced that the routines of the home were flexible to suit the needs of each service user, however some structured routines had been identified for those service users who benefited from these. Staff try to ensure that service users receive a healthy diet, and help service users plan a menu, examination of the records of food provided, evidenced that a varied diet was available to service users and individual likes and dislikes were recorded in service user plans, no nutritional assessment are completed but service users are weighed on a regular basis and Dieticians would be consulted if concerns were identified. For staffs development they are to have training on food and nutrition at Selby College, this will start in March 2006. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 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): 20 Service users health is monitored and staff can access all NHS health care facilities. Medication practice of secondary dispensing puts service users at risk of receiving incorrect medication. EVIDENCE: This standard was assessed at the last Inspection and issues were raised all have been addressed with the exception of secondary dispensing, but the organisations as taken a proactive approach to this and is working with the local pharmacist to try and resolve any issues. Thorne House Services For Autism DS0000007974.V281560.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 Service users, relatives and visitors can raise concerns via the organisations complaints procedure, which ensures that service users are protected. EVIDENCE: The organisation have a complaints policy and procedure, records were examined and found that complaints were responded to within a time frame investigated and a response to the complainant. Complaints are logged in a hardback book, therefore the organisation need to develop a new format for recording complaints, one that has clear procedures and documentation that details the process, what investigation, action taken and outcome. Thorne House Services For Autism DS0000007974.V281560.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 27 Tour of the environment noted that those areas that have been refurbished look and provide a pleasant living environment for those living there, but the organisation need a refurbishment and development plan for all sites. EVIDENCE: The organisation has four community houses, in addition to the main house. Each house has its own budget for decoration and refurbishment. But the main house belongs to South Yorkshire Housing Association (SYHA), and the organisation has to apply to them for any redecoration and refurbishment. Any environmental issues that were raised on the last Inspection had been addressed; although the organisation needs to develop maintenance and refurbishment plan for all the sites. During the inspection the inspectors carried out a tour of the majority of the environment, all of the units within the main house, Rusholme and Hillcrest community houses were also checked. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 16 The majority of the environments seen were well maintained, decorated and clean and tidy, also furnishings and fittings provided were in good condition. The inspectors did not check Bellwood Crescent and Alexandra Road on this inspection. Bathrooms and toilet facilities in the main house raised a number of issues on the last Inspection; although the organisation as carried out some minor general repairs and made them look more homely. All the bathrooms and toilets are very old and showing signs of wear and tear they require a complete refurbishment, and the organisation need to develop a refurbishment plan for bathrooms and toilets within the main house. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 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 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): 32 34 35 36 The organisation has worked hard at improving staffing, and as recruited a number of staff. Recruitment practices are very good; this ensures that service users are protected. Staff seen was competent and qualified to support service users and worked positively with them to improve their quality of life. EVIDENCE: During the inspection staff were observed to be respectful towards service users, they were noted to communicate effectively with individual service users. Staffing matrix shows that staff had undertaken training in Autism awareness. The home had a commitment to NVQ training, at the time of this inspection 11 care staff had achieved NVQ level 2 in care. The organisation is aware of the requirement to have 50 of care staff trained to NVQ level 2. The organisation had appropriate recruitment policies and procedures in place. Four staff files were sampled, these were well organised and contained a front sheet checklist to ensure all required information was obtained and kept. Criminal Records Bureau and POVA checks had been completed on all staff. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 18 All staff is employed on a probationary period, which is reviewed. The organisation had a staff training matrix, which was available and copy taken, this matrix shows when staff had completed training and each staff member had an individual training profile. Induction and Foundation training met Sector Skills Council workforce training targets, and staff training was linked to Learning Disability Award Frameworks (LDAF). One new member of staff was interviewed (this is her 7th week working within the organisation) and she confirmed that worked for three weeks totally supernumerary and then three more weeks’s under supervision and feels she’s been very supported during this time. Supervision was discussed with the management, staff spoken to and files checked. All files show that staff receives formal supervision, some staff members have gone a long time between supervision sessions, however they have improved. Staff confirms that training and development is discussed at supervision sessions, including any care issue that raise concerns. Staff receives yearly appraisals, although a few are still outstanding. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 19 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 41 42 Records required by regulation and for their protection of service users are maintained and up to date. Staff promotes health, safety and welfare, but the organisation must ensure that staff receive updates in health and safety to ensure that service users are protected. EVIDENCE: There continues to be a vacant managers post, however the day to day operations continues with an acting group manager who as the relevant experience and as completed NVQ 4 in management. Since her appointment she as met with team leaders and staff on a regular basis to discuss and care and regulation issues. Since the last Inspection staff has been made aware of completing Regulation 37 incident forms and these have been received on a regular basis along with Regulation 26 visit reports. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 20 Safe working practice was discussed and records checked on the last Inspection and no issues were raised, however on this Inspection this was partially assessed at individual satellite homes that were visited within the community. Health and safety was discussed with some members of staff, and examination of some records, which indicate that all appropriate fire tests are carried out on a weekly basis, but emergency lighting at one home had not been checked on a regular basis. Safe working practice was discussed with staff members and training file checked, which shows some outstanding training for example updates in fire training, moving and handling, health and safety and fist aid. All of the above was feedback to the acting group manager at the end of the Inspection. Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 21 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 X 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 2 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 2 X X X 3 2 X Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 22 YES 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 2 Standard YA17 YA20 Regulation 16(2)(I) 13(2) Requirement All service users must have nutritional assessments completed. Medication; Secondary dispensing by staff must cease and alterative arrangement must be made. The organisation must have a maintenance and development plan for all the services sites. Development plan for bathrooms and toilet Facilities within the main house. Appointment of manager as soon as possible. Safe working practice Staff must be trained and have updates in; 1) Moving and handling. 2) Health and safety. 3) First aid. Fire safety, 1) Staff must receive fire training and records kept. 2) Emergency lights must be checked on a monthly basis. Timescale for action 01/05/06 01/05/06 3 4 6 7 YA24 YA27 YA37 YA42 23(2)(b) 23(2)(c) 8(1) 13 01/05/06 01/05/06 31/05/06 31/05/06 8 YA42 23(4)(d) 31/05/06 Thorne House Services For Autism DS0000007974.V281560.R01.S.doc Version 5.1 Page 23 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 YA22 YA32 YA36 Good Practice Recommendations Develop a new format for recording complaints, one that has clear procedures that documents the process, investigation, action taken and outcome. Continue with the training to achieve a minimum ratio of 50 trained members of staff acquire the appropriate level 2 NVQ qualifications. Continue to update staff’s formal supervision on a regular basis and yearly appraisals. 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