Inspection on 21/04/05 for Autism Plus Limited

This inspection was carried out on 21st April 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 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 8 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 02/03/06

Autism Plus Limited 16/09/05

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 DN8 4AG Lead Inspector Janet McBride Unannounced 21 April 2005 12.45. 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. Thorne House Services for Autism Version 1.10 Page 3 SERVICE INFORMATION Name of service Thorne House Services for Autism Address St Nicholas Road Thorne Doncaster DN8 4AG 01405 812128 01405 812509 dj@thsa.co,uk Thorne Services for Autism 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) Mrs Yvonne Mitcheson PC Care Home only 33 Category(ies) of LD Learning Disability 33 registration, with number of places Thorne House Services for Autism Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16 December 2004 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. Along side this is the four satellite homes. 6 Bellwood Crescent and 35 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 Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by two Inspectors and commenced at 12.45 and finished at 18.45. The inspector assessed a proportion of the National Minimum Standards; those key standards not assessed at this inspection will be assessed at the next inspection. This visit included talking to management, staff and two service users, comment cards were also left at the home for two further service users who completed them and sent them to the local CSCI office. Tour of the main house (including all five flats) and one further satellite home was visited, a number of records were examined, and three service users records were case tracked to ensure all identified needs were met. Interaction between staff and service users was observed throughout the day. What the service does well: What has improved since the last inspection? Record keeping has been improved, particularly care plans, and they are continuing to review and streamline these documents enabling staff to meet the individual needs of residents. Since the last inspection some refurbishment and redecoration has taken place, thereby improving the overall appearance of the home. The majority of the environment seen was well maintained with some exceptions in the bathrooms of the main house. Thorne House Services for Autism Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Thorne House Services for Autism Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Thorne House Services for Autism Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 Potential service users do not have the information they need to make the choice about moving into the home, or what the service provides and if the home will meet their needs. EVIDENCE: The homes statement of purpose and service users guide is still in draft form, this was examined and requires information relating to South Yorkshire Housing Association, and work on the complaints section to be more service users focussed using graphics’. Any placing authority provides information to the home prior to admission, and information in care plans showed that staff completes all appropriate assessments, including suitable communication methods with service users if they are capable of being involved with planning their care. Thorne House Services for Autism Version 1.10 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) 6,9 All care plans are being reviewed and improving the format has ensured that staff deliver the appropriate care to service user and that specific details of care required are included. Service users are supported to take identified risks as part of an independent lifestyle. Whenever possible service users must be given the opportunity to agree and sign their care plan ensuring that they have contributed to its development. EVIDENCE: Three care plans examined provided sufficient details to enable staff to deliver the appropriate care required. The plans included a pen picture, information on self-help skills and likes and dislikes. Risk assessments were in place and the plan contained approaches and strategies when intervention was required for service users likely to be aggressive or cause harm. The care plan is reviewed on a regular basis involving significant professionals and family giving opportunity for comment and changes to be made to ensure needs are met at all times. Thorne House Services for Autism Version 1.10 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed at this Inspection. EVIDENCE: Thorne House Services for Autism Version 1.10 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 20 Service users are individually assessed and supported regarding personal care they required. Medication procedures/ policies are not up to date in all the houses and the practice of secondary dispensing puts service users at risk of receiving incorrect medication. EVIDENCE: Records clearly show detailed information of service users personal care needs. Staff interviewed were aware of any restrictions on privacy, e.g. danger when bathing alone, risk assessments were in place to identify any risks and how they can be managed. A record is maintained of current medication for all service users, these records were checked and some issues were raised; the medication policy and procedure the staff at Bellwood were referring to had not been updated, and they did not have an up to date BNF to refer to when required: e.g. checking side effects of drugs Staff are placing tablets in containers for staff at day care, or parents when on home leave, to give. Staff and parents do not therefore have information about what they are giving or if it is correct. On examination of MAR sheets some were found to be hand written and were not signed by two members of staff, to verify medication regime. Thorne House Services for Autism Version 1.10 Page 12 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) 23 Staff and management have a good understanding of Adult Protection and robust polices are in place to protect residents. EVIDENCE: On examination of the homes incident reports, it was found that the home has addressed the requirements made on the last Inspection, notifications of any incidents has been sent to the local Commission for Social Care Inspection. Protection of service users was also discussed with members of staff and care plans examined, and staff complete behaviour monitoring charts, evidence was found that these are monitored and service users re-assessed to ensure other service users are not at risk. Thorne House Services for Autism Version 1.10 Page 13 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 26 27 28 Those areas that have been refurbished now provide a pleasant living environment. Personnalisation of bedrooms reflect the interests and promote service users independence. Bathrooms in the main house appear very dull and cold and would benefit from some general repairs, and redecorating to make them more homely for service users. EVIDENCE: Although some redecoration has taken place since the last Inspection, some of the requirements made remain outstanding as they are waiting for quotes, e.g. floor in the lounge at Brambles and wood panelling in the main entrance hall. Tour of the main house and one satellite home found most of the environment well maintained, decorated and clean and tidy. Although the bathrooms and toilets provide sufficient privacy and meet service users needs, in the main house they all looked very bland and would benefit from some re-decoration to make them more homely. Some of the bathrooms are showing signs of wear and tear and require some minor general repairs: e.g. window boarded up for safety reasons, but has not been painted, one window requires a blind to ensure privacy for service users, window sill paint flaking off and one bathrooms floor was very grubby and would not come clean and needs new floor covering. Thorne House Services for Autism Version 1.10 Page 14 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 35 Service users are supported by staff who are competent and have the skills to deliver the care to service users. Staff have on the whole have the necessary information to perform these duties including contracts as workers. EVIDENCE: Evidence was seen that staff receives induction and foundation training, which met Sector Skills Council workforce training targets. Staff training was linked to Learning Disability Award Frameworks (LDAF). However Staff had not been provided with copies of the Codes of Practice issued by the General Social Care Council, therefore staff may not be aware of these codes, which are intended to reflect good practice, and describes the standards of professional conduct and practice required of staff. A previous requirement made in relation to this issue has been carried forward. Thorne House Services for Autism Version 1.10 Page 15 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 39 40 42 Noticeable improvements have been made since the new manager came into post and the staff have a more supportive structure in place. Members of the Board of Trustees are not undertaking Regulation 26 visits as regularly as required by the Commission, therefore the organisation does not ensure that the home fulfils its stated purpose and objectives thereby meeting the needs of the service users who live there. Good health and safety management is in place through out the organisation to protect its resident’s staff and visitors. EVIDENCE: Records show that despite previous requirements made at the past two inspections in relation to Quality Assurance and Regulation 26 visits these have not been completed, therefore no evidence is available that the organisation achieves the aims and objectives of the statement of purpose. Thorne House Services for Autism Version 1.10 Page 16 Examination of the fire logbook at Bellwood, and records indicate that all appropriate fire checks had been recorded; recent visit by the fire officer highlighted some issues that have been addressed. Some sections of the fire log were not completed thereby not confirming whether checks had been made. A timetable for staff to undertake mandatory training had been undertaken, and records show the home provide staff training in moving and handling, fire, first aid and food hygiene safeguards health, safety and welfare of service users. Thorne House Services for Autism Version 1.10 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 2 3 x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 2 x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 3 x 3 x Thorne House Services for Autism Version 1.10 Page 18 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. Standard YA1 Regulation 5 Requirement The Registered person must ensure that the statement of purpose and service users guide is available in an appropriate format suitable for current and proposed service users. Medication; secondary dispensing by staff must cease and alterative arrangement must be made. MAR sheets that are hand written must have two signatures for verification of medication regime. Policy and procedure must be updated and all units must have copy of current BNF guide. All communal areas must be maintained in a good state of repair and decoration. Continue with the refurbishment highlighted. (Previous timescale not met 01/05/05) Repair and decorate bathrooms in main house on Brambles and Willow units. All staff must be provided with copies of the Codes of Practice issued by the General Social Care Council.( previous timescale not met 01/03/05) Version 1.10 Timescale for action 30th July 2005 2. YA20 13(2) 1st June 2005 1st June 2005 30th July 2005 30th July 2005 3. YA20 13(2) 4. 5. YA20 YA24 13(2) 23 6. 7. YA27 YA31 23(2)(b) 18 30th July 2005 1st June 2005 Thorne House Services for Autism Page 19 8. YA39 26 Regulation 26 visits must be undertaken on a monthly basis.(previous timescale not met 01/03/05) 30thJune 2005 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 Thorne House Services for Autism Version 1.10 Page 20 Commission for Social Care Inspection First Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ 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 Thorne House Services for Autism Version 1.10 Page 21 - 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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