Inspection on 26/09/07 for Carlton Autistic Care Centre

This inspection was carried out on 26th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlton Autistic Care Centre 19/09/06

Carlton Autistic Care Centre 05/10/05

Carlton Autistic Care Centre 07/06/05

Carlton Autistic Care Centre 22/03/05

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 Carlton Autistic Care Centre 23 Greenway Milnsbridge Huddersfield HD3 4RZ Lead Inspector Cathy Howarth Key Unannounced Inspection 26th September 2007 09:00 Carlton Autistic Care Centre DS0000044408.V351551.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 Carlton Autistic Care Centre DS0000044408.V351551.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. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Autistic Care Centre Address 23 Greenway Milnsbridge Huddersfield HD3 4RZ 01484 649899 01484 649899 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) Carlton Nursing Homes Ltd Mrs Julie Christine Wignall Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 2006 Brief Description of the Service: Carlton Autistic Services is a care home providing personal care and accommodation for up to sixteen younger adults with a learning disability and autistic spectrum disorder. Carlton Autistic Services is a purpose built home that comprises three separate units. Carlton House provides accommodation for up to eight people. Opposite Carlton House, separated by a driveway, are two, four place houses, Greenway and Sycamore. All bedrooms are single and have en-suite facilities. Carlton House has two small communal lounges and separate dining room and also has a sensory room. Spacious hallways, both on the ground and first floor of Carlton House add to the feeling of space. A passenger lift to the first floor is provided in Carlton House ensuring that any relatives or visitors with mobility difficulties can reach the first floor if necessary. Both Sycamore and Greenway have a large kitchen with space for dining, a separate dining room and good-sized lounge. A small laundry room is available in all three houses. The home now also has a large separate laundry with commercial machines to wash larger items and bedding. There is also an office and store in this new building. Carlton House has its own secure garden, and a shared garden is available to the rear of the two four-bedded homes. A driveway with parking separates the main house from the two four-bedded houses. The home is situated approximately five miles from Huddersfield town centre. There are some local shops within a two minute walk. Milnsbridge and Golcar offer a range of amenities and are within easy reach. There is a bus stop opposite the home. Information about the service and inspection reports are available from the main office. The fees at the time of this inspection ranged from £1100 to £2050 dependent on the care package agreed with commissioners. Carlton Autistic Care Centre DS0000044408.V351551.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 using information about the service provided by the manager, responses to surveys sent to people using the service, relatives and social and health care professionals involved with people living there. The inspector made an unannounced visit to the service and spoke with people living there, staff and examined records. Overall responses from people connected with the service were very positive, both verbally and in writing. The service has built up confidence amongst relatives, who universally praised the staff working with their relatives. The inspector would like to thank all involved with this inspection for their contribution and for their welcome on this visit. What the service does well: What has improved since the last inspection? Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 6 Staff recruitment systems are improved. A new office and laundry has improved the environment in Carlton House by minimising the number of visitors to the house. Magnetic hold open devices have been fitted to allow some doors to be left open for the benefit of people living there. 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. The summary of this inspection report can be made available in other formats on request. Carlton Autistic Care Centre DS0000044408.V351551.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 Carlton Autistic Care Centre DS0000044408.V351551.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The processes for admission to the home are centred around the individual. EVIDENCE: Admissions are not made to Carlton Autistic Services until a full needs assessment has been undertaken. This involves the individual, and their family or representative, where appropriate. Where the assessment has been undertaken through care management arrangements, the service insists on receiving a summary of the assessment and a copy of the care plan. Admissions to the home only take place if the service is confident that staff have the skills, ability and qualifications to meet the assessed needs of the prospective user. A recent admission showed that detailed information had been obtained and a sensitive plan had been implemented to minimise the trauma of transition for the person involved. This appears to have been successful as the individual has settled happily in Carlton House and is thriving in his new placement. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 9 The manager said that there is no set process or timescale for introductions to the service as they prefer to tailor this to the needs of the individual. The last two admissions demonstrate this, as one was a very lengthy process of introductions and stays, whereas the other was very swift, following an initial visit and discussions with the perons and their advocate. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience excellent quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. EVIDENCE: As part of this inspection, three files of people living at the home were examined and several people talked to the inspector. It was noted that individual needs were very detailed. For some people who have communication difficulties, a detailed 24 hour plan has been developed outlining all aspects of daily lives and the particular approaches that have been found to be successful with the people. This ensures a good level of consistency of approach within the staff team. This is fundamental to the success of the service with this particular user group. One relative who responded to the survey said: Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 11 “Carlton Autistic Centre has an excellent and highly structured staff communication system in place whereby staff are working in unity….our son has a personal written negotiable contract agreed between him and Carlton. This we see as essential for clarity, communication being one of the problems for people on the autistic spectrum.” People have notes written daily, reflecting what they have done and achieved. The format for these makes it easy to see important information such as what people have eaten, done and if there have been any untoward incidents. The daily sheets are used to produce monthly reports on progress, which keep others informed of what is happening in people’s lives such as relatives or care managers. The home has an advocacy manager whose role is to consult monthly with people living there to establish that they are getting the service they want and that their personal goals are being met. Staff use written agreements with people as a means of establishing how goals are to be met. Reviews are held annually or more frequently if required. However, the manager or advocacy manager review monthly reports to pick up any issues before this. Risk assessments are an important part of the care planning process for people living at the service. Staff seek to maximise people’s independence and opportunities and this has to be done in a way that minimises risks. Risk assessments were found to be relevant, and reviewed regularly, which demonstrates the commitment within the team to supporting people to gain the most from their opportunities. The use of contracts with some individuals, for example around budgeting and alcohol use, also contributes to individuals developing skills and self-awareness to reach their potential. One person living there, who spoke with the inspector, said that he had found it helpful to have his contract in place as it had enabled him to take control of his life and learn new skills. The service has started working on implementing a system of person centred planning with the people living there. This process has involved people working through a “Listen to me” workbook to identify areas that are important to them in their lives and their aspirations for the future. Meetings are to be held in the coming months to turn this information into plans for the future. There are procedures in place to ensure that people are informed of their rights to confidentiality. Relatives who responded to the surveys were positive about how needs are met within Carlton Autistic Services. One parent said: Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 12 “for the first time in his adult life, my son has the correct specific Aspergers support. ” Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience excellent quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People who use services are able to make choices about their lifestyle and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals’ expectations. EVIDENCE: People using the service have the opportunity to develop and maintain important personal and family relationships. The practice of staff promotes individual rights and choice but also considers protection of individuals, supporting people to make informed choices. People living at Carlton Autistic Services are involved in a wide range of day and evening activities according to their different interests, from part-time jobs in a drop in centre or in the nursing home next door, to college courses and Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 14 visits to local pubs and social facilities. Two people living there responded to the surveys sent. Both indicated that they can do what they choose with support from staff as appropriate. One person said: “I find that if I want to do something at the weekend my carers are willing to support me.” It was positive to note that one person who requires two carers to support him when out of the home, is still managing to lead a full and active life and the high staffing required has not prevented this. In September, his daily notes showed he has been out shopping several times, had meals out, been on holiday, visited family and attended medical appointments. All the people living at Carlton Autistic Services have either been, or are planning to go, on holiday in small groups or individually. Several people told the inspector how much they had enjoyed their holidays supported by staff. Contact with families is something that the home is committed to supporting and does this very well. Several relatives who responded to the survey particularly commented that this is an area where the home excels. Staff regularly transport people to visit parents or facilitate telephone contacts. Visitors are made welcome at the home. For those people who can not communicate verbally, families report that staff keep them informed and up to date with events and progress and this is something they value. One relative said: “We, his family, are part of the team of people concerned for his wellbeing.” and described how they value being seen as partners in caring for their family member. One family summed up their views about the service: “X’s quality of life has improved beyond our wildest expectations” another also said: “the service has exceeded our expectations” People can have pets, one person has a rabbit and in one four bedded house, there is a cat. Where possible, people using the service are involved in the domestic routines of the home, they take responsibility for their own room, menu planning and cooking meals, making sure that they are able to enjoy the food they prefer and like. Meal times are organised to suit the specific needs of individuals and several people are able to make their own food. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People receive health and personal care that is based on their individual needs and preferences, and is managed well at the home. EVIDENCE: Plans for individuals detail health care needs, especially if there is a chronic condition or ongoing problem that needs regular appointments or monitoring. Each person has an ‘OK Health Check’ and health action plans are being developed from these as part of the person centred planning process. There was also evidence on the files that routine health care screening is done, eg files showed that people had attended dental and optician appointments. The individual care plans, and especially the 24 hour care plans, show how individuals prefer their support to be offered by staff. Routines and preferences, as well as ways in which they communicate their dislike of any particular thing, are shown in these plans. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 16 The home works to an efficient medication policy supported by procedures and practice guidance. All staff receive training in medication administration as part of their induction. Medication records for three individuals were seen and sample checks of stocks in the medication cupboards tallied with the records held. Records were also seen for one person who self-medicates in a limited way. These were acceptable. There is a medication cupboard in each house, two are located where they can be accessed easily and staff can prepare the medication without being disturbed or disturbing people. In Carlton House however, the medication cupboard has been sited in the old office which is now a new lounge. Although it is being managed reasonably well at present, this is not acceptable as people using the lounge may distract staff while they are preparing and checking medicines and also staff may disturb people who are enjoying relaxing or watching TV. It is recommended that an alternative site for this cupboard be sought as a matter of priority. One GP and a consultant responded to the inspector’s survey. Both indicated a positive view of their experience of the service. Communication and appropriate support for individuals at appointments was said to be good. Relatives who responded were likewise positive. One relative praised the staff’s efforts in enabling their relative to become medication- free. A care manager also confirmed that tranquilising medication had been reduced for their client through staff efforts. One person who spoke with the inspector told of how he had given up smoking with support and had also reduced his alcohol intake which had been problematic for him when he was admitted. These are positive outcomes for people using the service and staff should be commended for their support for individuals in helping them to achieve these benefits for their health. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People living at Carlton Autistic Services, and their relatives’,views are listened to. People using the service are protected from harm. EVIDENCE: There is a complaints procedure which is clearly communicated to people living there, families and professionals. A copy of this was found on files. In addition, recently, the advocacy manager has put comments boxes into each house for anyone to use, including staff and relatives. These are emptied weekly but it was reported that few comments have been received so far. There were no complaints recorded on the log but there were many compliments from relatives and social care professionals. It is a testament to the staff that people take the time to express their gratitude and to say how pleased they are. Evidence from surveys indicates that people living at Carlton Autistic Services, their families and involved social care professionals, are confident that the views and concerns raised will be responded to effectively by staff and managers within the service. Several relatives emphasised that they had not had any reason to make a complaint but that any minor issues which had been raised were listened to carefully and acted upon promptly. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 18 The advocacy manager meets monthly with each person living at Carlton Autistic Services to check out that they are happy with how things are going and if they have any concerns. One person did say that he would like there to be more regular house meetings to discuss issues of concern. This may be an area for development. There are systems in place to prevent abuse of people living at the home. Staff have received training in the protection of vulnerable adults and guidance in using the company’s whistleblowing procedures as part of their induction. Staff who spoke with the inspector were very clear about what they should do if they suspected any abuse. There has been one safeguarding (adult protection) referral since the last inspection, which related to an incident involving two people living at the home. This was dealt with promptly and efficiently. The relative of the victim said they were happy with the way the issue was dealt with. The social worker who co-ordinated the safeguarding meetings also reported that she felt that the home had dealt with the issue well and supported both people evenhandedly. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The physical environment of the home enables people living there to live in a safe, well maintained and comfortable environment, which encourages independence. Some improvements are needed however. EVIDENCE: The accommodation at Carlton Autistic Services is provided in three buildings, two four-bed houses and one eight-bed unit. The physical environment is suited to the specific needs of the people who live there. The décor is kept fairly bland because of the need to keep the environment free from too much stimulation as this can be detrimental to people with autism. In all areas there is a shortage of storage space, especially in Carlton House. The building has currently several unused bedrooms which have acquired a large amount of clutter as items have been dumped there for lack of a Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 20 designated store. As mentioned previously, there is a problem with the current siting of the medication cupboard also. Given that the building has been open for three years without these bedrooms being occupied, it seems logical to designate one of them as a store and fit it out accordingly so that the storage problems could be eased. One relative expressed a concern that, if Carlton House were to accommodate eight people, it might be overcrowded and that the quality of care would suffer as a consequence. The registered provider should consider these matters carefully in addressing the long-term needs of the unit and its occupants. People living at Carlton Autistic Services are encouraged to personalise their bedrooms. Some individuals have bought large beds and all can choose their preferred colour of paint. All rooms have ensuite bath or shower facilities. As well as a lounge area, there are activity areas in Carlton House such as a sensory room. Outside there are gardens; at Carlton House there is an enclosed safe area for people to use, where there is a rabbit belonging to one person living there. This area has been improved in the last twelve months by extra flagging and the removal of a motorbike which was being stored there. The garden fence still needs some softening or painting to improve its appearance however. One positive improvement has been the addition of a door from the dining room in Carlton House to the garden. Previously, people had to go through the kitchen to do this and therefore needed supervision to do this. The new door gives people the freedom to come and go as they please and staff said this has made a big difference to people’s freedom over the summer months. In all houses, the carpets in many of the communal areas and some bedrooms are in need of replacement as they are very badly stained. This was highlighted in the last inspection report, and some carpets have been replaced, but further improvements are needed. One sofa in Carlton House was seen to be torn too. This needs to be repaired or replaced as it is a potential source of infection as well as being unsightly. Generally speaking, the environment in all buildings is well maintained, thanks to a handyman who works permanently at the home. All areas were seen to be clean and generally tidy although the lack of storage space does sometimes mean that areas become cluttered. Some people are supported to keep their own rooms clean by staff. One person showed the inspector his room and this was clean and tidy. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34,and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People who live at Carlton Autistic Services are supported by an experienced and well trained team of staff in sufficient numbers and who are themselves well supported. EVIDENCE: Staffing levels at Carlton Autistic Services are good, generally there is one to one staffing for most people throughout the day. Two to one staffing is also provided for one person when going out. At night there is one member of staff in each building. This intensive staffing level enables people to follow their aspirations and receive the support to take risks to achieve their goals. Staff training is good. The Deputy manager co-ordinates this and the staff team has made great progress with NVQ2 qualifications. At the time of this inspection, 35 of staff had gained the qualification. Altogether 55 of staff either had or were close to achieving the award. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 22 Induction training is likewise of a good standard. All staff complete a 4-day programme in house, along with the sister home staff at Carlton Specialist Care. This induction covers a wide range of basic skills and knowledge such as Autism awareness, challenging behaviour, abuse, advocacy, confidentiality and safety issues such as fire safety. Whilst this is comprehensive, the inspector was concerned that some staff are working without this training, sometimes for some months, as they have to wait until there are enough people to warrant putting on the courses. In the meantime, some verbal guidance is given. This needs to be clearly documented and managers need to ensure that staff are not expected to work without some basic training. Staff receive ongoing training in basic skills such as First Aid, Basic Food Hygiene, Protection of Vulnerable Adults and Management of Violence and Aggression. In addition to this, one relative commented: “Quite apart from any specialist skills, they are generally blessed with a high degree of common sense and are sensitive to the needs of people.” And another commented: “the attitude of staff is positive and caring”. These are positive indications that the staff team is valued and serving the people well. One relative also observed: “Service users benefit from a relatively low turnover for the sector, which lends stability. Only four staff have left in the last year which, in a staff team of forty people, is very low, especially given the potentially stressful nature of the work. Staff support systems seem to work well. Communications are good and the staff who spoke with the inspector said they felt morale was high as they could see the success they were achieving with people. Achieving NVQ qualifications has also given some people a boost to their confidence. Formal support systems are not as well developed. Supervision has improved in frequency since the last visit but the standard of six per year is not yet being achieved. In particular, for new staff, it is recommended that more frequent supervision is documented, particularly where people are waiting before receiving their formal induction. The service now has an annual appraisal system for staff. Team meetings take place fairly regularly, approximately monthly within each house. Staff are rostered to attend. Recruitment of staff has improved since the last inspection. Three staff files were examined and found to contain all the necessary information, although one reference had been mislaid on the day of this visit. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The home is well managed in the interests of people who live there. Some improvements to fire safety are required. EVIDENCE: The manager is a qualified learning disability nurse and has recently completed her Registered Managers’ Award. The manager and her team have a strong ethos of being open and honest in all areas of running of the home. People living at Carlton Autistic Services, and relatives, appreciate this, one of whom commented: “Carlton communicates well with carers and with a degree of openness and transparency which we welcome”. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 24 Relatives also identified the positive management style and described the management as: “Quick to spot and address their own deficiencies as some recent building work and other improvements would testify” The advocacy manager plays a key role in quality assurance within the home. His role is to ascertain the views of people living there and to conduct quality assurance surveys with users, relatives and social care professionals. There is also a site coordinator, which is a new role. She keeps an overview of what is happening on a day to day basis and does checks that routine tasks are completed, as well as helping to develop systems to make things work better, and covering for staff in emergencies. She has also begun to send out a newsletter to relatives, which has been mentioned by relatives as something they value as it keeps them up to date with developments. Health and Safety matters within the home are managed well. There is a system of regular checks on equipment and the environment. Fire safety has improved with the addition of some magnetic hold open doors which close automatically when the fire alarm sounds. The handyman carries out weekly tests, and drills are held regularly. One area, which was noted on this visit, was that final exit doors were being locked and keys available in a break glass to be used in the event of a fire. This is not adequate from a fire safety point of view and the doors should be openable without the use of a key, to allow safe passage out of the building in the event of a fire. The fire officer who visited in 2005 recommended this but the recommendation was misunderstood and therefore the work was not completed. It should be done as a matter of priority now. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 25 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO 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 YA42 Regulation 23 (4) Requirement Final exit doors should be able to be opened without the use of a key for the safety of all people in the building. Timescale for action 30/11/07 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 YA20 YA32 YA36 Good Practice Recommendations The medication cupboard in Carlton House should be relocated into an area where it does not impact on communal space. 50 of staff should have NVQ2 or equivalent qualifications. Staff should have supervision a minimum of six times per year. New staff awaiting formal induction should have more frequent documented supervision. Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Carlton Autistic Care Centre DS0000044408.V351551.R01.S.doc Version 5.2 Page 28 - 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. 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