Inspection on 05/10/05 for Carlton Autistic Care Centre

This inspection was carried out on 5th October 2005.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlton Autistic Care Centre 26/09/07

Carlton Autistic Care Centre 19/09/06

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 Greenway Milnsbridge Huddersfield HD3 4RZ Lead Inspector Cathy Howarth Unannounced Inspection 5th October 2005 10:00 Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 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.V255797.R01.S.doc Version 5.0 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.V255797.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carlton Autistic Care Centre Address 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 John Sumpton Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 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 service users. Opposite Carlton House, separated by a driveway, are two, four place houses, Greenway and Sycamore. All bedrooms are single and have en-suite facilities. An additional adapted bathroom and toilet is provided in Carlton House. Carlton House has a small communal lounge 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 access 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. Carlton House has it’s own secure garden, and a shared garden is available to the rear of the two fourbedded homes. A driveway with parking separates the main house from the 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. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a five-hour period. Inspectors met with service users in each of the houses, had a tour of the buildings and met with staff. Records relating to the standards assessed were also examined. One visiting relative spoke with an inspector during this visit. Inspectors would like to thank the service users and staff for their welcome on this visit. What the service does well: What has improved since the last inspection? The information available, to help service users make informed choices about living at Carlton Autistic Services, has improved substantially, with the service user guide now being available in picture and talking book format. Risk assessments have improved and agreements with service users where they have limitations put on their freedoms are also recorded now. The home’s recruitment practices have improved and now provide a good level of protection for the welfare of service users. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 6 Freezer temperatures are now monitored daily. Staff training opportunities have improved through a partnership arrangement with a local provider of training. 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. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 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.V255797.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 The information available, to help service users make informed choices about living at Carlton Autistic Services, has improved substantially. Some minor improvements are still needed, however. EVIDENCE: Inspectors found that assessments were being completed on prospective service users. However the tool in use is rather unwieldy and does not give the information required in a manageable form. It was suggested that it would be of benefit to simplify this. Contracts are given to service users but those found on file were not signed. This should be done to ensure that service users are aware of their terms and conditions of residence. On a positive note the service user guide has been put into a picture format and in the form of a talking book to make it more accessible to the range of potential service users. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 The service is good at identifying and meeting needs of service users in a way that reflects their preferences and maintains their independence as far as possible. EVIDENCE: Service users who spoke with inspectors reflected an awareness of the issues, which were found to be detailed in their care plans. The staff use individual contracts to address specific issues with service users where there may be conflict. Also care plans reflect attention to specific details where there may be significant needs. Two care plans were examined in detail and were found to have improved since the last inspection. Inspectors suggested that these might be further improved by the plans addressing some of the wider needs and aspirations of service users as well as areas of evident need. For one service user there was one important area, which was not sufficiently well addressed in the care plan. This needs to be included as an important feature of this individual’s life. Risk assessments were found to be satisfactory. Where service users have risky lifestyle habits or a history of difficulties these are carefully addressed. Contracts are used with some service users to gain agreement to address Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 10 specific behaviours, which may pose a threat to themselves or others. Service users spoke positively about this approach in discussion with inspectors. Daily records gave a good indication of how service users spend their days and any contacts with friends and relatives as well as any visits from professionals. This is helpful when preparing for reviews, to ensure there is a good level of detailed information to inform decision-making. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 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): 13,14,15,16,17 Service users have good opportunities for self-development and to adopt a lifestyle that suits them. Individual choices and rights are respected. Service users choose meals. EVIDENCE: Service users who spoke with the inspectors explained that they enjoy going out and taking part in leisure activities within the local community. There are shops and other facilities close by, which several service users use regularly. People spoke of enjoying a canal boat trip, going swimming, going to the local college as well as activities within the house. Within the home an activities co-ordinator is employed to ensure that people are offered opportunities to follow their interests and aspirations. Consequently several service users are having guitar lessons on a weekly basis, and other activities such as aromatherapy sessions are also timetabled for individual service users. In recent months most of the service users have been away on holiday. Most recently two service users went to Centerparcs for a few days. For some Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 12 service users holidays can be very upsetting due to the change of routine and environment. Staff are sensitive to this and arranged day trips for those people who could not cope with an extended period away from home. Service users are encouraged to maintain relationships with family and friends. One relative, who was visiting during this inspection, spoke very positively about the service and how their son is supported. When visiting they explained they are made welcome and offered drinks and food. Service users reported that they enjoy meals at the home. Staff prepare meals generally but service users are encouraged to prepare meals where they are able to do this and to take part in activities such as baking. One service user reported that meals are planned as a group in the house where he lives. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 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): 19 and 20 Health issues for service users are addressed adequately. Improvements are needed in the management of medication within the home. EVIDENCE: The systems and procedures followed by the staff at the home make sure that the healthcare needs of people are assessed and recorded, and opportunities are created to make sure these needs are met. Visits to health professionals are recorded on individual files. No service users currently administer their own medication. There is a procedure for managing medication within the home and this works reasonably well. However there were some problems identified at this visit that must be addressed for the safety of service users. In particular in Greenway and Sycamore proper medicine cabinets should be purchased so that medicines are stored safely and access to the medicines can be confined to a single designated person on each shift. Also better systems need to be implemented for stock control of medicines so that balances can be checked more easily and inaccuracies followed up. Some service users have medicine to take on an ‘as required’ basis. There were protocols in place offering guidance for staff in when to administer this Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 14 medication. However the prescribing GP or consultant should sign these so that it is clear where the instructions for this have come from. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 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 the following standard(s): 23 The systems and procedures followed by the staff team make sure that people are protected against abuse and self-harm EVIDENCE: Staff receive training in recognising abuse and staff have in recent times brought issues to the attention of managers where there have been concerns about possible abuse or risks to service users. Whistle blowing and protection of vulnerable adults training is included in the home’s induction for new staff. Staff receive training in managing violence and aggression including training in breakaway techniques. This should be checked to ensure it is accredited training, for the protection of service users. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 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 the following standard(s): 24 and 30 The arrangement and presentation of the houses suits their individual purposes. The home is clean and tidy. EVIDENCE: The location and layout of the home was found to be suitable for its stated purpose. The building was found to be accessible and well maintained. Service users who spoke with the inspectors reported they are happy with the home. In Greenway and Sycamore this is more of a homely environment and suits the people that live there, who are generally more able to live more independently. In Carlton House the environment is deliberately more stark and bland to suit the needs of service users who require a less stimulating environment to enable them to feel relaxed and de-stressed. The premises were found to be clean, hygienic and free from offensive odours with systems are in place to control the spread of infection. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 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): 34 and 35 Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: Three staff files were checked as part of this inspection. They had improved markedly since the last inspection. Now staff are fully vetted before commencing work at the home. When starting work at the home all staff receive a thorough induction in accordance with TOPSS guidelines. Staff are quickly put forward to begin NVQ training as soon as the induction and foundation has been completed. The home has made links with another local organisation to provide elements of training, which will provide a good point of access for staff to gain training fairly quickly on a rolling programme. Staff working at the home reported in conversation with the inspectors that they were happy with the training provided and felt that it equipped them to do their jobs well. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 AND 42 Quality assurance systems are slowly developing within the home. Health and safety issues are treated seriously within the home. Some fire safety works are required to meet requirements. EVIDENCE: Quality assurance systems are being developed within the home but are not yet fully operational. There are questionnaires being developed for service users and families to be consulted about the operation of the home. The new proposed managers are also in the process of preparing a development plan for the home. Health and Safety issues are dealt with appropriately within the home. Staff appeared to have a good awareness of issues of risk and hygiene. A recent fire safety inspection has identified some areas that require attention, namely the locks on final exit doors. These need to be addressed as a matter of priority. Since the last inspection freezer temperatures have been checked and recorded. Carlton Autistic Care Centre DS0000044408.V255797.R01.S.doc Version 5.0 Page 19 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 X 3 X X 2 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Carlton Autistic Care Centre Score X 3 1 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 1 X DS0000044408.V255797.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES 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 YA20 Regulation 13(2) Requirement Timescale for action 2 YA42 23(4) Appropriate medicine cabinets must be purchased for Sycamore and Greenway. One designated staff member per house should have 31/10/05 responsibility for medicines on each shift. Stock control systems must improve so that accurate balances can be kept of medicines. Protocols should be signed by the prescribing GP for ‘as required’ medicines. The requirements of the fire 31/10/05 safety officer must be addressed. 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 YA5 Good Practice Recommendations Contracts with service users should signed by service users wherever possible, or their representatives/advocates. DS0000044408.V255797.R01.S.doc Version 5.0 Page 21 Carlton Autistic Care Centre 2 3 4 YA6 YA23 YA39 Care plans should include all relevant detail and should address wider aspirations and lifestyle issues of service users. The training for staff to manage violence and aggression should be checked to ensure it is accredited. Quality assurance systems need to be developed within the home and should reflect the views of service users. 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