Inspection on 12/02/06 for Cricklade House

This inspection was carried out on 12th February 2006.

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

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

Other inspections for this house

Cricklade House 24/03/09

Cricklade House 22/03/07

Cricklade House 03/10/05

Cricklade House 02/12/04

Cricklade House 17/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 Cricklade House The Regents 68 Strathearn Drive The Regents Royal Victoria Park Bristol BS10 6TJ Lead Inspector Karen Walker Unannounced Inspection 12th February 2006 09:30 Cricklade House DS0000048697.V283111.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 Cricklade House DS0000048697.V283111.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. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cricklade House Address 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) The Regents 68 Strathearn Drive The Regents Royal Victoria Park Bristol BS10 6TJ 01179380155 Autism Specialised Care Homes Ltd. Mr Andrew Coleman Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to have a clear diagnosis of autistic spectrum disorders including aspergers. 17th June 2004 Date of last inspection Brief Description of the Service: Cricklade House is registered with the Commission for Social Care Inspection to provide accommodation and personal care for four persons aged between 18 years and 64 years with a learning disability. The home is a newly built property and was registered in August 2003. The home is owned and operated by Autism Specialised Care Homes Ltd. The company specialise in providing individualised care for persons with Autism and Aspergers Syndrome. Cricklade House is situated in a residential suburb of Bristol close to local amenities with main bus routes nearby. The home provides four rooms all with en suite facilities. There is ample communal space, and externally there are well kept gardens. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this inspection was to review the requirement and recommendations made at the last inspection and to ensure continued good practice. The inspector met with the deputy manager and one of the management team and two staff members on duty. The inspector also met with two residents and documentation was examined in respect of them. One resident spoken with when asked said ‘I like it here I am doing my puzzle’. A tour of the premises was undertaken and there were no requirements made. What the service does well: The home provides individualised care for four persons who have complex personal and communication needs. The residents accommodated have lived in the home since it opened. There is a strong commitment to providing residents with a warm, comfortable, homely environment that reflects family life. Parental involvement is promoted in the development of individual care plans. Access to a wide range of activities is available predominantly through a day centre operated by the same provider. Structured activity plans are developed for each individual making full use of facilities in the local community. The assessment and care planning process means individuals can be confident that all aspects of their personal, social and healthcare needs are met. Care is provided within a risk assessment framework, focussing on positive behaviour, enabling residents to make decisions whilst minimising risks to health and welfare. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cricklade House DS0000048697.V283111.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 Cricklade House DS0000048697.V283111.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): 1-5 Prospective residents and their families have information needed to make informed choices about whether they want to live at the home. Residents have the opportunity to test drive the home and can feel confident that their assessed needs will be met. Each resident has an individual costed contract. EVIDENCE: There have been no recent admissions to the home. The individuals living at the home have been there since it opened. The home provides long-term care and accommodation. Admission to the home is through the care management approach, and the procedure involves trial visits, including overnight stays, an invitation to have lunch, or to view the premises with family members. Each admission is tailored to meet the needs of the individual. Residents will not move in without an up to date needs assessment taking place to ensure the home can met the persons assessed needs. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 9 There is an up to date statement of purpose that sets out the aims, objectives and philosophy of the home. One new staff member was able to discuss the philosophy of the home and said ‘we support people as much as they need to enable them to be as independent as possible’. The deputy manager confirmed that any potential residents would be given the appropriate information to enable them and their families to make an informed choice on service provider. It was noted that each resident has a contract stating the terms and conditions of occupancy. This includes room numbers and fees. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 Residents are aware of their assessed and changing needs and families are encouraged to take part in regular care reviews. Residents are encouraged to be as independent as possible within a riskassessed framework. EVIDENCE: The care files contained evidence of regular reviews and assessments of changing need. Support plans focussed on individual needs and likes or dislikes. Weekly reports are completed by the deputy manager, with a summary of events for the week. The reports were written in a positive style and did not focus only on negative behaviours. The manager said ‘I speak to families at least once a week to inform them of any changes or pass on details of healthcare visits etc’. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 11 A monthly summary from the day centre was also included detailing activities and therapy the individual had attended. Similarly there was a review of social and community activities, and comments on the residents participation. Risk assessments were varied and concentrated on all aspects of the residents’ lives both inside and outside of the home. Staff are aware of the procedure to follow should a resident ‘go missing’ whilst using the community facilities. The staff members present demonstrated a good understanding of the residents needs, and were able to provide the inspector with any information requested. The residents were observed making full use of the facilities in the home, and moved confidently from one area to another. The residents demonstrated confidence in the staff present. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 12 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): 16 Residents’ rights are respected and responsibilities recognised in their daily lives. EVIDENCE: It was confirmed that Residents are involved in the daily decision making of the home; they are invited to join house meetings and have opportunities to make their concerns known through one to one sessions. The deputy manager said ‘all residents are offered a key to their rooms but all declined’. This has been documented and the deputy confirmed that this decision was reviewed at least eight weekly to ensure residents have the option of changing their minds. Staff confirmed they do not open residents mail without them being present. There was an inclusive atmosphere noted at the home and staff were observed speaking to residents in a friendly respectful manner. Cricklade House DS0000048697.V283111.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 Residents are protected by the homes policies and procedures for dealing with medications. Medication is stored administered and recorded appropriately. EVIDENCE: The inspector took the opportunity to examine the medication storage and recording systems in place. It was noted that the medication records were individualised and contained side effects and uses of prescribed medication. Each set of records contained a picture of the individual. All medication was signed into the home and the pharmacist signs for all returns. A staff member explained medication to be used as and when needed (PRN) is also held for some residents who may exhibit challenging behaviour. A protocol in place states that staff must consult with a manager before this is administered. Staff members confirmed they had carried out medication training both in house and with an external provider. Records confirmed this. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 14 The consultant psychiatrist reviews the medication every 6 weeks and records are kept accordingly. A staff member explained medication to be used as and when needed is also held for some residents who may exhibit challenging behaviour. A protocol in place states that staff must consult with a manager before this is administered. Two signatures are required on the medication records in the event this medication is necessary. This is consistent with good practice. The medication cabinet was clean and well organised, and the records were up to date and in order. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 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 Residents are protected from abuse, neglect and self-harm. EVIDENCE: The provider confirmed that places had been booked with the Bristol City Council to provide protection from abuse training to all staff. This was due to take place in April 2006 and will ensure that training and knowledge is in line with the Local Authoritys policy and procedures for the protection of vulnerable adults. Two staff members confirmed protection from abuse training had already taken place through another external provider. Both were aware of the in house policies and procedures regarding ‘protection’ including ‘whistle blowing’. The deputy confirmed that all staff had access to the General Social Care Council’s (GSCC) Code of Conduct. The deputy explained that where communication is non-verbal staff pay particular attention to body language and other communication methods used including makaton. Makaton is a form of communication using signs. One new staff member said that although residents use makaton she is unfamiliar with it. It is recommended that all staff attend an updated makaton training session. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 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): 24-30 The home is suited to its stated purpose, safe, accessible and well maintained. It is able to meet residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: The property is detached and set within its own private rear garden, providing safety for the residents. A tour of the environment was undertaken and it was noted that each resident has their own room with en-suite toilet and bathing facilities. The rooms were individualised and homely reflecting the needs and preferences of the residents. There are currently no manual handling requirements and no equipment needed. Communal space consists of a dining room, lounge, and a spacious kitchen with dining area leading onto the well-kept garden. The provider explained a contract has recently been agreed with a landscaping contractor to maintain the garden on a regular basis. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 17 The residents were seen moving confidently around the home, making full use of the communal space. The home was clean and tidy, and the decor, furniture and fittings seen, were of good quality. The home has recently received a food hygiene award from the local council as the result of a recent inspection by the environmental health officer. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 18 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): 32,35 Competent and motivated team members support residents and are able to meet their joint and individual needs. EVIDENCE: The duty rota was seen and the deputy manager explained the shift patterns. There are no residents at home during the week and staff members attend the residents’ day centre to offer support. A member of the management team said ‘there is a training plan in place which identifies individual training suited to meeting the needs of individuals this also includes statutory training’. This was not seen on this occasion. The newest staff member explained the induction process and the deputy confirmed this was part of the Learning Disability Award Framework (LADAF) and would be accredited. The new staff member confirmed various training days had taken place and said ‘I had supervision and we discussed lots of things including training, needs of the residents, philosophy of the home and my duties’. Cricklade House DS0000048697.V283111.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): 38,39,42,43 Residents benefit from a sound management approach to the home. Residents and their supporters are asked about their views relating to service provision. The health and safety and welfare of residents are promoted and protected. EVIDENCE: The deputy manager said ‘we have an open door policy and all staff have my contact number. All of us have a good working relationship and I give them regular one to one supervision sessions’. A member of the management team said ‘everyone is aware of their roles and responsibilities and I carry out annual appraisals’. Staff said they felt well supported. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 20 The homes development plan was discussed and it was noted that plans are in place to improve the home over a period of say 3-5 years. Monthly regulation 26 visits take place on an unannounced basis. This are carried out to ensure the registered provider has the information needed to ensure adequate service provision and a quality service. Where announced inspections have taken place the home have taken advantage of providing family members with the feedback questionnaires provided and these have been used to inform the reports. The deputy said parents and appropriate family members are also spoken to every week to ensure they keep them updated and invite any feedback. The Individual Programme Plans (IPP) are reviewed at least 3 monthly and have the involvement of the resident and their family member. It was noted that the health and safety policies and procedures were many and staff were aware of their responsibilities. Portable appliance testing takes place on an annual basis and the appropriate fire system checks take place within timescales prescribed by the fire brigade. The fire logbook evidences that all appropriate staff training and fire drills have taken place. Drills also include input from the residents. Risk assessments are full and detailed. As an addition to the in house training provided staff confirmed that they attended fire training provided by the fire brigade at Avonmouth in a purpose built building, which was filled with smoke. Staff members involved said this was exciting and it provided real insight into what it would feel like if you were trapped in a hot smoke filled room. Cricklade House DS0000048697.V283111.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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X 3 3 X X 3 3 Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 22 NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA23 Good Practice Recommendations All staff to attend a makaton training session. Cricklade House DS0000048697.V283111.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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