Inspection on 22/03/07 for Cricklade House

This inspection was carried out on 22nd March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cricklade House 24/03/09

Cricklade House 12/02/06

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 Jacqueline Sullivan Key Unannounced Inspection 22nd March 2007 11:30 Cricklade House DS0000048697.V332941.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 Cricklade House DS0000048697.V332941.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. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 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.V332941.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to have a clear diagnosis of autistic spectrum disorders including aspergers. 12th February 2006 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.V332941.R01.S.doc Version 5.2 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 one of the management team and staff members on duty. The inspector also met with residents and documentation was examined in respect of them. A tour of the premises was undertaken What the service does well: What has improved since the last inspection? Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 6 Residents have benefited from the staff carrying out some makaton training to further benefit communication. 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. Cricklade House DS0000048697.V332941.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 Cricklade House DS0000048697.V332941.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): Quality in this outcome area is (excellent, good, adequate or poor) This judgement has been made using available evidence including a visit to this service. 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: 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.V332941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents cannot be completely assured that their assessed and changing needs are being met as their risk assessments do not reflect any changes. Residents are consulted about their views about living in the home EVIDENCE: Risk assessments were seen that reflected the needs of each individual, and covered all aspects of daily life, both in the home and in the community. However whist these are reviewed the majority seen had the same document with a series of staff signatures .The review does not indicate any changes over the reviewing period. A recommendation has been made that the staff team review these assessments to reflect any increased or decreased risk. The care plans indicated that various professionals, parents and the resident are consulted on the development of the plan. There are daily-recorded entries for all residents that record preferred routines and support provided. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 10 The residents are encouraged during one to one meetings with key workers. However the recording in the care meetings would benefit from more detail and evidence of the work that the staff complete. Residents have meetings on a regular basis. This is a useful way of ensuring that the staff team is meeting their needs. Scrutiny of the resident’s files confirmed that the residents are able to make choices although it was noted that some of the choices like for example wanting new bedding were the same for several residents. This then raised the question whether this was an individual choice or a choice made on their behalf as the bedding needed to be renewed. On order to resolve this issue a recommendation has been made that the staff team evidence that individual choices are recorded. Discussions with the staff team and examination of the resident’s files showed that the residents are encouraged during one to one meetings with key workers. Scrutiny of the resident’s files showed that the residents have timely reviews. 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.V332941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from and are supported to participate in a range of leisure and social activities organised by the home. The residents are offered a varied menu with choices available. Relationships with family members are encouraged. EVIDENCE: A varied menu was displayed on the notice board in the home, and the staff member described how the residents make their views known to the staff team. For example, residents would be shown the food or packaging to enable choices to be made. Observations confirmed choice being offered, and the residents were able to help with meal preparations. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 12 The kitchen was clean, tidy and well organised. The food storage areas were clean, and opened food was appropriately labelled. All records held in relation to food preparation were up to date and in order. There was a warm atmosphere noted at the home and staff were observed speaking to residents in a friendly respectful manner. The staff team ensure that the residents have access to up to date fashionable clothes. The senior staff member stated that, as the staff are around the same age as many of the residents they tend to like the same things. Discussions with the staff team confirmed that the residents have a busy and active day. The residents have access to evening activities if they so choose. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19.20,21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and health care needs of the residents are monitored effectively and action is taken promptly when concerns arise, so that residents can be confident their needs will be met. EVIDENCE: A review of the storage and administration of medication revealed no errors. Individual medication is dispensed in monitored dosage cassettes. At this inspection it was noted a review of the storage and administration of medication revealed no errors. Medication is dispensed from the pharmacy in a monitored dosage system. Advice is sought appropriately from health professionals when concerns arise. There was evidence of preventative health measures for example: visits to optician, dentist and GP where necessary. Staff members support the residents attending any health appointment. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 14 Scrutiny of the resident’s files confirmed that the residents are well supported by the staff team. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints system in place with some evidence that residents views are listened to and acted upon. This could be further developed to detail minor concerns or complaints. Although action is taken to ensure residents are protected from any form of abuse. EVIDENCE: A detailed complaints procedure is in place. The resident guide contains pictorial and symbol information to encourage residents to raise any concerns or communicate any problems on a day-to-day basis. The care files contained records of monthly concerns and suggestions meetings between residents and key workers. There were no complaints since the last inspection. However during the course of the year there will be minor concerns made by residents or their representatives. A staff member stated that these are sorted out by the staff but are not recorded as complaints. A recommendation has been made that these are recorded as evidence that the staff team are meeting the needs of the residents. Policies and procedures are in place to ensure residents are protected from any form of abuse. A rolling programme of training is in place. Staff were aware of Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 16 the in house policies and procedures regarding ‘protection’ including ‘whistle blowing’. A senior staff member stated that communication is non-verbal so staff pay particular attention to body language and other communication methods used including makaton. Makaton is a form of communication using signs. At the last inspection it was recommended that all staff attend an updated makaton training session. At this inspection it was noted that some training has taken place. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 17 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): 24,25,26,27,28,29,30.uality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Each room was seen to of a high standard. The rooms were individualised and homely reflecting the needs and preferences of the residents. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 18 The communal space consists of a dining room, lounge, and a spacious kitchen with dining area leading onto the well-kept garden. Each was seen to be clean and well presented. The house had a homely feel. When the residents returned from their daily activities with the staff they entered the house confidently and appeared very relaxed and at home. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Competent and motivated team members support residents and are able to meet their joint and individual needs. Staff members are clear about their roles but supervision is not frequently provided so the residents cannot be assured that the staff team is working consistently. EVIDENCE: A review of staffing information held in the home revealed that the files for the substantive staff held the majority of the required information. Staff supervision is in place but is infrequent. A recommendation has been made that supervision takes place every six to eight weeks. Examination of the staff training records indicated that all staff received induction training. A rolling programme of staff training is in place. Training Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 20 includes administration of medication and food hygiene. The organisation has recently implemented the LDAF induction programme and all new staff work through this programme. The duty rota was seen and the senior staff member explained the shift patterns. Whilst there were clear lines of deputise in the managers absence. The staffing arrangements are complex with staff from other homes working with residents from this home during the day. Staff from both homes attend activities in the community with the residents. Bank staff and agency staff are used to supplement the staff team. In order for the home to evidence that there is sufficient staff on duty at all times to meet the needs of the residents it is required that staff rotas clearly detail on a daily basis the staff on duty with the residents in the home and at the day centre, or on activities. Further, as the manager only works at the home two or three times a week and is often engaged else where in the wider organisation, it is required that rotas clearly show when the manager is working at this home and the member of staff that will deputises in his absence. There are no residents at home during the week and staff members attend the residents’ day centre to offer support. The staff present conveyed to the inspector that they were clear about their role and responsibility within the home. Observations of interactions between the staff and residents provided evidence of a high standard of sensitive care delivery. . Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 21 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): 38,39,42, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is no clear evidence when the manager is on duty therefore the right and interests of the residents are not being fully promoted. However there is sufficient evidence the home is otherwise well managed. EVIDENCE: Mr Andrew Coleman is the registered manager; he was not present during the inspection process. Mr John Coleman the registered provider was present throughout the inspection process. A previously noted, a requirement has been made in relation to management support that the staff rotas clearly evidence when the manager is working at the home and the arrangements for a staff member to deputise in his absence. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 22 Staff annual appraisals are completed by the management of the home. A review of care files and associated information revealed that they were up to date and in order. All other records reviewed during this inspection process were up to date and held securely. The commission receives copies of monthly monitoring visits carried out by the registered provider. A valid certificate of insurance was seen displayed in the home. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 23 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 2 3 3 3 3 3 Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 Standard YA36 YA33 YA38 Regulation 18 18 10 Requirement Timescale for action 30/08/07 All staff must receive supervision at more frequent intervals of between six and eight weeks. The staff rotas clearly evidence 30/08/07 which staff are on duty that work at the home. The staff rotas clearly show 30/08/07 when the manager is working at the home and the member of staff that deputises in his absence. 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 4 Refer to Standard YA9 YA8 YA6 YA22 Good Practice Recommendations Risk assessment reviews reflect any changes Resident’s individual choices are recorded. The format for key worker meetings is reviewed so it relates to individual care plans. Minor complaints or concerns are recorded and there is DS0000048697.V332941.R01.S.doc Version 5.2 Page 25 Cricklade House evidence that these are then resolved by the staff team. Cricklade House DS0000048697.V332941.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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