Inspection on 17/05/05 for Dunelm

This inspection was carried out on 17th May 2005.

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

The inspector 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

Dunelm 13/06/07

Dunelm 13/02/06

Dunelm 17/11/04

Dunelm 08/06/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Dunelm 115 Dunelm South Durham Road Sunderland SR2 7QY Lead Inspector Andrea Goodall Unannounced 17 May 2005 at 14:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dunelm Address 115 Dunelm South, Durham Road, Sunderland SR2 7QY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 510 2038 0191 522 7398 Tyne and Wear Autistic Society Mrs Brenda Nora Pearson Care Home 4 Category(ies) of LD Learning Disability 4 registration, with number of places Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17 November 2004 Brief Description of the Service: Dunelm is a family-sized house that is registered as a care home for 4 young people with Autism Spectrum Disorder. The service is operated by Tyne & Wear Autistic Society (TWAS), which also operates a number of other similar smaller homes in the nearby area. The home is a semi-detached 1930’s house on a main road near the City centre. The home has a short driveway, and a back garden. On the ground floor there is one bedroom, a comfortable lounge, a dining room and a large conservatory/sun room. There is also a family-style kitchen, a staff sleep-in room that also doubles as an office, and a small utility room. On the first floor there are 3 good-sized bedrooms, 2 of which have en-suite bathrooms. There is a third bathroom adjacent to the other bedroom. The bedrooms are decorated and furnished to a good standard in a style that suits the age and tastes of the people who live here. The home is not intended to provide accommodation for peoplewith physical disabilities. There is a small step into the home at the front entrance. However a portable ramp could be provided if necessary for visitors with mobility needs to access to the ground floor only. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon/evening. The Inspector spent time with staff and the 4 people who live here, and joined residents for the tea-time meal. Some parts of this small home were examined, and a sample of records including care plans, policies and procedures were also inspected. Throughout the rest of this report the people who live here will be referred to as ‘residents’, and Tyne & Wear Autistic Society will be referred to as TWAS. What the service does well: What has improved since the last inspection? There have been some changes to the resident group since the last visit. The needs of the people who live here are now very similar and they enjoy some of the same things. As a result, it feels very relaxed in the house and residents enjoy the calm atmosphere here. The resident are able to learn new skills, and the new kitchen space helps them to have more room to prepare meals with staff. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 6 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. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 & 3. Residents needs have been assessed and are continually reviewed. TWAS can demonstrate that Dunelm provides a specialist service to meet the needs of the people who live here. EVIDENCE: All of the people who live here who live here previously received educational and residential services through the TWAS Children Services. Their needs have been regularly assessment and reviewed throughout their formative and adult years. Annual reviews are held by TWAS for each resident to ensure that the home continues to meet their needs. The reviews include their relatives, Social Worker, and any other party involved in their care. Copies of the latest annual review minutes were seen to be in residents care files. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 9 There is evidence that the home operates in accordance with good practice and guidance from the National Autistic Society and the British Institute for Learning Disability. The home is audited and accredited by the National Autistic around bi-annually. In this way residents and their representatives are assured that the home provides a specialist service for younger adults with Autism Spectrum Disorder. Dunelm is one of 6 small homes for younger adults with Autism that is run by TWAS. The organisation and its Managers keep up to date with the latest good practice guidance, and all staff receive Autism-specific training. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 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 standard(s) 6 & 9. Support planning systems ensure that staff work consistently in supporting residents towards long term independent living goals. Residents are supported to take acceptable risks where capabilities allow. EVIDENCE: New support plans are in place for the 4 residents. These give details of what skills residents already have, and also identify specific goals for each person in 3 main areas of their lives, that is domestic, leisure and self development. The plans set out detailed instruction to staff about the level of support each person needs with their goals. The support plans are reviewed at the end of each College term, that is 3 times a year. Residents are encouraged to be involved and included in their own support plans, but due to Autism they find it difficult to understand them. Residents are often present when staff are completing their support plan records. The plans are not signed by residents or their representatives. There are also written risk assessment records in place that show whether an activity can or cannot be carried out by a resident independently, such as Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 11 shaving and making hot drinks. It is good practice that these records are signed by residents and copies are forwarded to their representatives for information. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 15 & 17. TWAS provides residents with fulfilling, purposeful daytime occupations. Residents are supported to use all local community facilities, and to keep in contact with family members. Meals are nutritious and appropriate for the people who live here. EVIDENCE: Throughout the week the 4 residents all attend day services provided by Tyne & Wear Autistic Society. These include vocational courses at the nearby Thornbeck College, such as IT, meal preparation and arts & crafts. Residents also have opportunities to gain practical skills at the TWAS Workshop where they make garden furniture, cards and jewellery, which is sold locally (on a not-for-profit basis). This provides residents with purposeful, fulfilling outcomes to their activities. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 13 This house is indistinguishable from other family properties in the area, and staff commented on the good relations with neighbours. The people who live here make good use of local facilities in the community including shops, sports centres, pubs, and post office. The home is a short distance from the city centre so residents have a good range of shops and leisure resources nearby. None of the residents are from the Sunderland area so the home makes sure that there is good contact with relatives by telephone. Most people also go for occasional holiday breaks to their family home. Relatives are fully included in reviews and invited to complete an annual questionnaire to give their views and suggestions about the service that residents get. Residents have opportunities to meet other people at sports and social events, although the nature of Autism makes it difficult for them to them to form new relationships. The 4 residents are all involved with staff support in shopping at local supermarkets and in preparing their meals. They dine with staff in the dining room when staff encourage residents to join in conversations and this supports their social and communication skills. The Inspector joined residents for a tea-time meal. Some residents were involved in cooking the meal with staff support, and all residents were encouraged to make their own choices. One person has a vegetarian diet due to their cultural beliefs and he is supported by staff to make suitable meals. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20. The health care needs of residents are identified and met. Following assessments of people’s needs, trained staff take responsibility for managing residents medication. EVIDENCE: The 4 residents are registered with a local GP practice and also use local dental and optician services when required. The people who live here are young and physically fit and do not use any other healthcare services at this time. TWAS employs a Speech Therapist who is involved in supporting staff to find ways of maximising residents communication skills including the use of photographs and pictures. Health care records are in place in care files to show when residents have received health services. At this time all the residents need support to manage any oral medication. This is managed by senior staff who have had suitable training in Safe Handling of Medication. One person can manage a prescribed cream with prompts. The medication is securely stored, and all medication records were seen to be up to date and in order. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 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 standard(s) 23. The home has policies, practices and staff training in adult procedures to ensure that people living in the home are protected from abuse. EVIDENCE: As with all care services for adults in the City of Sunderland, TWAS has adopted the MAPPVA (Multi-Agency Panel for the Protection of Vulnerable Adults) policy and procedures. These are robust procedures for dealing with suspected abuse. All staff have training in MAPPVA procedures so they would know what to do in the event of suspected abuse. All staff are trained in CALM (Calm Aggression-Limitation Management). This is a method of physical intervention that requires minimal restraint, and is used only to prevent harm to the resident or to others if residents need support to manage their behaviour. This method is approved by the BILD (British Institute of Learning Disabilities) and ensures that all staff can present a consistent approach when supporting a service user in this way. Intervention records were kept in bound books with numbered pages. These records include very clear details of the intervention used to support residents. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 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 standard(s) 24, 28 & 30. Residents live in a homely, comfortable and safe environment. The home has a good range of shared sitting areas, and is clean and hygienic. EVIDENCE: Dunelm is a detached family house that provides a very good standard of accommodation and furnishings for the people who live here. All areas of the home are decorated to a good standard, in keeping with the age and interests of the residents. There is a small driveway to the front of the home and a good sized rear garden. The home is not intended for people with a physical disability, although visitors with such needs could be supported to access the ground floor via a temporary ramp, if needed. Since the last inspection a new fitted kitchen has been installed which provides a more space for residents to be involved in preparing meals. The house has a choice of sitting areas for residents. There is a large, comfortable lounge, a dining room and a good-sized conservatory. Residents make good use of all areas of their home as they wished. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 17 The residents are all involved in household tasks with the support of staff, including cleaning and laundry. There is a separate small utility room where residents can do their washing with support. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 & 35. Staff are competent and are working towards appropriate qualifications. Residents are protected by the homes recruitment practices. The home has a Training and Development Programme to ensure that residents needs can be met. EVIDENCE: The staff team consist of the Manager, 1 senior and 3 support workers. The staff rota ensures that there are a minimum of 2 staff on duty to support the 4 residents at all times that they are at home. Two staff are training towards NVQ qualifications that are LDAF-accredited (Learning Disability Award Framework) which they expect to complete in the summer. The other two support staff are engaged in Foundation training and will then train towards NVQ qualifications. In this way, the home currently falls short of the national minimum standard of 50 of the staff team with NVQs. However it is anticipated that this standard will be met later this year. TWAS’s recruitment and selection procedures were seen to be thorough. Staff are only employed after satisfactory references and Criminal Records Bureau checks have been received, and this ensures the protection of the people who live here. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 19 Staff stated that there are good opportunities for training. Individual staff Development and Training records were seen and these confirmed that staff have received the necessary training in health & safety matters. All staff also receive Autism Focus training, which is specific training to support them to understand the needs of the people with Autistic Spectrum Disorder. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 42. Residents benefit from a well managed home. The homes procedures and practices promote the safety and welfare of the people who live here. EVIDENCE: Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 21 Since the last inspection the former Deputy Manager has been appointed and registered as the Manager. She has many years experience of care of young people with Autism Spectrum Disorder. It is a condition of her registration that she attain suitable management qualifications. To this end she is currently training towards NVQ level 4 and the Registered Managers’ Award, which she anticipates completing within the next year. There is a clear line of organisational management within TWAS Adult Services section. The Manager is supervised and supported by senior managers of the TWAS. In this way the residents, and staff, benefit from a well managed service. Staff records demonstrate that all staff receive statutory training in all health & safety matters. Records of health & safety checks are also in place. In discussions, the Manager demonstrated her knowledge of the necessary health & safety practices that are carried out to ensure the welfare of the people who live here. Dunelm B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 22 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 3 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dunelm Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 x B52-B02 S40712 Dunelm V217635 170505 Stage 4.doc Version 1.30 Page 23 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. 1. Standard 6 Regulation 15 Requirement Support plans should include written details of how the resident is involved and included in their care planning, or the reasons why this is not possible. Timescale for action 1.9.05 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 6 32 37 Good Practice Recommendations Support plan goals should include a pictorial clue for residents information. At least 50 of the staff team should have attained NVQ 2 or above by 2005. The Manager should continue to pursue an appropriate management qualification. 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