Inspection on 12/01/06 for Inverthorne

This inspection was carried out on 12th January 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Inverthorne 16/12/08

Inverthorne 02/05/07

Inverthorne 19/07/05

Inverthorne 30/03/05

Inverthorne 14/07/04

Inverthorne 03/02/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Inverthorne 20 Thornholme Road Sunderland SR2 7QG Lead Inspector Miss Andrea Goodall Unannounced Inspection 12th January 2006 02:00 Inverthorne DS0000015785.V263246.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 Inverthorne DS0000015785.V263246.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. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Inverthorne Address 20 Thornholme Road Sunderland SR2 7QG 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) 0191 5145853 Tyne & Wear Autistic Society Ms Christine Graham Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: Inverthorne is a care home for 4 younger adults with Autism Spectrum Disorder. It is owned and managed by the Tyne & Wear Autistic Society (TWAS). TWAS is a voluntary body that also operates specialist educational facilities for children and adults with Autism, and 5 other care homes in this area of Sunderland. Inverthorne is a semi-detached family house set on a main road near the City centre of Sunderland. There is a small driveway and garage to the front of the house and a garden to the rear. The home has an open hallway, off which there are a pleasant dining room, large lounge and large kitchen/diner. There is also one bedroom on the ground floor and a toilet. On the first floor there are 3 bedrooms, the bathroom and a games room. There is also a staff sleep-in room which doubles as a small office for the administrative tasks and storage. The home is indistinguishable from similar surrounding family properties. The home is next door to 2 other small homes operated by TWAS. The same Registered Manager manages the 3 small homes. The house does not offer accommodation for people with mobility needs, though visitors with such needs could access the ground floor. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in January 2006. Some time was spent looking through care records and talking with the Manager about the service and staffing. The rest of the time was spent with the 4 people who live here, joining them for a tea-time meal and looking around the house. Due to the nature of Autism Spectrum Disorder, the people living here find it very difficult to express views and opinions about the service they receive. Time was spent with staff and residents together, looking at how they get on, how residents are involved in their house, and how they are supported towards independent living. What the service does well: What has improved since the last inspection? There is now a record of whether or not residents can understand their support plan. There is now a shower room. This means that there are now 2 good bathrooms for the 4 young ladies who live here. One bedroom has now got a larger wardrobe so that the residents has plenty of space to hang up their clothes. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 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. Inverthorne DS0000015785.V263246.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 Inverthorne DS0000015785.V263246.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): 1. Residents have information in a suitable format about the place that they live. This would help prospective residents (or their representatives) to make an informed choice about whether to move here. EVIDENCE: The Service Users Guide includes a brief brochure that is written in plain English, which gives specific information about the house, the service, and the activities. It includes photographs of residents taking part in the daily domestic tasks and relaxing in the house. In this way any prospective new residents would have clear information about the house before they visited to see if it would suit them. Since the last inspection the Service Users Guide has been amended to reflect the new responsible individual who represents TWAS. Inverthorne DS0000015785.V263246.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 & 9. Residents individual goals are reflected in a support plan. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: There are individual support plans for each of the young people living here. These include details of what skills residents have, and sets specific goals for each person in 3 main areas of their lives - domestic, leisure and selfdevelopment. The plans set out detailed instruction to staff about the level of support each person needs with their goals. There are clear daily records about each residents progress and how staff can further support them towards independent living. Residents are often present when staff are completing their support plan records. Due to their Autism most people find it difficult to understand the support plans. There is now a record on each support plans that states whether the resident can understand their support plans or not. However support plans still do not include photographs or pictorial clues to help residents understand what these records are about. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 10 The people who live here are supported to take acceptable risks as part of an independent lifestyle. There are risk assessment records in place about activities that people carry out that might incur an element of risk, such as using a locked bathroom, keeping their own medication, and cooking. In this way staff are clear about the support people need to minimise any risk to them. It is good practice that these records have been sent to and signed by parents and the relevant Social Workers, and are reviewed at least annually. Inverthorne DS0000015785.V263246.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): 15 & 16. Residents are supported to keep in contact with family members and have opportunities to meet others at social and leisure events. Residents rights and responsibilities are recognised and respected. EVIDENCE: 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 have some holiday visits to the family home. Staff inform relatives of any important events about the residents. There are records of all telephone calls and correspondence sent to relatives by the home. The people who live here go out to activities where they may meet other people outside the service, e.g. pubs, gym, swimming pool and weekly disco. In this way they do have opportunities to socialise. However the nature of Autism makes it very difficult for people to form relationships with other people. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 12 The people who live here have information in plain language that outlines their rights and responsibilities whilst living here. All the residents are fully involved in the daily household tasks within their home, with support from staff. It is evident from observations at this and previous inspections that residents have really improved their independent living skills over the time that they have lived here. One person now chooses their own menu, makes all their own meals, manages small amounts of their own money, and showers on their own. Other residents have also improved in daily living skills, communication, and in their confidence. Staff encourage and promote conversations with the residents to help their language and communication skills, but also to involve and include them in discussions about the home. Staff were seen to be respectful and supportive when talking with residents. Residents can choose to use their own bedrooms for privacy when they are not involved in another activity. There are some set routines in the home because people with Autism benefit from structured programmes that helps them make sense of the pattern of their day. During this visit, as well as the 4 residents there were also 3 people from the neighbouring home being supported for the part of the afternoon in Inverthorne. This had become necessary due to a very recent change in college programmes. However it is not appropriate for other people to be supported in Inverthorne, and this compromises the residents rights to privacy and use of their own home. The Manager confirmed that this was an isolated situation whilst the new changes took effect. Inverthorne DS0000015785.V263246.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): 20. Residents retain their own medication, where appropriate. The home has suitable procedures for supporting residents with their medication. EVIDENCE: One of the residents has been assessed as being able to manage part of their medication, and this is encouraged and promoted by staff. At this time, all other medication is managed by trained, designated staff. Medication is delivered to the home by a local pharmacy in suitable containers. Medication is securely stored in a locked, alarmed metal medication cupboard away from residents accommodation. Records of the administration of medication are in place and up to date. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 14 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 and self harm. EVIDENCE: All staff (except one newer member) have had training in the local vulnerable adult procedures to ensure that residents are protected from abuse. 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 (except a newer member) are trained in CALM (Calm AggressionLimitation Management) and new staff will receive this training. 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 resident in this way. Intervention records were seen to be kept in bound books with numbered pages and clearly detail any triggers and the intervention used to support the resident. Financial records show that the personal monies of the people who live here are directly debited into their individual savings accounts. Residents are supported to access their monies by senior staff. All records relating to their monies were seen to be up to date, and the systems used demonstrate that residents monies are safeguarded. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 15 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 & 29. Residents live in very good quality accommodation. The house is homely, well decorated, comfortable and safe. Residents have the equipment they need to maximise their safety. EVIDENCE: Inverthorne is a semi-detached family house that is indistinguishable from other desirable properties in this area. It is decorated and furnished in a modern, bright style that suits the age and lifestyles of the 4 people who live here. The house is well-maintained, safe and comfortable. Since the last inspection, part of the bathroom and an adjacent store room have been converted to provide a separate shower room with WC. This means that the home now has 2 bathing facilities for the 4 young ladies who live here. The new shower facility is stylish as well as practical, and is in-keeping with the rest of the décor in the house. At the last inspection a relative had commented on the limited wardrobe space for one for the young ladies who lives here. Since then new wardrobes have been provided in this room that now provide sufficient storage. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 16 At this time the home uses an intercom for one resident who has epilepsy to monitor their well-being when using their bedroom at night. The staff team are fully aware that this is intrusive equipment but it is used to ensure the residents safety. There is a clear risk assessment in place regarding the use of the intercom and the limitations of when and why it is used. Inverthorne DS0000015785.V263246.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 & 35. Residents are protected by the homes recruitment practices. Residents individual and joint needs are met by suitably trained staff. EVIDENCE: There have been no changes to the staff team since the last inspection. The Provider, TWAS, operates very through recruitment and selection procedures. Staff are only employed after satisfactory references and police checks have been received, and this ensures the protection of the people who live here. Residents also have the chance to meet applicant staff during evening activities to see if they have suitable personalities and values to support young people with Autism Spectrum Disorder. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 18 There is a clear training and development plan for individual staff and for the team. Individual staff 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 Autism. Two senior staff have achieved the NVQ level 3 care qualification, and one other staff is engaged in training towards this. The two remaining support staff have completed Induction and Foundation care training and will commence NVQ training next. In this way, the home intends that all staff are suitably qualified. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 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): 39. Residents views are sought in order to review the service they receive. EVIDENCE: TWAS has a quality assurance policy in place to review the service, and this includes the views of the residents through their annual reviews and Residents’ Meetings. Pictorial questionnaires are also given to residents from time to time for them to indicate their likes and dislikes. The most recent pictorial questionnaire, in August 2005, invited residents to tick or cross to show whether they liked or disliked various aspects of the service including : staff; other residents; menus; activities; meetings; and lounges. One resident, who has good literacy and communication skills, wrote, I like the staff because they make me laugh and I like meetings very much because I can talk about what Id like to do. In this way, residents views are sought in suitable ways in order to review the service provided at this home. Inverthorne DS0000015785.V263246.R01.S.doc Version 5.0 Page 20 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 3 X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 4 X X X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Inverthorne Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000015785.V263246.R01.S.doc Version 5.0 Page 21 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 YA16 Regulation 12(4)a Requirement Arrangement must be in place to ensure that residents right to privacy in their own home is upheld, and that other people, who are not residents of this home, do not spend periods being supported in Inverthorne. Timescale for action 01/03/06 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 YA6 Good Practice Recommendations Consideration should be given to using photographs and/or pictures in respect of specific goals in support plans to help residents understand their own records. 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