Inspection on 19/07/05 for Inverthorne

This inspection was carried out on 19th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Inverthorne 16/12/08

Inverthorne 02/05/07

Inverthorne 12/01/06

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 Thornhill Sunderland SR2 7QG Lead Inspector Andrea Goodall Unannounced Tuesday, 19 July 2005 : 14:00 th 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. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Inverthorne Address 20 Thornholme Road, Sunderland SR2 7QG 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 514 5853 Tyne & Wear Autistic Society Mrs Christine Graham Care home only 4 Category(ies) of 4 x LD registration, with number of places Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30th March 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. Inverthorne is also on the same road as Thornbeck College operated by TWAS that is attended by the 4 people who live here.The house does not offer accommodation for people with mobility needs, though visitors with such needs could access the ground floor. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon and evening in July 2005. Most of the time was spent with the 4 young ladies who live here and a visiting relative, looking at their bedrooms with them, and joining them for a tea-time meal. The rest of the time was spent discussing the progress of the home with staff and examining care records and health & safety records. The people who live here prefer to be referred to as residents, and this report will respect their preference. The report will also refer to the Tyne & Wear Autistic Society as TWAS. What the service does well: What has improved since the last inspection? Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 6 Since the last inspection, new support plans have been put into place. These are easier for staff to follow and show how to help residents learn a small number of new skills at a time. New carpet has been fitted in the dining room, lounge and stairs and this makes the house look even brighter. 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 B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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 Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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. Residents needs have been assessed and are continually reviewed to ensure that the service continues to meet their needs. EVIDENCE: TWAS has clear written guidelines about Referral and Assessment to its services. Before they move here, prospective residents’ needs are assessed by social and health care (and educational) professionals. Relatives and TWAS staff are also included in making a decision about whether the home could meet people’s needs. Some people who live here previously received educational and residential services through the TWAS Children Services. Their needs have been regularly assessed and reviewed throughout their formative and adult years. One person moved here a couple of years ago. As with all potential residents who are new to TWAS services, she had a one-week trial stay at a TWAS home as part of the assessment process. This helped to determine whether TWAS could meet her needs and which of the small homes would be most suitable for her in terms of compatibility. A review is held after 3 months to make sure that the service is suitable for new residents. That persons care files contained a comprehensive assessment by TWAS and a full educational assessment for their placement at the Thornbeck College. This Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 9 demonstrates that all relevant professionals are involved in making sure that the placement is the right one for each person. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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 & 7. Support planning systems ensure that staff work consistently in supporting residents towards long term independent living goals. Residents are encouraged and supported to make choices and decisions about their lives. EVIDENCE: New support plans are being put into 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 plans give details about each residents progress and how staff can further support them towards independent living. Staff stated that the new plans are much easier to use. Due to their Autism some people find it difficult to understand the support plans. Staff stated that photographs are to be used to help residents understand the different goals that they are working towards. Residents are often present when staff are completing their support plan records. However the support plans have not been signed by residents or their representatives, so there is no written record to show how residents are involved in their own care planning. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 11 Many people with Autism Spectrum Disorder find it difficult to cope with too many choices, so residents tend to be offered a small number of choices from a range of their known likes. Discussions with residents and examination of care records show that residents are encouraged to make their own decisions. For example, residents choose their own clothes, the décor for their bedrooms, and are involved in choosing meals for the menus. One resident has chosen to have large cushions in their bedroom instead of chairs. Monthly Residents Meetings give residents the opportunity to make joint decisions about holiday destinations, menus, activities, and a rota for looking after the pet rabbit. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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 & 17. TWAS provides residents with fulfilling, purposeful daytime occupations. Residents are supported to be part of the community and to make use of local facilities. Meals are nutritious and meet the individual preferences and cultural needs of the people who live here. EVIDENCE: Throughout the week the 3 residents all attend day services provided by TWAS. These include vocational courses at the nearby Thornbeck College, such as IT, meal preparation, arts & crafts and sports. 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. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 13 This house is indistinguishable from other family properties in the area, as are 2 neighbouring houses that are also operated by TWAS and managed by the same Manager. The people who live here make good use of local facilities in the community including post office, shops, sports centres, take-aways, cinema, bowling centres, swimming pools and so on. The home is a short distance from the city centre so residents have a good range of shops and leisure resources nearby. The 4 people who live here are all involved in setting menus, shopping at local supermarkets, and preparing their meals. The Inspector joined residents for the tea-time meal, which residents had prepared with staff support so that their independent living skills are promoted. There are 2 dining areas, one in the dining room and one in the large kitchen. In this way, staff and residents do not have to crowd around one table, and residents have a choice of where they sit for their meals. Menus show that meals are healthy, nutritious and meet the age and lifestyles of the young people who live here. Residents said that they also enjoy occasional meals out. One person is a vegetarian and plans and makes all her own meals. Another resident is also supported to maintain her cultural diversity and this is also reflected in her diet. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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) 18 & 19. Residents receive appropriate personal support in the way that they require. Residents health care needs are met by community health care services. EVIDENCE: The 4 young ladies who live here are young and physically fit. None of the residents need physical support. Some people need some verbal prompts and supervision to help them with bathing and brushing their teeth. All the staff are female and this ensures that the residents get gender-appropriate support at all times. Discussions with staff confirmed that they are very knowledgeable about each residents support needs. The 4 residents are registered with a local GP practice. There is a visiting optician service, and residents also have access to suitable dental treatment. One person has specialist health care input for their epilepsy. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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) 22. Residents, relatives and care professionals have information from the service about the method of making a complaint. Information is provided to residents in pictorial form to support their understanding of the complaints procedure. EVIDENCE: TWAS has a very thorough Complaints Policy and procedures for relatives and other care professionals. Each resident has been given a copy of a short clear complaints procedure, which is in plain language and in pictorial form to support their communication skills. This information is included in their files and in the Service Users Guide, so that residents have access to it at any time. Residents are periodically reminded of the complaint procedure at Residents Meetings and are asked for their views of the service. The people who live here have a range of communication methods, and staff have a good understanding of those needs. One resident uses an electronic communicator and can use this to say whether she is happy or sad about something. Other people can use speech, noises and gestures to show their dissatisfaction. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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, 26 & 29. Residents live in a homely, comfortable and safe environment. The house is decorated and furnished to a very good standard and in a modern style that suits the people who live here. EVIDENCE: Inverthorne is a family house that 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 new carpets have been fitted in the dining room, lounge and the stairs. There are future proposals for a store room to be converted to a shower room and this would provide a useful second bathing facility for the 4 young ladies. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 17 The 4 bedrooms are comfortable, and residents can spend quiet time in their own rooms. A visiting relative commented that they were very pleased with the style and size of the home, and described the house as lovely. However they felt that there was rather limited wardrobe space in one bedroom for a young persons clothes. All the bedrooms doors are lockable from the inside for residents privacy if they wish. Two resident have a key for their bedrooms, and make good use of these to keep their rooms private when they are out of the house. The other 2 residents have had several keys in the past but found it difficult to manage them. There are risk assessments in place to show this, which have been signed by the residents and copies sent to their relatives. The risk assessments are reviewed every year and so the possibility is not ruled out that those residents may learn the skills to manage their key in the future. At this time the home uses an intercom for one resident who has epilepsy to monitor their well-being when using their bedroom. The staff team are fully aware that this is intrusive equipment and, whilst it is used to ensure the residents safety, it could be construed as an infringement of the persons right to privacy. This matter was raised at the last inspection but there are still no recorded risk assessments in place regarding the use of the intercom or the limitations of when and why it should be used. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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 & 33. Residents are supported by competent, qualified staff. The home has an effective staff team with sufficient numbers and skills to meet the needs of residents. EVIDENCE: Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 19 The small staff team comprises the Registered Manager, 2 seniors and 3 support staff. There is a good mix of skills and experience amongst the staff team. All staff have had Autism Focus training to help them understand the needs of people who live here. One senior staff has achieved NVQ level 3 in care, and the other senior staff is working towards this. The qualification is accredited by the Learning Disability Award Framework, so relates directly to their care of people with disabilities. Two support staff have completed Induction/Foundation training and the remaining new staff member is receiving Induction training. In this way the home demonstrates that the staff are competent and there is a clear training and development plan for individual staff and for the team. The staffing levels are sufficient to meet the needs of the 4 people who live here. There are 2 support staff on duty during the times that the residents are in the house. All residents are at their vocational or college placements during the week at term times, and at home all week-end. Staff are on duty from 1pm to 10pm during the week and from 10am to 10pm during week-ends, so that they can provide support at times when residents most need it. There is one member of staff on sleep-in duty each night. These duties are carried out by the seniors or experienced support staff (and occasionally by female staff from other similar small homes). The sleep-in staff help residents to get ready in the morning. A member of college staff calls for residents to accompany them to their daytime vocational activities, but is not involved in their personal care. In this way, the 4 young ladies who live here receive gender-appropriate assistance from the home support staff. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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) 39, 42 & 43. The views of residents and their relatives are included in the reviews of the service. Systems, procedures and practices promote the safety and welfare of the people who live here. Residents benefit from competent financial management of the service. EVIDENCE: Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 21 TWAS has a comprehensive quality assurance system in place, which includes a full audit of the service. TWAS also involve residents and relatives views to monitor whether the service is meeting their needs. This includes annual reviews with residents and their relatives, and a relatives questionnaire. Residents are encouraged to give their views at the Residents Meetings, which are held about once a month. From time to time the home also uses resident’s questionnaires to gain their views of what they like and dislike. However these do not ask what they think of the home or the service they receive, and so it is not clear if the responses are included in the quality assurance process. A rolling programme of training is in place to ensure that all staff receive statutory training in health & safety matters including fire safety, first aid, food hygiene and Infection Control. In this way staff understand their responsibilities in terms of safe working practices. The Assistant Manager carries out a monthly health & safety audit of the premises and risk assessments are in place for activities carried out by staff and residents that may involve a minimal risk to health, for example use of kitchen and laundry equipment. There were no health & safety hazards observed in the building during this visit. Residents and staff carry out a fire drill on a monthly basis so that resident would know what to do if the fire alarm sounded. However the fire log records indicated that fire alarms are not tested at the correct interval of every week. TWAS was recently registered to provide another similar service nearby. As part of the registration process, satisfactory financial clearances and checks were obtained by CSCI. In this way TWAS demonstrates its on-going financial viability. Although no accounts are held at this small home, these would be available for scrutiny if necessary from the organisation. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 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 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x 2 x Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Inverthorne Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 3 B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 23 YES 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 must demonstrate how residents have been included in their own care planning, or record the reasons why they are unable to be involved. There must be a risk assessment in place regarding the use of the intrusive monitoring device to one service users’ bedroom. (Previous requirement - timescale of 1.6.05 not met.) The fire alarm must be tested on a not less than weekly basis. Timescale for action 1.10.05 2. 29 12(4)a 1.10.05 3. 42 23(4)c(v) 1.10.05 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. Refer to Standard 26 32 Good Practice Recommendations Staff should consider if it is possible to provide more wardrobe space within the ground floor bedroom. There should be at least 50 of the staff team with NVQ level 2 or above. Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT 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. Extracts may not be used or reproduced without the express permission of CSCI Inverthorne B52-B02 S15785 Inverthorne V217648 19 Jul 05 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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