CARE HOME ADULTS 18-65
Lethbridge Road 2 Lethbridge Road Southport Merseyside PR8 6JA Lead Inspector
Miss Orla Murphy Unannounced Inspection 6th January 2006 12:30 Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lethbridge Road Address 2 Lethbridge Road Southport Merseyside PR8 6JA 01704 531385 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) lethbridge@autisminitiatives.org www.peterhouseschool.org Autism Initiatives Mrs Jacqueline Christine Emmett Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 7 LD Date of last inspection 10/05/05 Brief Description of the Service: The home has places for up to seven adults with a learning disability, specifically those with Aspergers syndrome. It is an assessment centre for people with Aspergers syndrome and the average stay of each resident is 2 years. Aspergers syndrome is on the Autism Spectrum, but is usually a high functioning condition. The company running the home is a charity, called Autism Initiatives. Each resident has their own bedroom and share 2 lounges, a kitchen and three bathrooms. The home is on Lethbridge Road, which is off Scarisbrick New Road, in Southport. There are several buses that run along Scarisbrick New Road to Southport, Liverpool and Preston. There is a mainline train station in Southport town centre. The home is ten minutes by car or bus from Southport town centre where there are a wide variety of shops, bars, and leisure activities. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Inspection was unannounced and neither residents nor staff knew the Inspector was coming. The last inspection report was examined but no requirements needed to be followed up on this visit. The Inspection was the second in the home’s required visits, which are 2 inspection visits per year. No residents were home on the day of the visit but three staff were spoken to at the inspection. One resident was “case tracked”. Case tracking means that the Inspector concentrates on the care given and experiences of one or more residents to get an idea of what is like to live there and how that person’s needs are being met. Case tracking also shows the inspector where needs aren’t being met. A variety of records (care plans, medical notes, complaints records, assessments, medication sheets, meeting minutes, menus, timetables, staff rotas and significant events) were examined. Given no residents were at home to allow access to their bedrooms, only communal areas were also examined. What the service does well:
The home specifically looks after people with Aspergers syndrome and helps them to learn to manage areas in their life they may need support with such as socialising, travelling, assertiveness, employment and independence skills (cooking, cleaning, budgeting, self development). Because it is such a complex condition, staff at the home, who are trained in and understand Aspergers syndrome, provide excellent support to those living there. The home has a positive key working system. A resident previously case tracked said his key worker was “Brilliant, helps me a lot” and “I know I can say what’s bothering me and they wont laugh at me or think I’m stupid”. Staff work hard at helping residents to find out what their strengths and needs are, and to work with residents to get to a stage where they can move on to more permanent or independent homes. The resident previously case tracked said the best things about living there was that “ Staff understand Aspergers and me; I’ve never had that before I came here”. He also said “ its good living with other people who have the same problems; you don’t feel like the only one”. Care plans are excellent and very appropriate to each individual.
Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 6 The home’s ethos is very consistent and whilst residents are supported, negative attitudes are also explored and challenged where needed. Residents are helped and encouraged to understand Aspergers and to see the benefits in the condition as well as the areas they need help with. Discussions & observations showed that staff continue to have a very positive attitude to Autism and Aspergers syndrome. The house is very relaxed with a welcoming atmosphere and “feels” like a home. Staff attend training enthusiastically and 80 are qualified in or undertaking vocational training. Records showed that staff communicate very well in writing/handover and in meetings. This all benefits the residents. Administration & recording systems are consistently of a high standard. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This standard was not assessed as it was exceeded at the last inspection. EVIDENCE: This standard was not assessed as it was exceeded at the last inspection. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 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): 9 Standards 6 & 7 were exceeded at the last inspection. Service Users are enabled and encouraged to take appropriate risks. EVIDENCE: The risk assessments for one service user were examined in detail. These showed that several areas of lifestyle and environment were assessed as to what risks were open to that service user. Many linked into areas in their care plan. All the risks identified were appropriate and guidance was in place to guide staff and the service user as to how to minimise the risks. The risk assessments focussed on the balance of taking risks against the value of independence, which is positive and empowering. All risk assessments are reviewed every 6 months and those seen were up to date. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 10 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): 13 & 16. Standards 12 & 17 were exceeded at the last inspection. Standard 15 was met. Service Users are part of the local community. Service Users rights and responsibilities are respected & upheld by staff and the service ethos. EVIDENCE: Service Users weekly timetables are agreed and led by them. Aspergers syndrome can affect the individual’s ability to interact socially, but it is an important aspect of all lives, so staff support service users very closely to integrate and involve themselves within the community. All service users have day placements in centres, colleges or voluntary jobs. Lots of preparation and support is required for them to do this and care plans and daily notes showed this support is consistent. The service user case tracked has developed social interaction very positively during their time at the home. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 11 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): 18 & 19 Standard 20 was exceeded at the last inspection. Service Users receive personal support according to their wishes. Service Users total health care needs are met. EVIDENCE: No current service users require physical support with personal care but do require advice, guidance & support. The service user case tracked had a detailed and agreed morning & evening routine, which showed a great deal of staff input & guidance and the importance of the routine for the service user. Regular key worker sessions allow the service user and staff to address any issues or changes to care that may be necessary. These records were seen and were detailed and satisfactory. The service user case tracked had very detailed health records with each intervention, treatment or appointment and their outcome recorded. All service users are registered with local general practitioners and health services. Staff support service users to access healthcare where required. All service users access community services based locally on an individual basis. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 12 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 Standard 22 was met at the last inspection. Service Users are protected from abuse. EVIDENCE: Records reflected that all staff are up to date with POVA (Protection Of Vulnerable Adults) training. The home follows the Local Authority procedure in relation to the identification and reporting of abuse. Service users have regular meetings as a group and individually with their key workers where they can raise any concerns or worries they may have. Due to the nature of Aspergers and that service users can be isolated, staff are keenly aware they need to encourage service users to discuss their feelings & concerns. Over previous inspections, all service users have been spoken to and all are quite assertive and positive about telling someone if they felt bullied or abused. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 13 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): 30 Standard 24 was met at the last inspection. The home is clean & comfortable. EVIDENCE: All communal areas of the home were seen on the day of the inspection in addition to the front & rear of the property. Bedrooms were not viewed, as service users were not present to give permission. Bedrooms have been viewed on several other inspections and all were comfortable & personalised to individual service users. All areas of the home examined were clean, tidy & comfortable. Service users and staff both undertake household chores. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 14 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 Standards 32 & 35 were exceeded at the last inspection. The homes recruitment practices protect service users. EVIDENCE: A selection of staff files were examined. These all contained the required identification evidence, reference copies, Criminal Record Bureau (CRB) checks and proof of qualifications. The recruitment policy is robust and meets the minimum standards. All current staff are skilled & knowledgeable regarding Autism & Aspergers Syndrome. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 15 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): 37 & 42 Standard 39 was exceeded at the lat inspection. The home is run to a very high standard. The health and safety of service users is mostly but not fully protected. EVIDENCE: Administration and recording systems in the home are of a very high standard, being detailed, relevant and up to date. Service Users opinion is valued by staff through the day-to-day running of the home. Service Users meetings and complaints are encouraged & supported. Staff are always observed to be extremely inclusive and respectful toward service users, placing them at the centre of their work. The staff team is consistent and staff meeting minutes seen reflected that the management & the staff are dedicated to service users welfare and to providing a high quality service. All fire safety records were examined and these were up to date and satisfactory, with drills and alarm tests carried out regularly. Electrical safety checks were up to date & also satisfactory. Staff training in statutory areas was Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 16 found to be up to date. Monthly health & safety checks are undertaken by staff. There was no annual gas safety check available but senior staff reported one had been undertaken. The home was requested to forward a copy by fax to CSCI but has not done so. All certificates confirming the safety of systems in the home must be held there and be available for inspection. Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 17 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 4 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 X X 4 X X X X 2 X Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 18 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 YA42 Regulation 16 Requirement The home must have an up to date satisfactory gas certificate & retain it in the home for inspection. Timescale for action 07/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lethbridge Road DS0000005309.V279215.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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