Inspection on 24/01/06 for Lorne Terrace (14)

This inspection was carried out on 24th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lorne Terrace (14) 28/06/07

Lorne Terrace (14) 13/09/05

Lorne Terrace (14) 17/02/05

Lorne Terrace (14) 24/08/04

Lorne Terrace (14) 17/03/04

Lorne Terrace (14) 26/09/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Lorne Terrace (14) Ashbrooke Sunderland SR2 7BU Lead Inspector Mrs Katie Tucker Unannounced Inspection 24th January 2006 03:00 Lorne Terrace (14) DS0000015775.V268164.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 Lorne Terrace (14) DS0000015775.V268164.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. Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lorne Terrace (14) Address Ashbrooke Sunderland SR2 7BU 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 564 0951 0191 563 7711 European Services for People with Autism Limited Mrs Amanda Catherine Morris Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Lorne Terrace is an end house that has been adapted to provide a care service. The home provides personal care for 4 adults who may fall within the Autism Spectrum or have Asperger’s. The house has four large bedrooms, one office/sleep-in room, 2 lounges, a dining room, kitchen, bathroom/shower and two toilets. These are divided throughout the home. However a toilet is not available on the ground floor and a few steps lead up to the entrance of the home. Therefore the home is not suitable for people who use a wheelchair. Lorne Terrace is in the Ashbrooke area and is within walking distance from the city centre. Corner shops can be found in the area, as well as pubs and an art centre. Backhouse Park is within walking distance plus there are ample bus routes, which travel to the city centre and other cities such as Durham. Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Lorne Terrace inspection was carried out as part of the routine yearly programme. No one working for ESPA was told that the visit was to take place. An inspector visted and spent part of the day at home. The inspector looked at the residents’ records, medication, staff training records and staff information. The staff were asked about the residents’ records, the guidelines for protecting residents, their training, staffing levels and changes to working practices. The residents were asked about their lives. Lorne Terrace cares for younger adults with either Asperger’s Syndrome or an Autism Spectrum Disorder. The residents have difficulty understanding abstract thoughts. And, find it hard to understand other people’s needs and feelings difficult. People are able to discuss their experiences whilst living at the home and express views about the service that they are receiving. But as part of the inspection staff practice, attitude and approach were also watched and judgements made on how well staff worked with people. During this inspection key standards were focused on but not all were checked. What the service does well: The manager and staff are very competent when working with people who have Asperger’s Syndrome and Autism Spectrum Disorders. Staff have a very good understanding of how to help people to develop their social skills. Thus people have been learning how to form relationships and friendships. Also staff have helped people deal with their obsessive-compulsive disorders and ritualistic behaviour, which has allowed people to live fuller lives. Staff obviously care a great deal about the residents. People work, as team rather than staff and resident groups. People have been supported to lead more independent lifestyles and some residents are now able to shop and travel by themselves. Staff chatted to residents and listened to people’s views. The staff valued resident’s wishes and responded to what people wanted. Thus people could choose what did and how they lived their lives. Residents were keen to talk about what they had been doing and what the home was like. Residents made very positive comments about the staff and services provided at the home. There was lots of friendly banter going on through the day, which everybody enjoyed. The manager is always looking at ways to improve the service. The style of management she has adopted has allowed staff to grow in confidence and develop there skills, as well as residents leader ever more independent lives. Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 6 ESPA employs and has access to a range of specialists such as psychiatrists and psychologists. These specialists regularly visit residents and provide support in all aspects of people’s lives including sex education, managing anxiety, and social skills. Staff’s in depth knowledge of the difficulties that people with autism spectrum disorders face allows them to work successfully with people. ESPA has a range of services, which includes colleges and a day service (the Croft Centre). The centre has been designed to meet the needs of this client group. It features a café were people can serve and provide meals, performing art facilities as well as crafts and aromatherapy. Dedicated and appropriately qualified staff team work at the Croft Centre. Residents regularly use these facilities and staff accompany people to offer help if it is needed. ESPA has a training department and over the last few years they have been working hard to make sure 50 of the care staff team hold a NVQ in care. Over 50 of staff now hold this award and the other staff are well on their way to obtaining this qualification. 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. Lorne Terrace (14) DS0000015775.V268164.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 Lorne Terrace (14) DS0000015775.V268164.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): 1 The various styles of service user guide makes it useful to all but the lack of information about fees flaws this record. EVIDENCE: The service user guide clearly shows what is available at Lorne Terrace and is available in a range of formats. Thus people have the full information needed to make a decision about whether they like the sound of the service. The generic contract, which is included in the service user guide, does provide space for the inclusion of the amount of fee. However the individual agreements do include this information or anything about special staffing arrangements. Also copies of the local authority placing agreement are not provided. These are not only required by regulation 5 of the Care Home Regulations 2001 but without them people cannot make informed decisions about whether the feel that the service they are getting is value for their money. ESPA has now worked with local authorities to develop these agreements. Blank copies of contracts that refer to the fees and staffing arrangements are now available but must be completed for each person. Lorne Terrace (14) DS0000015775.V268164.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): 6 and 7 The service user plan and risk assessments are comprehensive and meet the needs of residents. EVIDENCE: The records that staff have completed are well written and an excellent standard. They really tell staff how to work with people plus people’s idiosyncrasies as well as their needs. The care plans and risk assessment format have allowed staff to record full and detailed information about residents’ needs and the actions staff have to take to work with people. The plans identify the strengths people have and the common day risks that would be still acceptable for someone to take. Staff make sure they step out clearly each action that needs to be taken. Staff always record information about when they need to limit residents’ choices and wherever possible residents’ or their next of kin help to write the assessments and plans. Lorne Terrace (14) DS0000015775.V268164.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 and 17 The skilled work of staff and the range of experiences offered both by ESPA and Lorne Terrace have allowed residents to greatly widen their expectations. EVIDENCE: Staff have not become influenced by assumptions made about how they should work with people who have Asperger’s Syndrome or Autism Spectrum Disorders and this has lead to people be given access to a wider range of activities. People join in pottery and craft sessions, have paid employment work as conservationists and regularly go by themselves to football matches. Some of the people join in various local groups such as the women’s groups and self help groups for people with obsessive-compulsive disorders. One person has a friendships and travels to York to meet the person whilst others go to concerts. Therefore it can be said that people have varied and stimulating lifestyles. The staff are very competent and work with people to make sure healthy, balanced diets are provided. Also they approach other specialists to find out how to make sure people healthy nutritious diets. Plenty of food is always available and residents do some of the shopping. Lorne Terrace (14) DS0000015775.V268164.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 and 20 ESPA and the staff have an in depth knowledge of the difficulties residents experience and this means they can actively promote people’s wellbeing. EVIDENCE: ESPA employs and has access to a range of specialists such as psychiatrists and psychologists. These specialists regularly visit the residents at Lorne Terrace and provide support in all aspects of people’s lives including OCD, sex education, managing anxiety, and social skills and also provide support and advice to staff. The staff have acted upon the interventions the specialists have suggested and asked for further support when necessary. Also staff have worked closely with GP, community nursing services and hospital staff when someone is physically unwell. The staff work with residents in a sensitive and skilled manner. They have always ensured that appropriate medical help is sought. Staff have made sure the medication is stored and given out properly. The records were satisfactory. Also staff have had accredited medication training. Lorne Terrace (14) DS0000015775.V268164.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 The manager follows the local authorities protection of vulnerable adults procedures. EVIDENCE: Lorne Terrace has an appropriate protection of vulnerable adults policy and follow Sunderland Social Services Department guidance. In this guidance ESPA has to put in a section about what they would do if an allegation of abuse were made. Staff have had training around protecting residents. The Social Service Department has a continuous programme of training for all the staff working in care. Lorne Terrace (14) DS0000015775.V268164.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): 24 and 30 The building meets the needs of the residents and visitors. EVIDENCE: The design and location of the home is a positive feature as it blends in well with the community. The home exceeds the current space requirements of the national minimum standards for bedrooms but none offer an en suite facility. One bathroom is provided, which is below 3:1 requirements made of new homes being built and registered after 2002. A separate laundry is not provided but a good robust risk assessment and associated actions to minimise risk are in place. The guide must reflect where the home does not meet the requirements of the standards for new registrations. Lorne terrace is not suitable for someone who has a physical disability because of the access to and throughout the home is via stairs. ESPA have considered what reasonable adjustments could be made to meet Part 3 of the Disability Discrimination Act 1995 should someone visit who has a disability. Lorne Terrace is well maintained and always clean and tidy. Staff have completed infection control training, which helps to promote people’s health. Lorne Terrace (14) DS0000015775.V268164.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): 32, 34 and 35 The staff team are effective and meet resident’s needs. EVIDENCE: At all times during the day at least 2 care staff inclusive of a senior care are at work during the day but often 3/4 staff are on duty. At night 1 sleep-in staff member is on duty. Without the placing contracts being available it is uncertain whether Lorne Terrace is complying with any specific contractual arrangements that have been made. Care staff with residents’ complete domestic and catering tasks. ESPA provides an in depth training programme, which is specific to autism specific disorders and newly appointed staff receive induction and foundation training. All mandatory training is covered in the first six months. Training is delivered centrally and in-house. The person who completes physical intervention training has not received accredited training for some years. This means should any injury occur when staff are using an intervention ESPA is not covered by their public liability insurance and does not meet the requirements of Health and Safety legislation. Staff who are involved in most interventions have not been on accredited training. The staff files include a range of appropriate information. However in light of the recent changes to the regulations the owners need to check and make sure the practices fall in line with the changes. Lorne Terrace (14) DS0000015775.V268164.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 and 39 The management systems on the whole meet the needs of residents living at Lorne Terrace. EVIDENCE: The manager is a very competent. She is making good progress toward completing the registered managers award. And constantly makes sure her practices are line with recognised good practice. ESPA has developed a robust quality assurance system, which includes a service user board. Also the operational manager visit each home to conduct different audits of the service being offered and this information is provided to the local CSCI office. Recently some of the regulations were changed and the owners need to make sure their systems reflect these requirements. Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 16 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 2 2 4 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X X X LIFESTYLES Standard No Score 11 X 12 X 13 4 14 X 15 X 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 X 3 X 4 X 3 X X X X Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 17 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 YA1 Regulation 5 (3) Requirement The owners must ensure completed copies of the local authority placing contracts are provided to each service user guide and available in the home. All staff providing physical interventions training must be accredited. All incidents involving physical intervention must be recorded in a bound book with numbered pages. 3 YA37 18 (1) (c) The manager must complete the registered managers award. 01/12/06 Timescale for action 17/07/06 2. YA35 18 (1) (c)17 (1) (a) 21/05/06 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 Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock 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 Lorne Terrace (14) DS0000015775.V268164.R01.S.doc Version 5.1 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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