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Inspection on 15/03/07 for Montpelier Terrace (3)

Also see our care home review for Montpelier Terrace (3) for more information

This inspection was carried out on 15th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This house has three flats, each with its own kitchen and sitting room. It could provide a good place for people to learn to become more independent. It is close to the City centre as well as local shops, pubs and sports centres. ESPA always looks at new service users` needs to make sure it can support them in the right way and in the right house. ESPA has lots of policies and procedures that show it values service users` rights to make their own decisions and choices. ESPA has good links with community health services and has its own psychiatrist, psychologist and speech and language team for any new service users who may need this support. ESPA checks all new staff to make sure that they are the right people to provide care and support to service users. ESPA provides good training for its staff so they know how to look after people in the right way. ESPA makes sure that managers are supported to provide a good service. ESPA asks service users, and their relatives, what they think of the service they get at least once a year.

What has improved since the last inspection?

During the few months that the house has been empty, new kitchen units and cookers have been fitted into the small kitchenettes on each floor.

What the care home could do better:

Information about the service should be produced on a CD or signed onto DVD in readiness for new people who will move into the service.ESPA should continue with their plan to provide up to date training for all staff in physical interventions. The house will need to be redecorated before new service users move here. There are some minor repairs, such as sealant to the baths and damp in one bedroom, that will also need to be fixed before anyone moves here.

CARE HOME ADULTS 18-65 Montpelier Terrace (3) Ashbrooke Sunderland SR2 7TZ Lead Inspector Miss Andrea Goodall Key Unannounced Inspection 15th March 2007 14:00 Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 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 Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 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. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Montpelier Terrace (3) Address Ashbrooke Sunderland SR2 7TZ 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 565 6205 0191 565 6205 European Services for People with Autism Limited Position vacant. Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration:None Date of last inspection 1st February 2006 Brief Description of the Service: The home at Montpelier Terrace is a modern three-storey house that has previously provided accommodation for up to 6 people with Autism. The care service is operated by ESPA (European Services for People with Autism), whilst the building is owned and maintained by New Leaf Housing Association. The home has been registered for about 9 years. The home is close to the City centre and to a number of local facilities such as parks, library, shops and pubs. At this time the home is not occupied. The previous residents have all moved to new accommodation also operated by ESPA. The home remains registered while ESPA Provider considers proposals for further residential care services that could be provided within this house. The house is currently divided into three ‘flats’, one on each floor. Each flat has 2 good-sized bedrooms, pleasant lounge/dining room, small domestic kitchen and a bathroom. The home has a good-sized back garden with access via a ground floor room. The design of the house means that it is not suitable for people with physical disabilities or mobility needs as the entrance and all areas of the home are only accessible via steps. This is clearly outlined in the home’s Statement of Purpose, and ESPA have given every consideration to how this may be addressed. Charges to live at 3 Montpelier Terrace vary according to individually assessed levels of funding. This can range from approximately £5,000 to £7,000 per month and is fully inclusive. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was announced at short notice so that the Provider could make arrangements for a staff to be on site at this empty house. The visit included a discussion with an ESPA representative about the potential future of the house; a look around the premises; and the certificate of registration and public liability insurance certificate was examined. What the service does well: What has improved since the last inspection? What they could do better: Information about the service should be produced on a CD or signed onto DVD in readiness for new people who will move into the service. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 6 ESPA should continue with their plan to provide up to date training for all staff in physical interventions. The house will need to be redecorated before new service users move here. There are some minor repairs, such as sealant to the baths and damp in one bedroom, that will also need to be fixed before anyone moves here. 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. The summary of this inspection report can be made available in other formats on request. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 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 Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good information about the service is available for future service users so they know what to expect from the home. But no one lives there at the moment so it is not possible to assess how this impacts on people using the service. Comprehensive assessment tools are in place ready to use to ensure that prospective service users’ needs can be met at the home. EVIDENCE: The Statement of Purpose and Service Users Guide for the service at this home provided previous residents with good information. Clearly some amendments would be made for any new service provided within the house. For example, the details of a new manager, and any changes to the number of places. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 9 ESPA has a comprehensive assessment process that includes the input of the prospective resident, their relatives, social worker, care manager and, where appropriate, psychology, education and psychiatry services. In this way ESPA ensures that the needs of each prospective service user are fully assessed before a decision is made about whether the service can meet their individual needs. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Comprehensive systems are in place to promote and help people make choices. But their effectiveness to meet service user needs cannot be fully assessed as no one lives at the home. EVIDENCE: There are currently no residents at the home in order to test these standards. However at previous inspections these key standards were met. In all of its services ESPA uses comprehensive assessments to develop individual support plans for each service user based on their individual needs, goals and aspirations. Service users are supported, where capabilities allow, in the review of their support plans and goals for the future. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 11 The house at Montpelier Terrace is designed to promote independence for service users. It has 3 ‘flats’ (one of each floor) each with a separate sitting room and kitchen. This makes the house ideal for enabling service users to lead their own lifestyles and/or providing one-to-one support with independent living skills. The corporate procedures and values of ESPA support service users to make their own choices and decisions. Service users are supported to take acceptable risks as part of an independent lifestyle, within a clear risk assessment framework. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Clear policies and procedures that promote independent living are in place to ensure that service users have good opportunities for personal development. The house is near local amenities so offers good opportunities for prospective service users to be part of the local community. ESPA has clear procedures that value the rights and responsibilities of service users. EVIDENCE: There are currently no residents at the home in order to fully test these standards. However at previous inspections these key standards were met. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 13 There are good systems ready in place that offer the opportunity for the personal development of future service users. The house is modern building in a quiet side street near the City centre. It is indistinguishable as care home. It is close to numerous amenities such as shops, pubs, and sports centres and is a short walk from City centre. ESPAs corporate procedures clearly value the rights and responsibilities of service users. These are also set out in the Service Users Guide, Residents’ Agreement and Choices and Decisions policy – all of which are in pictorial format to support the potential communication needs of prospective service users. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Clear protocols are in place about assistance with personal care needs and access to community health services. This includes a clear risk assessment framework for service users to manage their own medication. But the effectiveness of these procedures cannot be fully assessed as no one lives at the home. EVIDENCE: There are currently no residents at the home in order to fully test these standards. A system to develop support plans for prospective service users is in place to determine any personal support needs and how this would be provided. ESPAs procedures are very clear about appropriate gender and cultural support for any prospective service users. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 15 The comprehensive assessment of prospective service users would be used to gather any information about health care needs is used to determine whether those needs can be met at this service. Links are already in place to ensure that future service users will be supported to access community health care services. ESPA service users also have direct access, if required, to ESPAs consultant psychiatry, psychology and speech and language services. Prospective service users would be assessed for their capabilities to manage all or part of their own medication within a clear risk assessment framework. If unable to do so this would be managed by staff on their behalf. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is clear written and pictorial information for some service users about how to make a complaint, but some prospective service users may not be able to access this. There is not sufficient training for staff in physical intervention so prospective service users may not be fully protected. EVIDENCE: There are currently no residents at the home in order to fully test these standards. ESPA provides clear information about how to make a complaint in easy language and in pictorial format. However some prospective service users may not be able to access this due to communication or visual needs. This information is not currently available for prospective service users either voiced onto CD or signed onto video/DVD. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 17 ESPA provides its staff with brief in-house training sessions on “restraint” to support service users with behavioural needs. However none of its staff has had training in physical intervention techniques from a BILD-accredited trainer (British Institute of Learning Disabilities). In this way staff may not follow current best practice guidance in this area of care, as outlined by the Department of Health and BILD. Since the last inspection a member of ESPA staff has been appointed as a training officer. It is planned that this staff will become a BILD-accredited trainer and will then provide physical intervention training for all ESPA staff. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The house is comfortable, clean and safe. EVIDENCE: For the past few months the house has been empty following the move by the former residents to a new, larger house in the city. The house at Montpelier Terrace had become too cramped for the number of service users and staff that were previously based here. This three-storey house lends itself to semiindependent living for a smaller number of service users and staff team. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 19 The building is owned by New Leaf Housing Association, which remains responsible for any repairs and maintenance. The premises are well maintained and safe. Gas services and maintenance checks have continued to be carried out, and new electrical circuit breakers have been fitted. While the house has been empty the small kitchenettes on each floor have been fitted with new units, cookers and worktops. However there are some minor signs of wear and tear to the décor and fabric of the house. For example the sealant around the 3 baths has perished, some tiles in bathrooms are loose; the lighting to bathrooms is very dim; there is some damp in a bedroom on the top floor; and most rooms are ready for redecoration. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures used by ESPA are in place to protect service users. ESPA provides good training opportunities to meet service users’ needs. EVIDENCE: There are currently no residents or staff at the home in order to fully test these standards. However these key standards have been met at previous inspections of this service. ESPA has robust recruitment and selection processes that ensure that only suitable applicants are appointed. ESPA provides all staff with induction and foundation training towards a social care qualification, in addition to specialist training in the needs of people with Autism Spectrum Disorder. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is currently no manager in post and the management of the home cannot be fully assessed. Good systems are in place to promote the health and safety of service users and encourage independence in a risk a managed way. EVIDENCE: There are currently no management arrangements at the house as no service is provided here at this time. However the key standards were met at the previous inspection. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 22 ESPA is fully aware that any proposed new service would incur the need for an application for registration of a suitable manager. ESPA has clear lines of accountability within its services. All managers are supervised and supported by as appropriate management representative of ESPA, who also carries out the required monthly visits to homes to report on its operations. ESPA has clear quality assurance systems, which include seeking the views of service users and their relatives. All ESPA staff receive statutory health & safety training, and new staff receive this through Induction training. In this way all staff understand the practices and procedures to ensure the health and safety of the people who use ESPA services. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 23 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 1 2 3 4 5 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 2 X X 2 X Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 24 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 YA23 Regulation Requirement Timescale for action 01/09/07 2. YA24 18(1)(c)(i) Plans to provide all staff members with BILD-accredited training in physical interventions must continue to ensure that all staff are equipped to support prospective service users in a consistent and acceptable way. 23(2)(b) & The house must be redecorated (d) and minor premises repairs (as outlined in the report) must be addressed before any new service users moved here. 01/07/07 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 YA22 Good Practice Recommendations Consideration should be given to providing information about how to make a complaint in other forms to meet the potential communication needs of prospective service users, e.g. voiced onto CD and signed onto video or DVD. Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South of Tyne Area Office St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Montpelier Terrace (3) DS0000015737.V319243.R02.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!