Inspection on 30/05/07 for Moorpine

This inspection was carried out on 30th May 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Moorpine 05/10/05

Moorpine 04/05/05

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 Moorpine 18 Thornholme Road Sunderland SR2 7QG Lead Inspector Miss Andrea Goodall Unannounced Inspection 30th May 2007 10:00 Moorpine DS0000062275.V336561.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 Moorpine DS0000062275.V336561.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. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorpine Address 18 Thornholme Road Sunderland SR2 7QG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 5102038 0191 5672902 sarah.hanley-smith@tawas.org.uk Tyne and Wear Autistic Society Mrs Christine Graham Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Moorpine is a care home for 3 younger adults with Autism Spectrum Disorder. It is owned and managed by the Tyne & Wear Autistic Society (TWAS), Moorpine is a family-sized house in a quiet area near the City centre of Sunderland. It is indistinguishable from similar surrounding family houses; including the neighbouring two houses which are also small care homes operated by TWAS and managed by the same registered Manager. The house has an open hallway, off which there are a comfortable main lounge, kitchen/dining room and one bedroom. On the first floor there are two generously-sized bedrooms, a bathroom and the small staff sleep-in room. The quality of furnishings and decoration are of a very good standard throughout the house. The home is a domestic dwelling, previously used as a family house. It is not intended for people with physical or mobility needs. There is a small step to the front door, although TWAS would provide a temporary ramp to allow access to the ground floor for visitors with mobility needs. The house has a short driveway for the home vehicle. There is a small front garden and an enclosed, private back garden. The weekly fees are from £1,555 to £2,443. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place over one day. The home was only told about the visit a short time before, and this was to make sure that someone would be at home on this day. A couple of months before the inspection the manager sent back some information about the home. The three people who live here filled in picture comment cards about their home with help from staff. Three relatives also sent in comment cards. During the visit the inspector talked with the manager about how the home helps the people who live here, and about staff and records. Most parts of the house were looked at, and one person showed the inspector their bedroom. The people who live here have Autism Spectrum Disorder. This makes it very hard for them to say what they think of the service they get at this home. There have been no complaints or concerns about the home since the last inspection. In this report Tyne and Wear Autistic Society will be called ‘TWAS’, and the people who live at Moorpine will sometime be called ‘residents’. What the service does well: There is some information about the home in pictures and photographs to help the residents. Staff keep good records about how residents are learning to do things for themselves, such as making meals, ironing and looking after their own money. People here go out to lots of different activities that they enjoy. One relative said, “Our son receives excellent and professional care at Moorpine.” There are good choices of meals. People go shopping and make the meals that they like, with help from staff. All of the house is nicely decorated. People can choose their own colours for their room. The staff have lots of training to make sure that they know how to help people in the right way. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 6 The manager has lots of experience and the home is very well run. 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. The summary of this inspection report can be made available in other formats on request. Moorpine DS0000062275.V336561.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 Moorpine DS0000062275.V336561.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 and 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides clear information so prospective residents can make an informed choice about whether to move here. Comprehensive assessment procedures ensure that only those residents whose needs can be met are offered a placement at Moorpine. EVIDENCE: The Service Users Guide includes a brief brochure that is written in plain English, which gives specific information about the house, the service, and the activities. It includes photographs of residents taking part in the daily domestic tasks and relaxing in the house. In this way any prospective new residents have clear information about Moorpine before they visit to see if it would suit them. TWAS has clear written guidelines about referrals and assessments. Before they move here, the needs of a prospective resident are assessed by social and health care professionals. The prospective resident, their relatives and TWAS staff are also fully included in making a decision about whether the home could Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 9 meet people’s needs. People who are new to TWAS services have at least a one-week trial stay at a TWAS home as part of the assessment process. The three young men at Moorpine have lived here since it opened a couple of years ago. All had previously been receiving an educational or residential service from TWAS, and so their needs have been subject to extensive assessment and continuous review over the past years. In this way TWAS are able to determine that their needs can be met at this smaller home. In a recent annual review of one person’s placement it was clear that social workers and relatives felt that his placement at Moorpine has been very beneficial. Moorpine DS0000062275.V336561.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear care planning means that residents are supported towards achieving their goals. People are supported so that they can make their own decisions, and take acceptable risks as part of an independent lifestyle. EVIDENCE: There are individual care plans for each of the young people living here. These include comprehensive details of each person’s abilities and strengths, as well as their background, cultural/religious beliefs, and a baseline assessment of their support needs. From the assessments, the care plans set out a small number of specific independent living goals (smart targets) for each person in 3 main areas of their lives - domestic, leisure and self- development. For example, ironing, Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 11 making a meal, and managing small amounts of their own money when out at a social event. The plans include detailed instruction to staff about the level of support each person needs with their goals. There are clear daily records about each residents progress and how staff can further support them towards independent living. Residents may sometimes be present when staff are completing their care plan records. Due to their Autism most people find it difficult to understand the care plans, but there is a dated record to show when the care plan was verbally explained to each resident and whether the resident can understand their care plan or not. For example one person can read the words in the care plan but does not understand the content, and this is recorded. Staff stated that the care plans do not contain symbols or pictures, as residents do not understand the wider concept of the care planning process. However staff do use picture schedules with one resident to show the sequence of what they will do at different times so that they can make sense of the pattern of their day. The people who live here use either speech, gestures or pictures to communicate their likes and dislikes. They are encouraged and enabled to make their own choices and decisions, such as their appearance, menus, leisure activities, and holiday destination. However, one person needs to have very structured routines and very limited number of choices to support his well-being and behavioural needs. This is clearly documented within his care plan and within his behavioural intervention guidelines. There is clear evidence of the agreement to this by Clinical Psychologists, Local Authority that funds his placement, social worker, relatives and TWAS staff. All staff are aware that they must provide a consistent approach in limiting his choices in order to support the reduction of his selfinjurious behaviour. The home has a Participation of Service Users policy that supports residents’ rights to be involved and included in making decisions about the home. Residents have a meeting about every month where they are encouraged to make suggestions and reach group decisions. For example at a recent meeting the three young men have chosen to go on holiday to Blackpool. The people who live here are supported to take acceptable risks as part of an independent lifestyle. There are risk assessment records in place about activities that people carry out that might incur an element of risk, such as rock climbing, using tools, and having a bedroom key. It is good practice that these records have been sent to parents and the relevant Social Workers, and are reviewed at least annually. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 12 One resident’s risk assessment states that staff will support him “to lock his bedroom door when he is in it.” This may be a typographical error, as this person actually prefers to keep his bedroom door open at most times when he is in it. The risk assessment does not currently show how staff support him to maintain his privacy and dignity when his door is open. Recently all TWAS small homes have been fitted with a new door security system, which is linked into the homes’ fire alarm systems. This allows the main entrance doors to be locked at all times for security, but the lock releases in the event of the fire alarm system being activated. In this way resident and staff can exit the house in the event of a fire without having to first unlock a door. However this system also means that people cannot access or exit their house without a fob (electronic swipe key). At the time of this visit none of the people who live here had their own fob, and there were no individual risk assessments in place about this restriction. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 13 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents can choose from a good range of suitable activities so that they have fulfilling, purposeful occupations. Residents have good support keep in contact with family members and enjoy community facilities so that they have opportunities to meet others at social and leisure events. Residents have clear information so they understand their rights and responsibilities. Residents enjoy nutritious, healthy meals so their choices and dietary needs are met. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 14 EVIDENCE: All the residents attend day services provided by Tyne & Wear Autistic Society. These include vocational courses at the nearby Thornbeck College, such as IT, arts & crafts, and performance arts. Residents also have opportunities to gain practical skills at the TWAS Workshop where they make garden furniture, greetings cards and jewellery, which is sold in the TWAS shop (on a not-for-profit basis). This provides residents with tangible, purposeful outcomes to their daytime occupations. All the residents have their own pictorial copy of their weekly schedule so that they can refer to it at any time. The home is a family residence and is indistinguishable from other similar properties in the area. It is a short distance from the city centre so residents have a good range of shops and leisure resources nearby. The people who live here make good use of local facilities in the community including shops, sports centres, pubs and cinema. In this way residents are included in the local community. The young men who live here are very active and enjoy a wide range of leisure activities in the evenings and at weekends. These include golf, bowling, swimming cycling, roller-blading, and rock climbing. On the day of this visit it was half term holidays so residents had enjoyed a long lie-in, and were going on for a long walk and picnic in the country. Residents are supported to keep in contact with their relatives by telephone, and some relatives visit the home from time to time. One person has occasional short breaks to the family home. Three relatives sent comment cards to the CSCI indicating that they were satisfied with the service provided at The Court. One relative also wrote, “We feel very privileged that our son receives excellent and professional care at Moorpine. His disabilities are considerable, but the staff enable him to enjoy a full and active life.” Staff encourage and promote conversations with the residents to help their language and communication skills, but also to involve and include them in discussions about their home. Staff were seen to be friendly and supportive when talking with residents. Residents can choose to use their own bedrooms for privacy when they are not involved in another activity. There are some set routines in the home because people with Autism benefit from structured programmes that helps them make sense of the pattern of their day. It is evident from observations at this and previous inspections that residents have really improved their independent living skills over the time that they have lived here. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 15 All residents are all involved in suggesting their likes for the menus, and the home uses pictures of different dishes to support residents to make their suggestions. Each person has the opportunity to go grocery shopping with staff at large supermarkets so that they have the chance to choose from a range of foods. The three men all have opportunities to be involved in preparing meals, and one person showed on a pictorial questionnaire that he particularly enjoys this. The residents and staff dine together in the family sized kitchen/diner. Meals are nutritious, healthy and suit the age and preferences of the young people who live here. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 16 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents receive the right support to access health care services where necessary so that their health and welfare is well met. EVIDENCE: The three people who live here are young and physically fit. They need support, guidance and verbal prompts to help them to carry out their own personal care. One person occasionally needs some physical support to get in the bath but this is to help his confidence. No-one needs support with intimate personal care needs. The staff rota is managed to ensure that there is always one male staff on duty at times when residents may need support when out on an activity in the community, for example swimming pools and sports centres. In this way there is always gender-appropriate support for the three young men who live here. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 17 The residents are registered with a local GP practice. They also have access to community dental, optician and chiropody services if required, or can continue to use their family practices if preferred. The home supports residents to access specialist health services if required, for example clinical psychology services. In this way the home ensures that residents health care needs are met by the appropriate health care services. Only one of the people who live here has prescribed medication, and at this time he has been assessed as unable to manage his own medication. All staff who take responsibility for administering medication have had certificated training in Safe Handling of Medication. There is a list of the designated staff that can manage this and this includes any peripatetic sleep-in staff. Medication is securely stored in a suitable medication cabinet. Medication records were seen to be in good order. There are consent forms that have been signed by the GP and by relatives about over-the-counter medication that can be given to residents if and when they might need it. In this way the home makes sure that medication is managed in a secure and appropriate manner on behalf of the residents. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 18 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 excellent. This judgement has been made using available evidence including a visit to this service. People have good information so they know how to make a complaint. Staff are well trained in safeguarding adults so residents are protected from abuse. EVIDENCE: The home has a Complaints Procedure, which is also in pictorial format, and is periodically explained to the people who live here. Staff ask residents for their comments at Residents’ Meetings. All of the people who live here can express their dissatisfaction with a situation, including by gestures or behaviour, for example if they are irritated by the noises made by other people. Relatives have good contact with the home so can raise any concerns either informally, or formally at annual reviews. There have been no complaints about this service. All staff receive training in the local vulnerable adult procedures to ensure that residents are protected from abuse. As with all care services for adults in the City of Sunderland, TWAS has adopted the MAPPVA (Multi-Agency Panel for the Protection of Vulnerable Adults) policy and procedures. These are robust procedures for dealing with suspected abuse. All TWAS staff are trained in CALM (Calm Aggression-Limitation Management) and new staff will receive this training. This is a method of physical Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 19 intervention that requires minimal restraint, and is used only to prevent harm to the resident or to others if residents need support to manage their behaviour. This method is approved by the BILD (British Institute of Learning Disabilities) and ensures that all TWAS staff can present a consistent, safe approach when supporting a resident in this way, in any of the TWAS services. Very detailed intervention guidelines for staff ensure that they work in the same way to support residents with their behaviour. For example one person can exhibit self-injurious behaviour. Intervention records were seen to be kept in bound books with numbered pages and clearly detail any triggers and the intervention used to support the resident. These mainly relate to the use of diversion, and time and space for the resident to regain control of their own behaviour. Residents are supported to manage their personal allowances in their own individual Post Office savings accounts. Smaller amounts of money can be stored at the home for access by residents whenever they want. All records of residents’ personal allowances were in good order, with receipts kept for any transactions made by residents. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 20 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, 26 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 provides very good quality accommodation that is homely, comfortable, and personalised so that residents live in a home that suits their taste. However, the washing-up arrangements mean that hygiene can be compromised for residents. EVIDENCE: Moorpine is detached family house that is well decorated, well furnished and well maintained. The style of decoration is in keeping with the age and interests of the residents. Occasionally the behavioural needs of some people can have an impact on the décor in the home. However TWAS employs a full-time decorator who support residents to keep their home in good decorative order. There is also a maintenance team that visits the home about weekly to address any minor Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 21 repairs and carry out fire safety tests. There have been no significant changes to the house since the last inspection. At the time of this visit a couple of minor premises issues were apparent, for example some tiles have been lost from the roof, and a radiator cover has become loose. Each person has their own spacious bedroom that they can personalise to their own taste. It was clear from the minutes of a recent Residents’ Meeting that each person has chosen the colour scheme for their bedroom as well as items of furniture such as bedroom chairs and pictures. All bedroom doors are lockable from the inside so residents can choose complete privacy when they wish (which would only be overridden by staffs master key to protect the well-being of a resident). This small home does not currently have a dishwasher. As a consequence the temperature of the hot water outlet to the kitchen sink has had to be raised to over 50°C so that dishes can be cleaned at a hygienic temperature. As this water is now scalding hot, risk assessments were carried out about how to wash dishes safely without scalding, for example each resident having their own individual rubber gloves. However, in practice this is difficult to achieve consistently. At the time of this visit there were no satisfactory gloves available in the home, and there is a continual risk of residents blending the water to achieve a lower (comfortable) temperature than would be hygienic. In this way it is possible that hygiene in this area is being compromised. The laundry equipment is in the garage, which can be accessed from the hallway. Residents are supported to carry out their laundry with supervision and prompts from staff. This area is very cold in winter as the standard garage door is not insulated against the outside climate (although the window and another entrance door are double-glazed). Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 22 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 good. This judgement has been made using available evidence including a visit to this service. Staff are competent and qualified so residents receive an effective service. TWAS uses robust recruitment practices to ensure that residents are safeguarded from unsuitable staff. EVIDENCE: The staff team is led by the manager and a deputy manager who are also both responsible for two other small homes next door to Moorpine. There are also two senior support workers and two support workers. It is good practice that there are now 2 male staff in the staff team. This means that there is always one male staff to provide gender-appropriate support to residents when they are out at activities. The staffing levels are sufficient to meet the needs of the 3 people who live here. There are least 2 support staff (and occasionally 3 staff) on duty during times that residents are in the house. All residents are at their vocational or Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 23 college placements during the week at term times, and at the house all weekend. Staff are on duty from 12:45 to 9:45pm during the week and from 9am to 10pm during weekends. There is one member of staff on sleep-in duty each night. It was clear from the staff rota that the manager has been covering a number of gaps on the staff rota due to vacant posts, holidays and sick leave across the three homes. Whilst it is acceptable for the manager to cover an occasional gap, recently there have been frequent occasions where the manager has carried out long shifts and sleep-ins. This takes her time away from the many managerial, administrative and supervisory tasks involved in running three small homes. The comment card received from one relative indicated that they perceived there to be less staff than “agreed”. Whilst the staffing is adequate to meet the needs of the 3 residents as a group, it is apparent that the relative felt that more staffing had been agreed at an individual residents’ previous review. There have been a couple of changes within the small staff team. However these were of existing staff from other homes that were already familiar with the people who live here. TWAS operates very thorough recruitment and selection procedures. Staff are only employed after satisfactory references and police checks have been received, and this ensures the protection of the people who live here. TWAS promotes a comprehensive equality and diversity policy for all those involved in its services, that includes equal opportunities protocols for its staff. Two staff have achieved NVQ 3 (a care qualification) and the other two staff are working towards similar qualifications. In this way the home anticipates that all staff will have suitable care qualifications in the near future. All staff receive Autism Focus training, which is specific training to support them to understand the needs of the people with autism. There is an individual learning plan for each member of staff that identifies any training that they need and a record of all training courses that they have attended. It is evident from records and discussions with staff that TWAS is committed to staff training so that residents receive support from a welltrained, competent staff group. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 24 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents and staff benefit from a well managed, well organised service. Systems, procedures and practices promote safety and welfare so residents are safe. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 25 EVIDENCE: The registered manager has many years experience of working in care settings with children and younger adults with autism, and has been registered as a manager for this and 2 other small homes for the past few years. She has attained a Diploma in Care Management, NVQ level 4, and the Registered Managers Award, all of which are suitable qualifications for a manager of a care home. She is also currently undertaking a certificate in Autism Spectrum Disorder, which demonstrates her commitment to updating her skills and competence in this specialised area of care. There are clear lines of accountability and management support within the TWAS organisation. In this way the residents, and staff, benefit from a well managed service. TWAS has a quality assurance processes in place to review the service, and these includes the views of the residents (and their representatives) through their annual reviews and Residents’ Meetings. Pictorial questionnaires are also given to residents from time to time for them to indicate their likes and dislikes about various aspects of the service including staff, other residents, menus, activities, and the house. As two people do not use speech, the manager also included their physical gestures and responses on the questionnaire. For example, one person put his arm around staff to show his approval, and the other resident pointed to the kitchen to show that preparing meals is one of his favourite activities in the house. A summary of the responses to the most recent pictorial questionnaire of March 2007 is in the Service Users Guide for any future prospective residents to see. Also, there are monthly visits to The Court by an external consultant (on behalf of the Provider) who seeks the views of residents and staff, and reports back to the organisation and CSCI on their findings. Staff training records demonstrate that all staff receive statutory training in all health & safety matters, and there are up-to-date records of health & safety checks in the house. All staff receive in-house fire instruction every 3 months, and all residents take part in a monthly fire drill to help them understand what to do in the event of a fire. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 26 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 3 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 3 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 2 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 4 X X 3 X Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 27 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 YA9 Regulation 13(4) Requirement There must be risk assessment in place for each resident whose access into and exit from their house is restricted by the new security door system. This will ensure that residents are individually assessed for their capability, or otherwise, to manage their own front door fob. Timescale for action 01/09/07 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 YA9 Good Practice Recommendations Risk assessments regarding one resident locking his bedroom door should be amended to reflect the actual preference of the resident in keeping his door open, and should reflect how staff can support him to maintain his privacy and dignity. The minor premises issues should be addressed, that is the missing roof tiles and the loose radiator cover. Serious consideration should be given to the provision of a dishwasher that would allow residents to continue to be involved in clearing up but would ensure that the hygiene DS0000062275.V336561.R02.S.doc Version 5.2 Page 28 2 3 YA24 YA30 Moorpine 4 YA30 5 YA33 management of dirty dishes could not be compromised. Consideration could be given to replacing the garage door with a double glazed (or similar) unit that would help to insulate this room against the cold, and make it more comfortable for residents and staff to use the laundry equipment in cold weather. TWAS should ensure that the manager is not responsible for covering gaps and shift on the duty rota as this removes her from her managerial responsibilities, and this could lead to a negative impact on the three services that she is responsible for managing. Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South Shields Area Office 4th Floor 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 Moorpine DS0000062275.V336561.R02.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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