Inspection on 08/08/07 for National Autistic Society, 4 Heath Rise

This inspection was carried out on 8th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

National Autistic Society, 4... 28/11/06

National Autistic Society, 4... 30/11/05

National Autistic Society, 4... 14/07/05

National Autistic Society, 4... 07/12/04

Similar services:

Hunter`s Lodge

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 National Autistic Society, 4 Heath Rise Wellingborough Northants NN8 5QN Lead Inspector Sarah Jenkins Key Unannounced Inspection 8th August 2007 07:45 National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.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 National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.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. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service National Autistic Society, 4 Heath Rise Address Wellingborough Northants NN8 5QN 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) 01933 676786 F/P 01933 676786 Vanessahalfacre@nas.org.uk National Autistic Society Miss Joanna Hughes Care Home 4 Category(ies) of Learning disability (4) registration, with number of places National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 4 Heath Rise care home is registered to provide personal care to male and female service users who fall within the following categories: Learning Disability (LD) 4 Persons accommodated in 4 Heath Rise care home must be diagnosed with an Autistic Spectrum Disorder. That the age range of persons accommodated at 4 Heath Rise care home is 18 to 40 years of age. The maximum number of persons to be accommodated at 4 Heath Rise care home is 4. 28th November 2006 Date of last inspection Brief Description of the Service: 4 Heath Rise is a large modern house in a residential area on the outskirts of Wellingborough. It is run by The National Autistic Society. 4 Heath Rise is on a quiet road but is close to a main road with a regular bus service to the town centre. Service Users each have their own bedrooms and there is a pleasant, well-used garden area. The ranges of fees at the home are £1309.74 for the residential placement with additional costs of between £274 and £564.40 for service users day care placements. The National Autistic Society provided this information on the day of the inspection, and individual arrangements are detailed in service users individual copies of their Service Users Guide. Information about the home is available from the National Autistic Society in the form of a Statement of Purpose and Service Users Guide. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. Prior to the inspection visit the inspector reviewed the recent history of the home. The Inspector visited for a period during the morning from 7.30a.m to observe practices by staff and to meet with service users. A further visit was undertaken on the same day from 3.30pm. The inspection site visit took a total of approximately 4 hours. No feedback comment questionnaires were available to the inspector at the time of the inspection. Service users have autistic spectrum disorders and thereby communication for some is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. What the service does well: The staff are committed to providing a professional service and staff feel well supported by their training and support from the manager in doing this. Service users individual needs are well recognized and responded to by staff with sensitivity and awareness. Staff met at the time of the inspection demonstrated warm and caring attitudes and the delivery of care in a quietly calm and effective manner. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 6 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. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.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 National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process is supportive of service users care needs, and they are enabled to understand and make choices about their care at the home. EVIDENCE: There have been no recent admissions to the home. The Registered Manager described the admission process, which was being undertaken in respect of a prospective new service user. This was understood to be a flexible process with a full assessment adapted to the potential service users wishes and needs. There was no documentation of this available at the home at the time of the inspection for the inspector to review. The National Autistic Society has detailed processes and procedures for staff to follow, regarding the admission of new service users. Documentation such as the Statement of Purpose was reported by the Registered Manager to have been updated but was not reviewed at this inspection. Other documentation which was seen such as the Service Users Guide and contract, showed that the National Autistic Society has created a good deal of information in user-friendly styles for service users. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are committed to meeting service users needs properly. Service users can be confident that staff have access to comprehensive and updated care plans that reflect the details of the care that the service users need. EVIDENCE: Service users were properly supported by staff throughout the inspection periods, in accordance with the detail on their care plans. Service users expressed confidence in staff and approached staff appropriately to communicate their needs. Staff were able to engage in the signing systems used, such as Makaton, and to communicate effectively with them. Care plans and reviews were up to date and reflected the focus and thought that staff give to providing a professional and positive service. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 10 Service users are enabled to participate in the running of the home through discussion in their weekly meetings. It was evident from the records of these meetings that they are well run and service users are supported to express their opinions, feelings and wishes appropriately. The Registered Manager has undertaken training in the implications of The Mental Capacity Act, and service users are supported to take responsible risks. Risk assessment documentation is available and the Inspector understands that reasonable risk taking is discussed with service users and in reviews, and that multidisciplinary decisions are made with and in respect of individuals. This process was not always fully recorded. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users generally lead active, stimulating, and fulfilling lifestyles and are enabled to maintain and develop appropriate relationships. EVIDENCE: Service users are enabled to take part in fulfilling opportunities at their day or work placements and at local colleges, and are supported to participate in the local community. Service users were seen to be relaxed and happy both when preparing for their day activities and on their return. They expressed positive feelings about both their day placement and their leisure activities. There was evidence in records of the ways in which staff offer effective support to Service Users in maintaining their relationships with families and friends. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 12 Service users have an opportunity to discuss their choices of activities at the regular residents meetings chaired by staff, and staff ensure that they keep service users appropriately informed at these meetings about details of the running of the home. Service users spoke of some of the activities they had undertaken with support from staff and there was evidence from staff interviews how much more flexibility and opportunity has been afforded to service users recently in this outcome area. Staff were seen to give sensitive encouragement to Service Users in their routines and service users were seen to respond well. There was evidence that the daily routines promote independence and choice. Menus are planned on a weekly basis at the residents meeting and Service Users are fully involved in the preparation on a rota’d basis. Staff take an interest in encouraging service users to eat a varied and nutritious diet and assist them to choose and cook new meals. Menus show a variety of appetizing and nutritious foods. There was evidence of staff response to service users individual needs and wishes regarding their diets. Service users expressed general satisfaction with the food provision at the home, and said that they enjoy growing and using some of their own provision from the garden. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 13 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are alert and responsive to service users care and health needs and these are well met. Service users can be confident that they will be properly supported to maintain good health. EVIDENCE: Staff are providing sensitive and flexible personal support to service users with a proper awareness of service users privacy dignity and rights. Staff are aware of ways in which to empower service users and follow good practice guidelines in many areas of care. There was evidence that all areas of service users healthcare needs were properly observed, responded to and recorded by staff. Medication management is generally good with effective procedures for ensuring service users are fully informed and involved in their treatment, medication profiles on files are now fully functional for the purpose, and service users medication histories can be seen from these. Advice was given on National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 14 ensuring unused or discontinued medication is disposed of promptly in accordance with procedures. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that a well trained and experienced staff team will protect their best interests. There is documentation and process relating to safeguarding adults, and an understanding by staff of the ways in which situations can be abusive to vulnerable people. EVIDENCE: Service users opinions are listened to, and any concerns they may have are likely to be picked up quickly by the staff. The Registered Manager and staff have become alert to the various manifestations of abuse, and have implemented proper responses where needed, to issues between service users. There was minor shortfall in recent recording, which was discussed with the Registered Manager. There have been no recent complaints to the Commission for Social Care Inspection about the home, but one was received by the National Autistic Society since the last inspection and investigated properly through their complaints procedure. The record of this complaint showed that one shortfall identified by the complainant in relation to a premises issue, had been resolved. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are comfortable and homely, and convenient for reasonable access to the town for mobile people. The lack of prompt response to decoration needs should be addressed as the outcome for service users is thereby compromised. EVIDENCE: The home is bright and airy, but the decoration in the communal areas is looking “tired”, with a number of areas being in need of attention. Wallpaper in several areas is peeling or torn and some paintwork is noticeably damaged. The issue of decoration has been noted on Regulation 26 reports but the response to this issue has been slow. The garden area is pleasant, and well used by service users, who grow their own fruit, vegetables and herbs for use in the kitchen. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 17 Service users did not comment about the homes premises but seemed satisfied. Service users were happy to show the Inspector their rooms, which were comfortable well maintained and decorated. The home was found to be clean and hygienic throughout. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a competent qualified core staff team and further recruitment is in process. Service users feel supported by the staff at the home EVIDENCE: The rota was discussed with the Registered Manager and staff, and as the home is small the continuity of staff through the core team is seen as reasonable. The Inspector had an opportunity to meet with one of the “bank” staff who said she was able to keep closely in touch with the home and was thereby confident that she was up to date with service users needs when she came on shift. Staff were satisfied with the training and supervision they receive at the home and a sample of records showed that their training needs were generally well met, and that they receive up date or refresher training as needed. Staff said that the quality of the training was good, and their attitude towards training was positive. The Inspector noted that training information in a number of relevant areas was available for staff, for example Person Centred Planning, National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 19 Bereavement for people with Learning Disabilities and individual information on service users specific needs. The inspector did not fully review the recruitment process at this inspection as the relevant staff files were not available at the home and the Registered Managers time was limited as she was interviewing for staff vacancies on the day of the inspection. However the National Autistic Society recruitment process has recently been reviewed at another home locally and found to meet the Standard. The occasional lone working undertaken by staff for short periods at quiet times, as on the day of the inspection from 3.30-5.00p.m, should be continually reviewed as a potential area of risk. Service users showed their trust in staff through their general interactions and confidence. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager has worked hard since the last inspection to bring the home up to standard, and has done this with the wellbeing of service users as of central importance. Service users now benefit from a well run home where they can be involved in decisions about their lives and lifestyles. EVIDENCE: Both service users and staff see the Registered Manager as approachable and responsive. She is fully involved “on shift” and also undertakes her management responsibilities conscientiously, and has improved access to relevant information in the office. She pursues her own training needs and those of her staff appropriately and is committed to the professionalism of the service. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 21 Only one shortfall in Health and Safety issues was identified at this inspection as the tests of portable electrical equipment were overdue, but generally there were good systems and records. The Registered Manager reported that the Health and Safety Manager for the National Autistic Society was supporting her in this area. Records, and access to information have been considerably improved since the last inspection, and records are generally updated properly with few shortfalls. National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 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 3 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 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 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 3 x 3 x x 3 x National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP24 Good Practice Recommendations A programme of redecoration of communal areas should be developed National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 National Autistic Society, 4 Heath Rise DS0000061905.V346714.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!