Inspection on 06/07/05 for National Autistic Society

This inspection was carried out on 6th July 2005.

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 17/08/06

National Autistic Society 08/02/06

National Autistic Society 08/12/04

National Autistic Society 14/04/04

National Autistic Society 18/12/03

National Autistic Society 19/08/03

National Autistic Society 02/09/02

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

CARE HOME ADULTS 18-65 National Autistic Society 19 Camden Road Leicester Leicestershire LE3 2GF Lead Inspector Bhavna Keane-Rao Unannounced 06 July 2005 10:00 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 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 Stationary 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 C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service National Autistic Society Address 19 Camden Road Leicester Leicestershire LE3 2GF 0116 2630991 0116 2630992 None The National Autistic Society Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Robert Houghton Care home only 12 Category(ies) of LD Learning disability (12) registration, with number of places National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 08/12/04 Brief Description of the Service: Camden Road residential home is part of the National Autistic Society providing care for up to 12 people. It is registered to provide care for people who need care due to a learning disability. The age of service users can be sixteen and over. However there is no one under the age of 18 at the home. The emphasis is on homeliness and relaxed atmosphere. However this is not always possible as the building was originally a children’s home. The home is made up of two separate buildings (19A and 19B) providing care almost independently of each other. For example there are two sets of staff group in each areas, two offices, two kitchens and two front doors. All rooms are single, four with full en-suite; four bedrooms have hand wash basins and four with out. All bedrooms are decorated to the wishes of the individual service users. They are situated on the ground and first floor, and there are two lounges and two dining rooms, two kitchens in each area. The two separate gardens are well tended and reflect the different interest of the service users. The home has recently hired an allotment for the staff and residents to grow their own produce. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during a Wednesday morning and early afternoon. The inspection took four and half-hours. Residents who live at this home are not able have detailed discussions about the provision of services due to their care needs. However they were observed in their daily routine. A tour of the premises was undertaken and opportunity was taken to view residents daily records, menus of meals, fire records and staff rota. The registered manager was not on duty on the day of the inspection. The team leaders in both houses spent time discussing many issues that arise in the running of a residential home and facilitated this inspection. No comment cards were received from the residents or their relatives. What the service does well: The registered manager and the staff at the home have always been willing to learn and improve the service provided for the residents and although the manager was not working on the day of the inspection there was no exception to this. The individualised service provided is of a high quality. The residents were spoken with, but this was not in detail, due to their care needs, appeared happy with the staff and the home. The residents are provided with structured extensive activities to encourage all hobbies and interest. The observed interaction between the residents and the care staff was extremely positive. The National Autistic Society have established a parents group called the ‘Service Support Group’ which has input in to the overall NAS committee. This group is involved in all areas of provision of care for residents who use these services. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 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. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 and 5 The admission process is flexible and well managed, which ensures care needs are met at the home. EVIDENCE: Examination of the Statement of Purpose indicated that the document accurately describes the services provided in the home. The admission procedure is extensive and the staff at the home always carry out initial individual assessments over a period of time. These are recorded. This is thorough as relatives and health and/or social care professionals are consulted, as part of the referral process. Three service users files were viewed they detailed the specific care needs of service users, identifying the needs that would be met by health and/or social care professionals. One recently admitted resident’s files indicated that their care needs were assessed in detail, staff from the home visited them on a number of occasions in their previous place of residency. Discussion was held with a member of staff who has been involved in recent admission. The work undertaken for a smooth transition for this resident was paramount for a successful admission. This has been recorded reviewed and monitored on regularly over the initial few days. The home is commended for this working practice. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 and 9 Care plans reflect changing needs, thus individual care needs are met. Resident’s information is secure and treated with confidence EVIDENCE: There has been improvement in the development of person centred plans for residents. A number of Staff have completed training in the development of person centred plans (PCP). Four residents were observed receiving care by staff trained to provide it. Three individual care plans of residents were viewed. These were found to be up to date and accurately reflect the care needs of residents. The care records and observation on the day of the inspection shows how involved residents and their families are in what happened to them in this home. They are able to choose the food they eat, what clothes they wear and what actives they participate in. Different forms of communication, sign, pictorial etc, are used to ensure that residents are consulted, as much as they are able, to decide what happens to them. Review records for residents were found to contain minutes of meetings and action plans. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16 and 17 Residents have a stimulating and varied lifestyle at the home that is individually tailored and flexible. EVIDENCE: All the residents go out and do something different everyday and that this was what they enjoy. However this not always the case as occasionally some residents will decide not to go out or are not well and so this is accommodated. Social organised excursions are provided through consultation with the residents and their families and linked to individual goals and aspirations. Residents have a very active social life, which is encouraged and supported by the staff and their own relatives. Where residents do not wish to participate in activities then this is recorded in their individual records. Residents are supported to access the local community and social events. Residents who enjoy helping around the home are accommodated. Residents attend day centres as structured activities provided by the home. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 11 However, at present day, due to summer holidays the staff at the home provide day care. The staff were seen to seek the permission of residents before entering bedrooms. Residents wandered around the home freely, accessing communal areas. This was observed to be the case on the day of the inspection. Resident were observed enjoying their lunch. Meals are cooked and prepared by staff. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 Residents and staff working together meet the physical, emotional and health care needs of residents. EVIDENCE: The records of three residents were viewed, records detailed visits made by and to health care professionals, which includes Community Nurses, Social Workers, Dentists and Opticians. At present residents are able to manage their own medication, risk assessments have been carried out to ensure that resident’s rights are not compromised and their capabilities assessed. The medication administration, recording and safe handling of medication is satisfactory. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Residents are safe and protected from abuse. EVIDENCE: The home’s complaints procedure is given out to all resident’s relatives and is displayed. Residents’ relatives are made aware of these procedures by the staff but also by being involved in the parents support group. The National Autistic Society (NAS) has an established parents group called the ‘Service Support Group’, which has input in to the overall NAS committee. This group is involved in all areas of provision of care for residents who use these services. The Commission for Social Care Inspection has not received any complaints since the last Inspection. There is a procedure in place to ensure that residents are protected from any form of abuse. Staff to protect the residents and their rights uses these procedures. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The residents are provided with a comfortable, clean and safe standard of accommodation, which individually and collectively meets the resident’s needs. EVIDENCE: The homes, two semi-detached houses, are well maintained and suited to residents’ needs. There is constant wear and tear due to the extensive care needs of the residents. There is a person employed full time to deal with this. However this does not affect the care provided for the residents. There is ample natural light throughout the home. It is decorated and furnished to create a comfortable atmosphere. In both the individual houses there is a lounge and kitchen dining room leading to the back garden. The garden area is flat with plants and seating. Three residents’ bedrooms viewed were homely with ample space. Residents are able to bring items of furniture and personal possessions with them. Two bedrooms viewed were individualised reflecting the interests and hobbies of the residents. All areas of the home were clean and tidy. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Training and supervision is in place to ensure staff are able to carry out their work safely and competently. EVIDENCE: Since the last inspection there have been a number of new recruitments. The resignations have been due to career progression. At present there are five residents in 19A and six residents in 19B for whom care is provided. There is always at least five care staff on duty to provide care when all the residents are in the home. All the residents have a very active life and so are always out and about. Staff are supported and access specialist training to focus on meeting the needs of the residents. The responsibilities of the staff in the home, in addition to care, include cleaning, preparation and cooking of meals, the laundry and any other tasks as identified by the registered manager. However the emphasis is very much on encouraging residents to be involved in all aspects of daily living. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 Residents and staff benefit from clear leadership. EVIDENCE: There are regular staff meetings, which identified the expectations of the registered manager of his staff. The members of staff who were spoken with felt that they could go to either the registered manager or the team leaders at any time with any concern. The members of staff who were spoken with have had formal supervisions. There is a maintenance programme for the home and the equipment. A random sample of records checked was up to date including fire drills. It is noted that records of fire drill records do not show staff participation. Discussion was held with the team leader as to the reason why this was necessary i.e. to ensure that all the staff have been provided with at least two training sessions of what to do in case of a fire. National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 National Autistic Society Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 18 None 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 Regulation None 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 None Good Practice Recommendations National Autistic Society C51 S1819 National Autistic Society V235262 050705.doc Version 1.40 Page 19 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park, Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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