Inspection on 10/01/06 for National Autistic Society, The

This inspection was carried out on 10th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

National Autistic Society, The 04/10/05

National Autistic Society, The 28/04/05

National Autistic Society, The 23/11/04

National Autistic Society, The 29/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 National Autistic Society, The Prospect House Whalley Road Altham Accrington Lancashire BB5 5EF Lead Inspector Mrs Lynn Mitton Key Unannounced Inspection 8th January 2007 10:00 National Autistic Society, The DS0000030071.V314778.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, The DS0000030071.V314778.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, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service National Autistic Society, The Address 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) Prospect House Whalley Road Altham Accrington Lancashire BB5 5EF 01254 384117 01254 386724 amandaponton@nas.org.uk Vanessahalfacre@nas.org.uk National Autistic Society Amanda Jane Ponton Care Home 7 Category(ies) of Learning disability (7) registration, with number of places National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: Prospect House is registered to provide long term personal and social care for up to 7 adults with a learning disability aged over 18 years. The home is staffed and managed by the National Autistic Society. At the time of the inspection the service user group was all male. The home is part of the Hyndburn National Autistic Society Scheme, which has two other residential care homes and a domiciliary support agency, and is a charitable organisation specialising in caring for those diagnosed with Autistic Specific Disorders. The home is a large detached property situated on a busy main road and adjacent to local amenities. The home had been decorated and furnished to meet the needs of service users, bearing in mind the specific needs of those with Aspergers Syndrome. A range of communal space was available. All service users have their own spacious bedroom, but share bathing facilities. Fees for the cost of a weeks care at Prospect House is £1968.50. Additional hours for 1:1 support is purchased additionally. There was information available to potential service users and their families advising them of the home and giving them details about the type of service they could expect. National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted on 8th January 2007. The deputy manager of the home completed a pre inspection questionnaire. The inspector spoke to most service users, visitors to the home and to the support staff on duty at the time of the inspection. Throughout the report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small representative group of service users. Records regarding these people were inspected. One service user was case tracked, their file examined in detail and two support staff member’s files were also case tracked. None of the Commissions resident’s questionnaires were returned, but 4 visitors/relatives questionnaires were returned. Comments and findings of these surveys are referred to throughout this report. The inspector conducted the inspection with the registered manager. During the inspection a number of records, policies and procedures were also viewed. What the service does well: One representative wrote; “I am a social worker for one of the service users and in my opinion Prospect House provides an excellent service with regular updates”. Another service users social worker wrote; “I feel this service user has made great progress towards independence. Staff have built up excellent working relationship with service user”. Service users said they were able to make decisions about their lives, and valued the support they received from staff. They also felt confident that any concerns/issues raised with staff were listened to and acted upon. Staff helped and encouraged service users to find positive and fulfilling ways of spending their time, for example one service user attended full time education and 3 other service users had voluntary and/or part time employment. Comprehensive and up to date plans of care were in place for service users. Staff training undertaken by all staff members ensured that the needs of the service users could be met. Staff had the skills and competencies to meet service users needs. There were clear policies and procedures in place to ensure service users are safe and well cared for. Service users were regularly consulted about the running of the home. National Autistic Society, The DS0000030071.V314778.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. National Autistic Society, The DS0000030071.V314778.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, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA2, YA5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure for new service users ensured that all information about their care needs was obtained before they arrived. This enabled the staff to have a clear understanding of what they needed to do for them. Service users had clear information about the terms and conditions of their stay at Prospect House. EVIDENCE: The service user case tracked had a completed needs assessment in place, which gave very detailed information about the service users needs and abilities. The inspector advised that this information should be dated and signed by the author. Service users contracts were seen. These were in the process of being updated and would be signed and dated by the service user. They fully explained the “house rules” and terms and conditions of their residence at Prospect House. National Autistic Society, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA6, YA7, & YA9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of service users were identified and documented. Service users individual needs were know by staff. Regular reviews of care plans ensured that any changes were regularly documented any action needed was taken. Policies and practices enabled service users to make decisions about their lives. The risk assessment and management framework supported service users to take responsible risks. EVIDENCE: Person centred plans were in place for each service user. The plan case tracked included a behaviour support plan, communication profile, personal and social support. Service users had an allocated key worker for each shift. The care plan was due to be reviewed, and service users took place in this process. Service users talked to the inspector and observations were made demonstrating a number of ways in which they made decisions about their daily lives, for example, each service user had there own individualised activity programme which included National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 10 attending college, work placements and part time employment. The inspector observed staff supporting service users following their programme on the day of the inspection. There was now reference to service users preferred form of address on their care plan. The policy of the home was to promote responsible risk taking and freedom of choice. The care plan case tracked contained a number of risk assessments and management strategies, and the service user signed these. The inspector was advised that service users managed their own monies and each were supported by support staff as needed. National Autistic Society, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA12, YA13, YA15, YA16 & YA17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home was run to make sure the service users enjoyed their life and had regular access to their local community, and had opportunities to fulfil their potential. Service users were respected and felt valued as individuals. Service users had opportunities to maintain family links. Individual dietary needs were catered for. Service users were encouraged to participate in shopping, planning and preparation of meals. EVIDENCE: On the day of the inspection, all the service users took part in different fulfilling community based activities. The inspector noted these activities included fulltime education; part time paid and voluntary work. Staff support service users to access these activities dependent on each persons needs. The National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 12 inspector noted service users also accessed community facilities at evenings, and weekends, whilst taking part in leisure activities, for example, one service user helps out on match days at Accrington Stanley Football grounds. Three service users spoke to the inspector, telling her about what they were doing and how much they were enjoying it. Service users were able to keep in regular touch with their families and friends, usually by ‘phone, although service users lived a long way away from their family. There was a bedroom available to accommodate visitors. Personal relationships were supported and facilitated, and there were policies and practices in place to support this. Service users said they felt that their rights and wishes were respected and that they usually felt valued as individuals, although there were occasions when service users had disagreements between themselves. The inspector saw the homes three weekly menu. It had been devised and implemented following a service user questionnaire. Weekend meals were service users own choice. The menu accommodated service users favourite foods, and also endeavoured to balance service users likes and dislikes and ensure a wholesome and nutritious diet. Records were made on each service users daily report of their dietary intake. Most service users were involved in the preparation and cooking of one main meal each week. The inspector noted that all support staff had completed the basic food hygiene training course. National Autistic Society, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA18, YA19 & YA20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Personal support was offered in accordance with service users wishes and needs, and in a way that promoted privacy dignity and independence. The health needs of service users case tracked had been identified and, how they would be met, recorded. Practices for managing and administering medication needed attention to detail. 13 out of 20 support staff had completed accredited administration of medication training. EVIDENCE: The inspector was advised that no service users needed practical support with their personal care, only verbal prompts and reminders. The inspector observed that service users individuality was encouraged and their appearance reflected their personality. Each service user had an allocated key-worker. The inspector noted that Prospect House staff on duty wore plain black polo shirts this was in order to help one service user focus/gain eye contact with staff, and was considered to be excellent practice by the inspector. National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 14 The service user case tracked had a health check document in place, however it had not been signed or dated. There was evidence that this service users physical and mental health needs were being met. Policies and practices for managing and administering medication were in place. A Monitored Dosage System of administering medication was in use. The inspector noted an error had been made regarding a recording on the controlled drugs register. The inspector also advised that expiry dates should be checked on PRN (as and when required) medication as one seen was dated April 2005. Patient information leaflets were seen and a staff initials register was also seen. Accredited training for staff regarding the safe administration of medication had now taken place. National Autistic Society, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA22 & YA23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were clear complaints and protection policies and practices in place and evidence that the service users views were sought and acted upon. Staff spoken to had a good understanding of adult protection issues and how to deal with complaints made by service users. EVIDENCE: No complaints had been made to the Commission or the home since the previous inspection. There were clear complaints and protection policies and practices in place and these were in the process of being reviewed at the time of the inspection. Service users spoken to by the inspector said they would talk to the registered manager if they had any concerns. There were detailed prevention of abuse policies and practices in place and these were also in the process of being reviewed at the time of the inspection. Staff spoken to had a good understanding of adult protection issues and how to deal with complaints made by service users. All support staff had completed prevention of abuse training. National Autistic Society, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA24 & YA30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the standard of décor and furnishings provided a comfortable and suitable environment for service users. EVIDENCE: The inspector conducted an inspection of the communal areas of the home. Laminated flooring had been fitted at the entrance hall and the staircase carpet had been replaced since the previous inspection. The inspector also noted that paper towel dispensers and paper bins had also been replaced in the bathrooms. Blinds had been fitted in place of curtains in communal areas. The back lounge had been re-furbished, and one bedroom converted into a games room, complete with a pool table and play station. The home was clean and odour free. The inspector was advised that there was a cleaner employed for 20 hours per week. There was a lot of litter in the garden/car park area and a leaded window in the dining area which was seen to be disturbing one service user was discussed with registered manager. National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 17 The laundry facilities were sited in a prominent position in the home and suitable for the needs of the service users. National Autistic Society, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA32, YA34 & YA35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff spoken to and observed by the inspector demonstrated a good understanding of the needs of the service users. There were sufficient staff members on duty to meet service users needs. 60 of support staff had completed NVQ3 training. Other appropriate training was on offer and ongoing for support staff. Staff members were receiving regular management support and development meetings. Staff recruitment records, which ensure service users were safe, were available to the inspector. EVIDENCE: The inspector observed service users being supported by competent staff, and were seen to be treat in a positive and respectful manner. The inspector case tracked two staff member’s files. These now contained information, which demonstrated that checks had been taken to ensure that service users were safeguarded. CRB checks were now available in the home. National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 19 Both support staff case tracked had completed LDAF Induction and one had also completed the LDAF Foundation training. One staff member told the inspector; “the staff team I work with are really supportive”. According to the rota, there were three teams of support staff, each team consisting of five staff members. In addition, there were 2 “day staff” working 9.15am until 4.30pm. There was always a nominated senior staff member on duty or on call. Of the 20 support staff, 12 had completed NVQ 3 training; a further 1 was undertaking this training. The next team meeting is due 16/01/07. A training matrix was seen also by the inspector, which demonstrated that support staff were offered regular opportunities to undertake training relevant to their job. LDAF induction and foundation training was mandatory. National Autistic Society, The DS0000030071.V314778.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA37, YA39 & YA42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The attitude of the staff and management is to run the home with the needs and wishes of the service users as the highest priority. Service users were regularly consulted in a number of ways. The home was run to ensure the safety and welfare of service users and staff. General good practice was in place with regard to the safety and welfare of the staff and service users. EVIDENCE: The registered manager had completed the Registered Managers Award in May 2006, and the NAS Certificate for Registered Manager’s in June 2006. A 2006 Quality Assurance plan for the home was in place. A service user feedback form and a staff feedback questionnaire had also been completed since the last inspection. The inspector advised that these forms should be National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 21 dated, and suggested that one should also be completed for service users relatives. Service users meetings did not take place on a formal basis. More often, discussions took place with 2 or 3 service users. These discussions were recorded. Records regarding the prevention of fire, and routine maintenance records of the gas and electrical supplies and appliances were seen and found to be in good order. Training for support staff had been taken regarding to ensure the safe working practices. Accident records were seen – these were being kept appropriately, and fridge, freezer and hot water temps were being regularly checked and recorded. National Autistic Society, The DS0000030071.V314778.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 2 3 X 4 X 5 3 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 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 3 X National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13(2) Timescale for action The registered person shall make 30/03/07 arrangements for the recording, handling, safe keeping, administration and disposal of medication. The homes premises must be 30/03/07 suitable for its intended purpose, safe and well maintained. Requirement 2. YA24 16 & 23 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. 2. Refer to Standard YA2 YA19 Good Practice Recommendations Assessment of service users needs should be signed and dated by the author. OK Health Check should be signed and dated by the author. National Autistic Society, The DS0000030071.V314778.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI National Autistic Society, The DS0000030071.V314778.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. 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