Inspection on 28/04/05 for National Autistic Society, The

This inspection was carried out on 28th April 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 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

National Autistic Society, The 10/01/06

National Autistic Society, The 04/10/05

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 The National Autistic Society Prospect House Whalley Road Altham Accrington, Lancashire BB5 5EF Lead Inspector Lynn Mitton Announced 28 April 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. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Nationmal Autistic Society, Prospect House Address Whalley Road Altham Accrington Lancashire BB5 5EF 01254 384117 01254 888535 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) The National Autistic Society Miss Amanda Jane Ponton Care Home only Personal Care (PC) 7 Category(ies) of Learning Disability (LD) 7 registration, with number of places The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 23rd November 2004 Brief Description of the Service: Prospect House was registered with the Commission in June 2002 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, and is part of the Hyndburn National Autistic Society Scheme, which has two other residential care homes and a domiciliary support agency in the area, and is a charitable organisation specialising in caring for those diagnosed with Autistic Specific Disorders. At the time of the inspection, all the service users were all male. The home is a large detached property situated on a busy main road and adjacent to local amenities. The home was 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 bedroom, but share bathing facilities. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and lasted over 6 hours. There were 6 service users accommodated at this time. A tour of the communal areas of the home took place. Over the course of the inspection three of the staff on duty, plus the registered and deputy manager were spoken to, four of the service users also contributed to the inspection process. Documents were read and care practice observed. Some service users and relatives had completed the Commission’s comment card. These indicated that a good service was received at Prospect House. What the service does well: What has improved since the last inspection? What they could do better: Ensure that all staff are trained to safely administer medication. The registered manager should complete appropriate training. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 6 Service users meetings should be recorded. Improvements (as identified in the report) to the grounds of the home would be in keeping with the local neighbourhood and promote a positive image. Improvements (as identified in the report) to the furnishings of the home would benefit the comfort and hygiene of service users. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 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 The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 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 & 5 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: There had been one new admission since the last inspection. The staff at Prospect House had documented written information, which gave a clear picture of the service users needs and abilities. Other professionals involved had also contributed written information to assist in this process. The service user was living at Prospect House on a trial basis at the time of the inspection. The inspector was told “ I’ve settled in really well – the staff are sound”. The inspector saw that service users had a completed and up to date contract in place. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 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 and 9 The care needs of service users were identified and documented. Service users individual needs were know by staff. Policies and practices enabled service users to make decisions about their lives. Regular reviews of care plans ensured that any changes were regularly documented any action needed was taken. 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. All service users had an allocated key worker for each shift – one service user said how much he liked his key worker and that “he helps me do all the stuff that I want to”. Care plans had been reviewed, and service users took place in this process. One service user told the inspector that he had been involved in his recent review and that “ I got everything in I wanted to say”. Service users talked to the inspector and observations were made demonstrating a number of ways in which they made decisions about their The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 10 daily lives, for example, there were a number of minor variations to the menu to accommodate everyone’s personal tastes to the lunch served on the day of the inspection. The policy of the home was to promote responsible risk taking and freedom of choice. Individual plans contained risk assessments and management strategies. The risk assessments were signed by service users, and one person told the inspector that they understood that risk assessments were a way of minimising risks. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 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 standard(s) 12, 15 &16 The home was run to make sure the service users enjoyed their life and had opportunities to fulfil their potential. Service users were involved in their local community. Service users had opportunities to maintain family links. Service users were respected and felt valued as individuals. EVIDENCE: Service users told the inspector about their daily activity programmes. One service user worked 3 days per week at a local farm, one service user worked at McDonalds. Both told the inspector how much they enjoyed their work and how valued they felt. One service user was going to a local football club’s presentation evening. Service users were able to keep in regular touch with their families and friends, usually by ‘phone, even though all of the 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. There was still no reference to service users preferred form of address on their care plan. Service users said they felt that their rights and wishes were The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 12 respected and that they usually felt valued as individuals, although there were occasions when service users had disagreements between themselves. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 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 standard(s) 19 & 20 Personal support was offered in accordance with resident’s wishes, and in a way that promoted privacy dignity and independence. Service users could, with appropriate risk management strategies in place, administer their own medication. Policies and practices for managing and administering medication were generally in good order. One recommendation regarding medication training remained outstanding. EVIDENCE: The service user case tracked had a health check document dated September 2003. It was noted that this service user did not wish to have staff support in attending to his health needs. There was a risk assessment in place with this regard. This service user visited health professionals unsupported and reported any issues to staff. The service user told the inspector that this was his wish and he did not feel he needed support in this regard. He said he understood the need for staff at Prospect House to be kept up to date with any changes regarding his health and medication. Policies and practices for managing and administering medication were in place. The inspector advised that medication be only recorded in one place, to avoid potential errors. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 14 Accredited training for staff regarding the safe administration of medication had not yet taken place. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 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 standard(s) 22 & 23 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: All the service users spoken to could explain the homes complaints procedure to the inspector. They said they felt comfortable in raising issues of concern with staff. The Commission had received no formal complaints. Policies and practices regarding concerns, complaints and protection were in place. Two staff spoken to by the inspector knew what to do if they had any concerns about service users wellbeing, and had an awareness of the Whistle blowing policy. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 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 standard(s) 24 & 27 Overall the standard of décor and furnishings provided a comfortable and homely environment for service users. Further improvements as identified below would improve the standard of the home. EVIDENCE: The inspector conducted an inspection of the communal areas of the home. It was noted that the carpet at the entrance and staircase of the home was in need of attention. The inspector was advised that there were plans in this year’s budget to replace this carpet. The inspector also noted that paper towel dispensers and paper bins were needed in two of the bathrooms. The home was clean and odour free. An outstanding recommendation regarding the unkempt state of the garden had been resolved, but the inspector noted that the garden/hedge would soon be in need of further attention. There was a lot of litter in the garden/car park area. There were 3 bath/shower rooms available to the service users. There was an outstanding requirement that staff must regularly check and record water temperatures. The inspector saw these records and noted that they were being completed appropriately. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 17 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) 31, 32, & 36 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. Staff should continue to complete their NVQ training. Other appropriate training was also being undertaken. Staff members were receiving regular management support and development meetings. Appropriate staff recruitment records were in place. EVIDENCE: There was a requirement for standard YA31 regarding information, which must be kept at the home about staff members and their employment. The inspector case tracked 2 recent employees who had most of the information required available to the inspector. All other records were in place by the end of the inspection. The inspector was told that 7 out of 21 care staff members had obtained their NVQ level 3. A further 3 were undertaking this training. (Outstanding Recommendation YA32). There was one 37-hour vacancy at the time of the inspection. Interviews were due to take place in the near future. The inspector noted that the staff member’s case tracked had had regular management support and development meetings. (Outstanding Recommendation YA 36). The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 18 Three staff members spoken to confirmed that there was always a senior staff member on duty, and that any issues or concerns were discussed as they arose. The staff also told the inspector about the fire evacuation practices, the complaints and protection of vulnerable adults procedure. The staff also knew where the policies and practices files were and one staff member told of when she had recently looked up a policy to check the action she was taking was correct. Another staff member told of his induction when he started working at the home and said, “it was the best and most thorough induction I’ve ever had”. The inspector noted on the staff members’ case tracked had undertaken a number of appropriate health and safety and autism specific training. The inspector observed a staff changeover. Issues regarding this were discussed with the registered manager. The inspector observed service users and staff having positive and supportive interaction. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 19 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) 37 & 39 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. EVIDENCE: YA 37 was an outstanding recommendation. The registered manager has begun her management element of NVQ4 training, and is expecting to complete this by the end of 2005. 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 not recorded. The registered manager agreed to do this in future. A service users survey was completed by the home in April 2005. The results were about to be published. The Commission received Regulation 26 reports each month. There was a Hyndburn District Annual plan in place completed by the Area Manager. The registered manager and inspector discussed the development of this into one more pertinent to Prospect House. The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 x x x Standard No 11 12 13 The National Autistic Society Prospect House x 3 x Standard No 31 32 33 34 35 Score 3 2 x x x Version 1.20 Page 21 F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc 14 15 16 17 x 3 2 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x x x The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 22 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. 2. Standard YA16 Regulation 12 Requirement Service users prefered form of address must be included in the plan of care. Timescale for action 30th June 2005 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 YA20 Good Practice Recommendations Accredited training should be implemented for the administration of medicines in accordance with National Minimum Standards 20.10. Medication should be recorded in only one place, to avoid potential errors. Ensure that the homes grounds are in keeping with the local community and promote the home in positive way. Ensure that the homes bathrooms and toilet facilities are appropriate to needs. Sufficient numbers of care staff should be engaged in training to ensure compliance with this standard by 2005. The registered manager should complete NVQ4 training. Service user meetings should be recorded. 2. 3. 4. 5. 6. YA24 YA27 YA32 YA37 YA39 The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road Clayton-Le-Moors, Accrington Lancashire. 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 The National Autistic Society Prospect House F57 F07 S30071 Prospect House V214107 280405 Stage 4.doc Version 1.20 Page 24 - 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!