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Inspection on 15/12/06 for Parkbourn (Autism Initiatives)

Also see our care home review for Parkbourn (Autism Initiatives) for more information

This inspection was carried out on 15th December 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service has procedures in place, which aim to ensure that prospective residents needs are fully assessed so that the home can be sure of meeting the person`s needs. The manager was knowledgeable about the process for assessing the needs of prospective residents and admitting new residents to the home.Each of the residents had a care plan, which clearly set out how best to support the individual. A new care-planning format, which has been introduced to the home, was completed for one resident. The plan puts a lot of emphasis on promoting independence by supporting residents to learn and develop new skills, which are realistic and achievable. Residents are supported to make choices and decisions by use of their preferred and most effective way of communication. This includes the use of pictures cards, signs, photographs and symbols. Residents each had structured activity and personal development plans. Case tracking showed that they have been developed around the persons individual needs and aim to develop daily living and social skills. This also showed that residents are involved in household routines and a range of recreational and leisure activities both at home and in the wider community. Records showed that residents have taken part in activities such as discos, board games, snooker, music, TV and trips to the local shops, pubs and cinema. Each of the residents care plan had a good level of information about their routines and the type and level of personal and healthcare support that they need. Residents are encouraged to carry out their own personal care were possible. Case tracking showed that residents are given personal and healthcare support in accordance with their plan of care. Residents benefit from a staff team that have a good understanding of their roles and responsibilities and have the qualities and competencies required for the job. Staff receive a good level of training, which is linked to the aims, and objectives of the home and the needs of the residents. Residents are protected by the homes robust recruitment and selection procedures. Residents and staff benefit from a well run home. The manager showed a good understanding of her role and responsibilities and an enthusiasm for ensuring high standards of care. Staff spoken with were complimentary of the manager and the way she runs the home, the following comments made by staff supported this: "The manager is flexible, supportive and very approachable" "No faults, the manager is brilliant very supportive" "The manager is a very good listener, supportive and professional"

What has improved since the last inspection?

The pre-inspection questionnaire detailed a number of improvements, which have been carried out to the inside of the house since the last inspection. They include the redecoration of two bedrooms and all upstairs bathrooms. These areas were looked at during a tour of the premises. The work has been carried out to a satisfactory standard. Since the last inspection staff have completed protection of vulnerable adults training so that they have a better understanding of what to do following evidence or suspicion of abuse. Staff spoken with appropriately explained what they would do if they thought a resident had been abused. The staff team is made up of twelve support staff and the manager. There is one full time and two part time vacancies at the home. The manager explained that the full time vacancy is expected to be filled in the near future. Details provided in the pre-inspection questionnaire and discussion with the manager showed that the recruitment of staff at the home has improved since the last inspection.

What the care home could do better:

CARE HOME ADULTS 18-65 Parkbourn (Autism Initiatives) 1-4 Parkbourn Maghull Liverpool Merseyside L31 1LH Lead Inspector Mrs Janet Marshall Unannounced Inspection 15 & 28 December 2006 10:00 th th Parkbourn (Autism Initiatives) DS0000005310.V318872.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 Parkbourn (Autism Initiatives) DS0000005310.V318872.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. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkbourn (Autism Initiatives) Address 1-4 Parkbourn Maghull Liverpool Merseyside L31 1LH 0151 527 1009 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) www.peterhouseschool.org Autism Initiatives Mrs Lisa Hankin Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 8 LD Date of last inspection 24th February 2006 Brief Description of the Service: Parkbourn is registered as a care home for eight people who have a learning disability. The service is provided by Autism Initiatives, which is an organisation which specialises in providing services to people who have autism. The property is owned by Riverside Housing Association. The home is located in a residential area in Maghull. The home was originally four domestic sized properties. These have been converted to create one building. The building is divided for practical purposes into two separate living areas. Each living area has a lounge, kitchen and dinning area and two bathrooms. Five members of staff are on duty throughout the day when all of the service users are at the home and there is also one waking and one sleep in staff available throughout the night. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection visit (site visit) at the home this inspection year. The inspection took place over two days for a total of 7 hours. The first day of the inspection was unannounced and there were no residents at home, however discussion took place with a member of staff and a number of care records were examined. Arrangements were made for the inspection to continue over a second day at a time when the residents were at home. The Commission considers 22 standards for Care Homes for Adults (18-65) as Key Standards, which have to be inspected at least once in a 12-month period. All Key standards, which are identified in bold within the main body of the report, were inspected during this inspection. During the site visits the requirements and recommendations from the last inspection report were discussed and checked. A number of them have been met. Those that have not have been raised again as part of this report as well as one requirement identified during this visit. A partial tour of the home was conducted. Care records and other required records were inspected, they included a selection of resident’s care plans, daily diaries, medical notes, and medication and associated records, staff rotas and certificates of health and safety checks. Two residents were “case tracked”. Case tracking means that the Inspector concentrates on the care given and experiences of one or more residents to get an idea of what is like to live at the home and how that person’s needs are being met. Prior to the site visit the commission sent out to the home a pre - inspection questionnaire. The document was completed and returned to the commission, details provided in the document have been used as evidence for this report. The manager and three members of staff were spoken with during the site visit. The nature of the disability of the residents is such that it was not always possible to obtain direct views about their experiences, however, non-verbal communication and general observations took place throughout the visit and have been used towards measuring standards for the purpose of this report. What the service does well: The service has procedures in place, which aim to ensure that prospective residents needs are fully assessed so that the home can be sure of meeting the person’s needs. The manager was knowledgeable about the process for assessing the needs of prospective residents and admitting new residents to the home. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 6 Each of the residents had a care plan, which clearly set out how best to support the individual. A new care-planning format, which has been introduced to the home, was completed for one resident. The plan puts a lot of emphasis on promoting independence by supporting residents to learn and develop new skills, which are realistic and achievable. Residents are supported to make choices and decisions by use of their preferred and most effective way of communication. This includes the use of pictures cards, signs, photographs and symbols. Residents each had structured activity and personal development plans. Case tracking showed that they have been developed around the persons individual needs and aim to develop daily living and social skills. This also showed that residents are involved in household routines and a range of recreational and leisure activities both at home and in the wider community. Records showed that residents have taken part in activities such as discos, board games, snooker, music, TV and trips to the local shops, pubs and cinema. Each of the residents care plan had a good level of information about their routines and the type and level of personal and healthcare support that they need. Residents are encouraged to carry out their own personal care were possible. Case tracking showed that residents are given personal and healthcare support in accordance with their plan of care. Residents benefit from a staff team that have a good understanding of their roles and responsibilities and have the qualities and competencies required for the job. Staff receive a good level of training, which is linked to the aims, and objectives of the home and the needs of the residents. Residents are protected by the homes robust recruitment and selection procedures. Residents and staff benefit from a well run home. The manager showed a good understanding of her role and responsibilities and an enthusiasm for ensuring high standards of care. Staff spoken with were complimentary of the manager and the way she runs the home, the following comments made by staff supported this: “The manager is flexible, supportive and very approachable” “No faults, the manager is brilliant very supportive” “The manager is a very good listener, supportive and professional” What has improved since the last inspection? The pre-inspection questionnaire detailed a number of improvements, which have been carried out to the inside of the house since the last inspection. They include the redecoration of two bedrooms and all upstairs bathrooms. These areas were looked at during a tour of the premises. The work has been carried out to a satisfactory standard. Since the last inspection staff have completed protection of vulnerable adults training so that they have a better understanding of what to do following evidence or suspicion of abuse. Staff spoken with appropriately explained what they would do if they thought a resident had been abused. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 7 The staff team is made up of twelve support staff and the manager. There is one full time and two part time vacancies at the home. The manager explained that the full time vacancy is expected to be filled in the near future. Details provided in the pre-inspection questionnaire and discussion with the manager showed that the recruitment of staff at the home has improved since the last inspection. What they could do better: During the tour of the premises the manager was advised of a number of improvements, which are required to the premises to ensure the comfort and dignity of the residents, they include: • • • • The replacement of carpets in a lounge and the main hallway which are thread bear Repair and re - plastering of walls in and outside the doorway of a residents bedroom. Repair and redecoration of damp patch in downstairs bathroom Some minor repairs to kitchen cupboards. The records for two residents showed gaps were they had not been signed at the appropriate time. A member of staff was advised of this and the need to ensure that all medication records are signed at the appropriate time. this was raised again with the manager on the second day of the inspection. the manager explained that she had investigated the matter. Her findings were that the medication had been administered by a member of staff who failed to sign the medication administration record. The manager evidenced that she has dealt with the matter appropriately. Medication record sheets must be signed at the appropriate time to show that residents have received treatment and medication on time. 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. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 8 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 Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 9 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 good. This judgement has been made using available evidence including a visit to this service. The service has procedures in place, which aim to ensure that prospective residents needs are fully assessed so that the home can be sure of meeting the person’s needs. EVIDENCE: There have been no new residents admitted to the home since the last inspection and there are no vacancies. A number of policies relating to prospective residents were available at the home including, assessing needs and admitting a new resident. The policies included information about how a prosepctive resident is matched to the service and how they are introduced to the home. Information about these processes were also available in the homes statement of purpose. The manager was able to explain in good detail the process that she would follow for prospective residents. The homes needs assessment document which was looked at covers important aspects of the persons life such as personal and healthcare support, relationships, risk management, communication and financial information.. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service encourages residents to make choices and take responsible risks as part of an independent lifestyle. EVIDENCE: Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 11 At the last inspection the manager reported that a new way of care planning was being introduced to the home. A care plan using the new format, which has been completed for one resident, was looked at. The plan identifies particular goals for the resident to aim for, for example choosing an activity or learning a new skill. Pictures are used to assist the resident in meeting the identified goal. Daily records were seen detailing how the staff have supported the resident with their care plan. The new care planning format puts more emphasis on promoting independence by supporting residents to learn and develop new skills, which are realistic and achievable. The manager said that a care plan using the new format would soon be in place for all residents at the home. The organisation has a practice support team, which is made up of speech and language specialists. The manager explained that the team have been providing training for staff about how to use the new plans. All other residents had a care plan. Case tracking showed that care plans have been put together using information from assessments and reviews. They covered important things about the persons life and the support that they need with things such as health and personal care, social support, relationships, management of risk, method of communication, likes and dislikes and behaviour. There were also clear and detailed protocols and guidelines in place to help staff to support residents in difficult situations and with difficult behaviours. Information was available to show that care plans are reviewed and updated at regular intervals. During discussion staff showed a good understanding of care plans, the following comments made by staff supported this: “Care plans are important because they provide essential information about how best to support individuals” “Care plans help us to get to know and understand the person” “Care plans are used to identify and support areas for development which is important to encourage independence”. All the people that live at the home rely on staff for support in many aspects of their lives including help to make choices and decisions. Residents that have limited verbal communication skills are supported to communicate choices using a number of different ways for example by use of pictures, signs, photographs and symbols. Care plans, which were looked at described residents, preferred methods of communication and the help and assistance that they need to make choices and decisions. Pictures boards displaying symbols and pictures were seen around the home. One resident was seen communicating by use of pictures and photographs. The practice support team provide staff at the home with training, advice and guidance on how to communicate effectively with people with special needs. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 12 Risk assessments were part of each residents care plan. They showed that they have been reviewed and updated since the last inspection. Risk assessments have been carried out on tasks and activities, which have been assessed as posing a potential risk to the resident for example travelling, handling money, daily living skills and personal and healthcare. Risk assessments enable residents to take safe risks as part of an independent lifestyle. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given opportunities for personal development and enjoy an active and healthy lifestyle. EVIDENCE: Each persons care plan had a lot of information about the activities that they prefer to take part in during the day, evenings and weekends. From this a weekly timetable for each person has been developed detailing the things that residents are involved in at in and outside of the home. These suggest that residents are given appropriate opportunities for personal development. Pictures, photographs and symbols, which are used to help residents make choices about activities, were displayed around the home. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 14 Discussion with staff and details provided in the pre-inspection questionnaire showed that residents take part in a range of activities both at home and in the local community. Activities include TV, videos, music, snooker, jigsaws, art and craft, discos, trips to the pub and cinema. All residents attend various day care services. On the day of the visit residents were involved in various activities at the home including snooker, listening to music and watching TV. Staff reported that everybody was looking forward to a party that evening to celebrate a residents birthday. Residents bedrooms and shared rooms in the house were equipped with such things as televisions, music systems, beanbags and comfortable chairs. Each persons care plan had information about the support that they need to get out and about and with using public transport such as buses, trains and taxis. The manager reported that residents have regular contact with their family and friends. During the visit one resident was seen opening birthday cards and presents that she had received from her family and friends. Each persons care plan had information about important personal and family relationships and how staff need to support them. Discussion with the manager and staff showed that family and friends are welcomed and they are encouraged in the daily routines and activities at the home. Residents are encouraged to take part in routines at the home as part of an independent lifestyle. For example helping to keep their bedrooms and other shared parts of the home clean and tidy. None of the residents have a key to their rooms or the front door this is because assessments show this as not being safe for the person. This information was recorded in each persons care plan. Residents are encouraged not enter each other’s bedrooms unless they are invited. Staff were seen knocking before entering residents bedrooms. Each unit has a combined kitchen/dining room, which look out onto the back garden. Dinning areas were furnished with several small dining sets. The kitchens were bright and clean. They were equipped with domestic style appliances such as a microwave, washing machine, fridge and freezer. There was plenty of cutlery, pans, cups and dishes which were in good condition There was also plenty of food at the home. Menus at the home were varied and healthy. A member of staff said that a choice of food is available if a resident doesn’t like what is on the menu. Another member of staff said that staff help residents shop for food. Residents were seen having snacks and drinks in between meals. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 15 Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with appropriate personal and healthcare support to ensure their physical and emotional well-being, however the recording of medication does not ensure the full protection of residents. EVIDENCE: Each of the residents care plan had information about bout routines and the type and level of personal and healthcare support that they need. Residents are encouraged to carry out their own personal care were possible. Case tracking showed that residents are given support in accordance with their plan of care. Staff spoken with showed a good understanding and the importance of ensuring residents privacy, dignity and independence. The following comments made by staff supported this: “I encourage residents to carry out their own personal care” “I make sure doors are shut “ “I always knock before entering bedrooms and bathrooms” “I am always polite to residents” Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 17 During the inspection the manager and staff were seen treating residents with respect, they spoke to them in a polite way and responded to them positively. Each of the residents care plan had a section about their healthcare needs and information detailing how best to support them. Records within this section showed that residents are offered minimum annual checks and that there health is regularly reviewed and monitored and dealt with in a respectful way. As well as visits to primary healthcare services such as dentist, opticians and doctors residents are also supported to attend specialist services if they need to. Records detailing the visits were available in good detail as was information about specialist health care needs and requirements. Information given in the pre-inspection questionaire and records that were looked at showed during the visit that residents are registered with a local GP and use other healthcare services in the local community. A weekly health check record was available for each of the residents. The records for two residents were looked at. Records included monitoring of general health and personal care, such as weight and the care of hair and nails. The records, which were seen, were detailed and up to date. The health section of care plans provided good information about how residents with communication difficulties communicate when they are unwell or in pain. A record of medication received and leaving the home was seen. On the first day of the inspection medication and medication administration records were examined. Medication was stored securly. The records for two residents showed gaps were they had not been signed at the appropriate time. A member of staff was advised of this and the need to ensure that all medication records are signed at the appropriate time. this was raised again with the manager on the second day of the inspection. the manager explained that she had investigated the matter. Her findings were that the medication had been administered by a member of staff who failed to sign the medication administration record. The manager evidenced that she has adressed the matter appropriately. Medication record sheets must be signed at the appropriate time to show that residents have received treatment and medication on time. Details provided with the pre- inspection questionaire showed that the home has available policies and procedures for the safe handling and administration of medication. The manager said that medication is only administered by staff that have completed medication awareness training. Records that were seen evidenced this. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 18 Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 19 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. Available at the home are policies and procedures, which aim to ensure that residents are listened to and protected from abuse, neglect and harm. EVIDENCE: There has been no complaints received by the Commission about the home since the last inspection. Information provided in the pre-inspection questionnaire and discussion with the manager and staff showed that there have been no complaints made at the home in the last 12 months. There was a complaints procedure on display at the home. It was available in written and picture format. The manager said that residents friends and family also have the information that they need to make a complaint if they wish to. Staff spoken with said that would complain if needed to. The following comments supported this: “I know about the complaints procedure, I would complain if I needed to” “I would definitly complain if I needed to” “I am confidient about complaining and I know it would be dealt with in the right way”. Discussion with staff and details provided in the pre-inspection questionaire showed that staff have received protection of vulnerable adults training. During discussion staff ahowed a good understanding about what they need to do if they witnessed or suspected abuse of a resident. A copy of the local authorities protection of vulnerable adults procedure was avaialbe at the home. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 20 Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 21 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. All parts of the home were clean and tidy and most parts were comfortable and safe, however the comfort and dignity of residents is undermined by some parts of the home that require attention. EVIDENCE: Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 22 The home is located in a residential area in Maghull. The house was originally four houses and it provides a good amount of living space. The home is divided into two separate ‘units’ each of which has a domestic sized kitchen / diner and sitting room. The home has a third lounge area, which can be used, as a private room for visitors and there is also a music/‘chill out’ room. Communal areas easily meet the standard for space. The home has a very large back garden, which is easily accessible to residents. One resident was sweeping up leaves in the garden during the inspection visit. The resident appeared to be happy doing this. The manager reported that residents use the garden mostly in the summer months when they sit out and have barbeques. The pre-inspection questionnaire detailed a number of improvements, which have been carried out to the inside of the house since the last inspection. They include the redecoration of two bedrooms and all upstairs bathrooms. These areas were looked at during a tour of the premises. The work has been carried out to a satisfactory standard. During the tour of the premises the manager was advised of a number of other improvements, which are required to the premises to ensure the comfort and dignity of the residents, they include: • • • • The replacement of carpets in a lounge and the main hallway which are thread bear Repair and re - plastering of walls in and outside the doorway of a residents bedroom. Repair and redecoration of damp patch in downstairs bathroom Some minor repairs to kitchen cupboards. All parts of the home were clean and tidy at the time of the visit. Detailed in the pre-inspection questionnaire and available at the home were a number of policies and procedures, which aim to ensure a clean and safe environment, they include infection control and disposal of soiled waste. The home had a good supply of disposal protective gloves and aprons which staff use appropriately to ensure the health and safety of them and residents. The home employs a member of staff to carry out domestic duties. The member of staff was spoken with during the inspection and said that there are always plenty of cleaning materials available at the home. She showed a good understanding of policies and procedures relating to the handling and safe keeping of hazardous cleaning substances. All cleaning materials and equipment was locked away safely to ensure the safety of residents. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 23 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. Residents benefit from a staff team that have a good understanding of their roles and responsibilities and have the qualities and competencies required for the job. EVIDENCE: The staff team is made up of twelve support staff and the manager. There is one full time and two part time vacancies at the home. The manager explained that the full time vacancy is expected to be filled in the near future. details provided in the pre-inspection questionnaire and discussion with the manager showed that the recruitment of staff at the home has improved since the last inspection. Three members of staff were interviewed during the inspection. They all showed a good understanding of their roles and responsibilities and were very knowledgeable about the needs of the residents. Examination of records and discussion with the manager and staff evidenced that staff complete training to update their knowledge and skills. The training is linked to the aims and objectives of the home and the needs of the residents. Staff confirmed that they have completed training in the following Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 24 subjects: Protection of vulnerable adults, health and safety, fire awareness and first aid. The organisation has a practice support team, which is made up of speech and language specialists. The team provide staff at the home with training, advice and guidance on a number of subjects including, autism and how to communicate effectively with people with special needs. The pre-inspection questionnaire and staff training records held at the home evidenced that at least half of the staff team have achieved or are currently undertaking a National Vocational Qualification in care level 2 or above. A senior member of staff who is an assessor for National Vocational Qualifications and has supported a number of staff to complete the award. Staff made the following comments about training: “We get a lot of training” “I enjoy the training” “The manager is arranging training for me which is relevant to my work” “The training is very good, it helps me understand things better” Examination of records and discussion with the manager evidenced that staff are formally supervised at the required intervals. Staff files included supervision notes, which are written records of formal supervision, which take place between the worker and a member of the management team. Topics of discussions include staff role and responsibilities, training needs and policies and procedures. The pre-inspection questionnaire detailed a number of policies and procedures relating to the recruitment of staff they include equal opportunities and recruitment and selection. The pre-inspection questionnaire shows that four staff have started work at the home since the last inspection. Personnel records for two new staff were examined. They showed that the home operates a robust recruitment and selection process. Recruitment records required by regulation were available in staff files that were seen. Records included, two references, fully completed application forms, record of interviews and details of criminal record beuarea (CRB) checks. Records showed that staff had undertaken induction training during the first part of their employment. During discussion a member of staff confirmed that they took part in an induction programme when they first started work at the home. The member of staff said, “the induction was very good, detailed and useful”. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 25 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 home is managed well to the benefit of the residents and staff. EVIDENCE: The registration certificate and insurance certificates showing up to date information were clearly displayed at the home. The second day of the inspection was carried out with the manager Lisa Hankin. The manager has a National Vocational Qualification level 4 in management, and undertakes periodic training to maintain and update her knowledge and skills. She showed a good understanding of her role as registered manager of the home and a commitment to ensuring high standards of care. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 26 Information detailed in the pre-inspection questionnaire and examination of a selection of records during the inspection showed that records required by regulation are available, up to date and accurate. Staff spoken with were complimentary of the manager and the way she runs the home, the following comments made by staff supported this: “The manager is flexible, supportive and very approachable” “No faults, the manager is brilliant very supportive” “The manager is a very good listener, supportive and professional” Also As part of the homes quality assurance process and in accordance with Regulation 26 of the Care Homes Regulations a representative for the home visits the premises monthly. They talk to residents and staff, check records and inspect the environment. It is important that this is done to check the standard of care in the home. Following the visit a report detailing the visit is written. Records show that the visits and reports are being carried out each month as required. The health safety and welfare of residents are well protected this was supported by a comprehensive set of policies and procedures, which were detailed in the pre-inspection questionnaire and available at the home. Information provided in the pre-inspection questionnaire and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Staff spoken with confirmed that they hear the fire alarm system regularly being tested. Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 27 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 3 32 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 4 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 2 X 4 X 3 X X 3 X Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 (2) Requirement All medication records must be maintained accurately. (This was a previous inspection requirement) The registered person must ensure repairs and redecoration of parts of the home identified. Timescale for action 28/01/07 3. YA24 23 (2) (d) 28/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Parkbourn (Autism Initiatives) DS0000005310.V318872.R01.S.doc Version 5.2 Page 30 - 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. 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