Inspection on 26/06/06 for St Winnow

This inspection was carried out on 26th June 2006.

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

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

Other inspections for this house

St Winnow 31/01/06

St Winnow 26/07/05

St Winnow 26/01/05

St Winnow 22/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 St Winnow Rocky Park Road Plymstock Plymouth Devon PL9 7DQ Lead Inspector Tina Maddison Unannounced Inspection 26th June 2006 10:00 St Winnow DS0000054152.V300441.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 St Winnow DS0000054152.V300441.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. St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Winnow Address Rocky Park Road Plymstock Plymouth Devon PL9 7DQ 01803 882296 01803 882296 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) Peninsula Autism Services & Support Limited Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: The Registered provider for St Winnow is Peninsula Autism Services and Support (PASS) a Ltd company managed by a board of directors. The organisation states that it concentrates solely on providing care services to those with Autistic Spectrum Disorders. St Winnow has been Registered since February 2004, and has three registered beds. Residential care and support is provided for younger adults with Autism and Aspergers syndrome. The house is a large, attractive, detached property, situated in a quiet cul-de-sac in the Plymstock area of Plymouth. The home is close to all local amenities and is within walking distance of the bus route into Plymouth. Service users have been assessed as requiring support to access opportunities in the community and to attend to some daily living skills. St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. Two service users were spoken with throughout the inspection and in private. Two members of the care staff and the Manager took part in discussions with the inspector, again throughout the inspection and in private. Three service user surveys were returned. A variety of documents and records were examined. A tour of the building was conducted and two service users bedrooms were shown to the Inspector by the relevant service users. A pre inspection questionnaire had been completed and returned by the Manager prior to the inspection. What the service does well: St Winnow provides an individual person centred service within a safe and comfortable environment, that promotes independence and the development of daily living skills, and aims to increase the service users ability to make choices. The homes recording and care planning process ensure that service users care needs are clearly understood, and are easily accessible to those providing the care. The home exceeds the standard in this area. Risks and choices are appropriately balanced and the homes risk assessment process ensures that safety in all areas is considered and necessary advice given. The location of the home promotes independence, as it is near to local facilities and a bus route to the city centre. This enables service users to access these facilities with minimal support. One service user is supported in his university course with appropriate support from staff at St Winnow, and this is an example of how the staff and management succeed in maximising the potential of service users living at the home. The staff group are well trained and supported, and during the inspection have demonstrated a good level of understanding of the service users care needs and emotional needs. St Winnow DS0000054152.V300441.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. St Winnow DS0000054152.V300441.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 St Winnow DS0000054152.V300441.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): 2,3,4,5. Prospective service users can be sure that St Winnow will be able to meet their care needs. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection there has been one new service user admitted to the home. Records and documents and discussion with the Manager evidenced that a pre admission assessment was carried out for this prospective service user by the Manager of St Winnow and the Director of the company. After gathering information from the service user, family of the service user and involved health and social care professionals, a transition plan had been formulated. There is an opportunity for a prospective service user to “test drive” the home before a decision to move there is made, and several visits can be made prior to admission. There is a written admissions procedure, and this includes a template for the pre admission assessment, visits and interim care plan. Care is taken to ensure that the prospective service user will be compatible with the other service users in the home. All service users had a signed contract in place. A statement of purpose is available and a service users guide that describes the home and the facilities and services provided. St Winnow DS0000054152.V300441.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): 6,7,8,9 Service users are enabled to make choices and have control over their lives. They are consulted and participate in all aspects of life in the home. Risk management and individual choices are appropriately balanced. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user had a very comprehensive care plan and risk assessment in place. There was evidence that the Manager is currently updating all of the care plans. Three care plans were examined during the inspection and evidenced that these documents were detailed and comprehensively described each service users care needs and how these needs would be met at the home. Discussion with service users confirmed that they are consulted regarding information on the care plans, and were aware that they could see their care plans at any time, and where they were kept. Guidelines and procedures were in place to give guidelines and procedures to the staff regarding how to manage behaviours that challenged the service and how to defuse potentially challenging situations. The quality of these guidelines and care plans exceed the national minimum standards. St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 10 Risk assessments were found to be comprehensive and gave clear guidelines for staff to follow. Any restrictions on freedom were explained and agreed with the service users family and care manager and this was documented. Service users are encouraged to manage their own finances and one service user confirmed that they are encouraged to budget and offered guidance and support to manage their own money. This information is documented in care plans. Financial records were found to be in good order. Service users confirmed that they are included in the day to day running of the home. They contribute to the cooking and shopping for meals, and are encouraged to keep their own rooms clean and contribute to keeping the communal areas clean and tidy. One service user runs a music session at the other home in the group. There was documented evidence of service user meetings and attendance at advocacy groups. St Winnow DS0000054152.V300441.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): 11,12,13,14,15,16,17. Service users are encouraged and supported to participate in appropriate work, educational and leisure activities. Service users are encouraged to have a healthy diet and enjoy the meals at St Winnow. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information in care plans and discussions with service users confirmed that they are encouraged and supported to live as full a life as they wish and have opportunities for personal development. Service users plan their own daily routines and attend to most daily tasks independently. Each service user has an activities timetable, which includes a range of planned work/educational activities and leisure time. One service user attends Plymouth University and possible employment opportunities are being actively sought for another service user. The home is conveniently located for the bus route into the town. Care plans and risk assessments included agreed guidelines for staff about how to support service users with their social, family and leisure arrangements. Contacts with family and friends is encouraged, and any restrictions on freedom are agreed with service users, and documented and reviewed. One service user St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 12 commented that staff were always available to offer support with relationship difficulties and difficult situations. Service users said that they liked the meals at St Winnow, and with the support of staff chose the meals, and helped with the shopping and cooking of the food. St Winnow DS0000054152.V300441.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): 18,19,20 Service users receive personal support in the way they prefer and require. Service users physical and emotional needs are met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information regarding personal care needs of the service users was contained in their care plans. All of the service users currently living in the home are able to attend to their daily personal care needs independently, and just need prompting and motivating to undertake these. Service users confirmed that staff respect their privacy and times for getting up and going to bed were flexible and based on individual choice. Service users access health services locally, and are able to choose the location of their Doctor. Care plans examined confirmed that appropriate specialist health services are accessed when necessary. Medication is stored appropriately in a locked metal cabinet, and staff have received medication training. Medication dispensing sheets were appropriately and accurately completed. Staff are trained to manage any behaviour that challenges the service, and the home has a no restraint policy, and distraction techniques are used to defuse any potential situations. St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 14 During the inspection, staff were observed to interact with the service users in a positive and enabling manner, that evidenced the positive relationships between the staff and service users. St Winnow DS0000054152.V300441.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): 22,23 Service users at St Winnow are protected from abuse, neglect and self harm. They can feel confident that their complaints and views are listened to and acted upon. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission for Social Care Inspection has not received any complaints regarding this service since the last inspection. St Winnow has a written complaints procedure, and documentation confirmed that this has been used appropriately by the home when investigating any complaints made direct to the provider. Service users spoken to confirmed that they were aware of the complaints procedure, had opportunities to raise any concerns that they had, and felt that their concerns would be listened to. The home has an adult protection procedure in place, as well as copies of the local alerters guide. All staff have received Protection of Vulnerable Adults training, and staff spoken with were aware of the issues concerning the protection of vulnerable adults. Individual guidelines were in place regarding how the staff should manage any difficult or challenging situations. Staff spoken with were very clear about how they manage and understand behaviour from service users that challenge the service. Staff added that because there is a consistent staff team who know and understand the service users needs very well, they can recognise the early stage of any problems and deal with them appropriately. St Winnow DS0000054152.V300441.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): 24,25,26,27,28,30. St Winnow offers a homely, comfortable and safe environment that is clean and hygienic. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: St Winnow is a large detached house that is situated in a pleasant residential area in a quiet cul de sac near to local shops and community facilities. It is adjacent to a sports field and sports facilities. Building work has started on an extension to provide two additional en suite bedrooms. This work is intended to be completed by October 2006. One of the current service users is moving to one of the new bedrooms, and said that they were looking forward to moving, and the building work was not causing any disruption to the service users. Two service users bedrooms were inspected, and reflected individual tastes and hobbies. All bedrooms have locks fitted. One service user commented on a small area of damp on his bedroom wall, but was aware that they are moving to the new bedroom extension shortly, and this will be repaired when he has moved. There is a large kitchen area with sufficient space and facilities for service users to store and prepare meals independently. St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 17 A tour of the home including two bedrooms evidenced that the home is clean and hygienic throughout. Toilets and the bathroom were hygienic and contained clean towels. The upstairs bathroom was found to be fitted with an inappropriate lock, that was not able to be overridden in an emergency, but since the completion of the site visit, the Manager has informed the Inspector that an appropriate lock has been fitted. St Winnow DS0000054152.V300441.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): 31,32,33,34,35,36 Service users are supported by a competent and qualified staff team, who are appropriately trained and are well supported. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All staff had clearly defined job descriptions and from discussions with staff it was clear that they understood their roles and responsibilities. Service users commented at the inspection that they felt the staff were supportive and helpful and always willing to help. Staff meetings are held once per month and minutes of these meetings were seen at the inspection. Supervision takes place every six to eight weeks and supervision notes are taken. From staff records it was apparent that there is a low turnover of staff at the home, therefore a consistent approach is maintained. Training is offered, according to staff records, by a mix of in house and external providers. One team leader is responsible for organising the training and keeping a record of training received. Training courses offered include health and safety, first aid, low arousal techniques, food hygiene, fire prevention training and NVQ training. All staff spoken with were very aware of the individual needs of the service users, and how support should be provided. Staff were observed to have a good rapport with the service users, with humour used appropriately to encourage service users to complete a task. Staff said that service users are St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 19 able to plan their day and attend to many daily tasks with minimal support. The role of staff is to be aware of each individuals needs, build up a good relationship and to provide reassurance, support and guidance as and when necessary. The Manager confirmed that service users have been assessed as requiring 1:1 staffing levels at different times of the day and for some activities outside of the home. The staff rota and levels of staffing during the inspection confirmed that appropriate numbers of care staff are on duty at all times. There is also an on call rota and guidelines for staff when working alone. Staff files inspected confirmed that the home has a robust recruitment procedure and records were seen for three members of staff and evidenced all required records and checks were in place. St Winnow DS0000054152.V300441.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): 37,38,39,42,43. St Winnow is a well run home that ensures that the health, safety and welfare of service users are promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: At the time of the inspection, the acting Managers application to become the Registered Manager was being processed. Mr James Cripps (Director of Services) has been overseeing the day to day management of the home, along with the staff team, which includes a Deputy team Manager, senior team leader and two further team leaders. Staff spoken with were aware of the homes policies and procedures and arrangements for the day to day running of the home. There appears to be an open and supportive style of management operating in the home. All documentation relating to service users was up to date and accurate. Records relating to health and safety issues, such as risk assessments the St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 21 accident/incident book and fire prevention log book were available and up to date. The documentation to evidence the servicing of the boiler could not be found and the manager agreed to forward it to the Inspector. In October 2005, the home was awarded the Investors in people award. A formal quality assurance system has yet to be developed. Currently informal feedback regarding the service is sought through house meetings, parents evenings and social work reviews. St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 3 4 3 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 3 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 2 3 x 3 3 St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA39 Good Practice Recommendations The home should develop a quality assurance system that measures success in achieving the aims, objectives and statement of purpose of the home. St Winnow DS0000054152.V300441.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 St Winnow DS0000054152.V300441.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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