Inspection on 31/01/06 for St Winnow

This inspection was carried out on 31st January 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 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.

Other inspections for this house

St Winnow 26/06/06

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 Wendy Baines Unannounced Inspection 31st January 2006 10:00 St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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.V263968.R01.S.doc Version 5.1 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.V263968.R01.S.doc Version 5.1 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.V263968.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 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 Adults with Autistic Spectrum Disorders. St Winnow has been Registered since February 2004, and currently has three Registered beds. The house is a large, attractive, detached property, situated in a quite cul-de-sac in the Plymstock area of Plymouth. The home is close to all local amenities and is within walking distance of the main bus route into Plymouth. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and took place on the 31/01/06 between 10am and 2pm. A Pre-inspection questionnaire had been completed and returned to CSCI prior to the inspection and this contained current details relating to the home, service users and staff. The Acting Manager was present throughout the inspection and the inspector was also able to meet and talk to staff on duty. Service users were at home and met with the inspector throughout the day and in private. A tour of the premises took place and a sample of records relating to the home, staff and service users were inspected. What the service does well: What has improved since the last inspection? St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 6 The Registered Provider has considered the current and future needs of service users when making plans for changes to the environment. As part of this possible change the staff have considered the involvement and views of service users. 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.V263968.R01.S.doc Version 5.1 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.V263968.R01.S.doc Version 5.1 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): 1.5. Current and prospective service users are provided with sufficient information to make an informed choice about where they live. EVIDENCE: A Statement of Purpose is available to current and prospective service users, which describes the home and the services provided. The current service users have lived in the home since it opened and there have been no new admissions. The home has a written admissions procedure and this includes a Preadmission assessment, visits and interim care plan. Local Authority contracts are available within service users files and a Statement of Terms and Conditions between the home and service user has been completed. This information had been signed and dated by both parties. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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. The home has a clear and consistent care planning system in place to provide staff with the information required to satisfactorily meet service users needs. Service users are enabled to make choices and have control over their lives. EVIDENCE: Each service user has a care plan and risk assessments, which are regularly reviewed. Any restrictions on choice or freedom are agreed with the service user, documented and reviewed. Discussion with service users confirmed that changes are made to care plans with their agreement and involvement. Care plans were seen during the inspection and these were found to be in good order with details of all care needs and clear guidelines for staff. Staff were able to demonstrate a good understanding of service users needs and said that they use this knowledge to encourage and support each individual to make decisions and choices about their lifestyle. Service users spoken to said that they are able to live an independent lifestyle at St Winnow and are involved in discussions regarding the home and their care. It was evident that service users had been involved in discussions relating to possible changes within the home and consideration had been given to the support each individual would need during this time. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 10 Risk assessments confirmed that service users are supported to take risks as part of an independent lifestyle. Risk assessments and guidelines for staff included ways of supporting service users and offering them advice and guidance about how to keep safe. Care plans and discussion with the manager confirmed that the home offers support and guidance regarding finances dependent on the skills and needs of each individual. The reasons for and type of support offered is documented and is reviewed as part of the care plan process. All records relating to service users finances were found to be in good order. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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 Service users can learn life skills, attend work/educational opportunities, participate in community leisure activities and maintain friendships with family and friends. 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. Staff reinforce to service users that they are available to support them, and offer advice and guidance when requested. Each service user has an activities timetable, which includes a range of planned work/educational activities and leisure time. One service user said that staff were offering advice and support to explore work opportunities and this was documented within the service user plan. Service users are able to access local community facilities including shops, pubs and sports centres. The home is within easy reach of the main bus route for those who wish to go further, and to visit family and friends. Care plans and risk assessments included agreed guidelines for staff about how to support service users with their social, leisure arrangements. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 12 Contacts with family and friends is encouraged and any restrictions are agreed with service users, documented and reviewed. One service user recognised that some support was required with issues relating to friendships, and said that ‘ staff were always available to offer support with difficult situations’ St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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. Information within service user files ensures that staff are aware of personal and healthcare needs and how this support should be delivered. EVIDENCE: Service user plans provided information about personal, emotional, and health care needs. Service users currently living in the home are able to attend to daily personal care needs independently and will ask staff for support when required. Service users spoken to said that staff were respectful of their privacy and times for getting up and going to bed were flexible and based on individual choice. Although service users live together there is much consideration given to respecting each individual’s personality and interests. Staff spoken to said that these differences are considered in relation to all aspects of the individual’s care and support. Service users have access to local healthcare services and the home liaises with specialist agencies when required. This was confirmed within daily records and service user plans. One service user said that ‘ the staff team had recently been more consistent, which ensures that any problems a service user may be having is recognised and the correct support can be offered’ St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 14 St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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 are protected form abuse, neglect and self- harm. Service users are provided with opportunities to express their views and opinions and can feel confident that the Registered Provider will deal with any complaints and concerns. EVIDENCE: The Commission For Social Care Inspection has not received any complaints regarding the home since the last inspection. The home 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 said that they were aware of the complaints procedure, had opportunities to raise any issues and felt their concerns would be listened to and acted on. There is an Adult Protection procedure in place as well as copies of the local Alerters guide. The acting manager said that all staff receive regular in-house POVA training (Protection of vulnerable adults) but have not completed the local multi-agency adult protection training course. Individual guidelines were in place to advise staff of how to deal with difficult situations and episodes of challenging behaviour, and appropriate and regular training opportunities for all staff are provided. Staff spoken to demonstrated a good understanding of service users needs and said that this knowledge of the individual ensures that any problems are recognised and dealt with promptly. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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): 24.28.30. The home is sufficient in size and has adequate communal and private facilities for the number and needs of current service users. Service users have been supported by staff to make the house their home and are offered guidance and support to attend to daily tasks. EVIDENCE: St Winnow is a large, bright attractive property, which is situated at the end of a quiet cul-de-sac near to local shops and other facilities. The current service users have been able to organise the rooms to meet their individual needs and to allow for sufficient communal and private space. Service users bedrooms were not inspected on this occasion, but staff said that service users attend to the cleaning and organising of their own rooms with help from staff if requested. Throughout the house there were a number of personal belongings, which reflected the interests and personalities of those living in the home. There is a large kitchen area with sufficient space and facilities for service users to store and prepare meals independently. The kitchen and all parts of the house were found to be clean and hygienic. The acting manager said that the provider was awaiting planning permission to extend the property, which would include additional bedrooms and a St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 17 communal sitting room. It was evident through discussion with staff that the long- term needs of service users had been considered when planning these changes. The acting manager said that as the plans progress service users would be involved and consulted on issues, which may affect them. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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. Staff have a good understanding of their role and the individual needs of service users. This is evident form the positive relationships, which have been formed between the staff and service users. Recruitment procedures are robust and there are sufficient formal and informal systems in place to ensure staff receive the support required to fulfil their role. EVIDENCE: On the day of the inspection there was a staff meeting taking place in the home. The Inspector was able to meet with several members of the team as well as those on duty. All staff spoken to were very aware of the individual needs of service users and how support should be provided. Staff had a good rapport with service users and were observed responding promptly and sensitively to requests. Staff said that service users are 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 when necessary. The acting 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 the home. The staff rota confirmed these arrangements. There is an on-call rota and guidelines for staff when working alone. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 19 Staff files inspected confirmed that the home has a robust recruitment procedure and records were seen for a recent member of staff appointed to the team. Training records were provided for 2005/06 and these confirmed that all staff complete statutory Health and Safety training which includes; First Aid, Infection control, Manual Handling, Food Hygiene and Fire Safety. This training is available for all staff and is regularly updated. In addition staff undertake a range of training opportunities relevant to the home and individual needs of service users, these include; Autism/Aspergers awareness, studio 3(low arousal techniques) Person Centred Planning, POVA and Total communication. All staff are registered to completed NVQ training and six of the current nine staff team have completed NVQ level 2 or above in care. Formal supervision sessions take place on a monthly basis and a timetable was available to confirm these arrangements. In addition the home has a daily communication book and shift handover meeting. Each month staff attend core group meetings to discuss individual service users and regular house meetings are arranged. One staff member who works night shifts for the home said that the regular arrangements for 1:1 supervision are crucial particularly when working a night duty. The home has a clear system for recording any incidents in the home and information is sent to CSCI as required. As part of the incident recording process staff are offered the opportunity to discuss and receive support regarding what has occurred and this information is recorded. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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): 37.38.41.42. In the absence of a Registered Manager the Registered Provider has made sufficient interim arrangements to ensure the home is run effectively. EVIDENCE: At the time of the inspection the home did not have a Registered Manager. The provider has advised the Commission for Social Care of this on-going situation and provided details as requested of arrangements for managing the home during this time. 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. The Registered Provider is aware that they must submit an application to register a Manager as agreed in the Requirements. Mr Cripps was available throughout the inspection and all staff spoken to were aware of procedures and arrangements for the day-to-day running of the home. Staff spoken to said that the current acting manager was very supportive and available to support staff when required. It was felt that this open and St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 Page 21 supportive management approach has ensured the consistency of the staff team, which ultimately benefits service users. This view was reflected in discussions with service users who commented that the small, consisted staff team ensured that they had help when it was needed. All documentation relating to service users was up to date and accurate. Records relating to health and safety issues, such as risk assessments, the accident/incident book and fire logbook were available and up to date. St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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 3 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 N/A 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 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 2 3 X X 3 3 X St Winnow DS0000054152.V263968.R01.S.doc Version 5.1 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. 1 Standard YA37YA37 Regulation 8 Requirement The Registered Provider for St Winnow must appoint a Registered Manager. When this appointment has been confirmed the Registered Provider must advise CSCI by completing a Registered Managers Application form. Timescale for action 30/04/06 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 YA23 Good Practice Recommendations The Registered Provider should ensure that staff are aware of how the homes Adult Protection procedures relate to local guidance. The Registered Manager should attend local multi-agency training. 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