Inspection on 05/04/07 for Stonepit Close (42-44)

This inspection was carried out on 5th April 2007.

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

Stonepit Close (42-44) 03/11/05

Stonepit Close (42-44) 19/07/05

Stonepit Close (42-44) 24/11/04

Stonepit Close (42-44) 09/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Stonepit Close (42-44) 42-44 Stonepit Close Godalming Surrey GU7 2LS Lead Inspector Sarah MacLennan Unannounced Inspection 5th April 2007 09:00 Stonepit Close (42-44) DS0000013501.V333399.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 Stonepit Close (42-44) DS0000013501.V333399.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. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonepit Close (42-44) Address 42-44 Stonepit Close Godalming Surrey GU7 2LS 01483 861066 01483 861055 vannessahalfacre@nas.org.uk Vanessahalfacre@nas.org.uk National Autistic Society 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) Vanessa Halfacre Care Home 10 Category(ies) of Learning disability (10), Sensory impairment (1) registration, with number of places Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the category/categories `LD` (LEARNING DISABILITIES), one of whom maybe in the category `SI` (Sensory Impairment) The age/age range of the persons to be accommodated will be 18-50 YEARS 3rd November 2005 Date of last inspection Brief Description of the Service: 42-44 Stonepit Close is a purpose built residential home for up to ten young adults with autism or Aspergers syndrome. The service is operated by the National Autistic Society, and is situated in a residential area approximately one mile from Godalming town centre. The accommodation consists of two houses, known as Holly House and Jan Norton House. The houses have separate entrances, but are connected by an office and recreation room (hobby room). Each service user has a single bedroom. With the exception of one bedroom, which is on the ground floor with en-suite facilities, the bedrooms are all on the first floor. The home does not have a lift therefore; service users need to be ambulant and able to negotiate the stairs. All bedrooms have hand washbasins. Each house has a domestic style kitchen and adjoining pantry, a utility room with domestic laundry facilities, a communal lounge, quiet lounge and conservatory and dining room. Holly house has a separate shower and bath; Jan Norton has two baths. Both houses have ample toilet facilities. There are payphone facilities. Each of the houses has an enclosed garden and the home has three vehicles. There is limited street parking available. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit formed part of the key inspection process and took place over 5 hours commencing at 09:00 and ending at 14:00. Sarah MacLennan, Regulation Inspector, carried out the visit. Mrs Vanessa Halfacre, the Registered Manager, was present throughout the inspection. As part of the inspection process a partial tour of the premises took place. Various written records were examined, including two care plans and service user assessments, three staff personnel files, samples of staff training records, the complaints record, the medication storage facilities and a sample of the medication administration records. The inspector spoke to a number of service users. Some staff members were spoken to during the course of the inspection. Some of the comments made to the inspector are quoted within this report. The inspector would like to thank the staff and service users for their time, assistance, and hospitality during the visit. What the service does well: The home has an extensive assessment and transition process in place for the admission of new service users. Integration into the existing service user group is paramount during the assessment process. Service users have comprehensive care plans in place that cover all aspects of personal and social support and healthcare needs. All aspects of the care plans include detailed behavioural guidelines and triggers, communication methods and pictures and photographs were appropriate. The provision of activities enables service users to lead a full and active life. Service users are encouraged to be as independent as possible and to make their own choices. Staff were observed to treat the service users in a calm and confident manner and with respect. Staff spoken to were aware of the guidance and support required by the service users. The home had a robust policy for the administration of medication especially in view of the service users challenging needs and behaviours. Staff informed the inspector that service users had a sense of ownership of their home, and that their personal space reflected their individual lifestyles. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 6 Staff morale appeared high and the workforce dedicated. All staff spoken to stated how much they enjoyed their jobs. One staff member stated that ‘there is a brilliant atmosphere, all the staff get along’ The registered manager demonstrated a thorough knowledge and awareness of the service users needs, a sound grasp of her managerial responsibilities, regulations and legal requirements. All staff spoke highly of the registered manager and service users were seen to interact readily with her. An open and inclusive atmosphere was evident within the home. 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. The summary of this inspection report can be made available in other formats on request. Stonepit Close (42-44) DS0000013501.V333399.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 Stonepit Close (42-44) DS0000013501.V333399.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has an up to date statement of purpose. Service users are assessed prior to admission to the home to ensure that the home can meet their needs. EVIDENCE: The inspector sampled the homes statement of purpose. The previous requirement that the home produces an up to date Statement of Purpose had been met. The inspector discussed pre-admission assessments with the manager and the service coordinator. The process to assess a service user begins with a referral form being sent to the National Autistic Society. The care manager, parents, carers and the service user, then complete a comprehensive assessment form. Following this the registered manager and another staff member make an initial visit to the service user. Two staff members always conduct this initial visit in order to gain a wider insight into the service user. Integration into the existing service user group is paramount during the assessment process. A transition process is then set with specific timescales that could last a period of a few months and Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 9 includes various social meetings with the existing service users. Several discussions take place at service user and staff meetings to ensure compatibility of the service user group. During the inspection the registered manager and the service coordinator were making arrangements to conduct an initial visit to a prospective service user. Stonepit Close (42-44) DS0000013501.V333399.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): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Comprehensive care plans are in place for service users. Service users are encouraged to make decisions. Risks to health and safety of service users are assessed. EVIDENCE: Two service users care plans and daily statements were looked at. The service users had comprehensive care plans that covered all aspects of personal and social support and healthcare needs. All aspects of the care plans included detailed behavioural guidelines and triggers, communication methods and pictures and photographs were appropriate. All staff spoken to were aware of the specific needs of the service users and the need for consistency. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 11 Conversation with staff and service users evidenced that the service users are encouraged to be as independent as possible and to make their own choices, such interactions were observed. Many of the service users are non-verbal, but those able to speak with the inspector said they could choose things. Service user comments included ‘sometimes I choose stew and dumplings for dinner’ ‘I chose where to go on holiday’ and ‘I’m going shopping today, because I like shopping’. Staff were able to show the inspector detailed pictures and photographs which were used to enable the non-verbal service users to make decisions. The specific methods that service users use were clearly detailed within their care plans. Discussion with staff evidenced their familiarity with these methods. Samples of comprehensive risk assessments were seen. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provision of activities enables service users to lead a full and active life. Service users participate in the local community. Contact with family is unrestricted. Service users rights and responsibilities are promoted within the home. Meals are well balanced, varied and chosen by the service users. EVIDENCE: From examination of the service user recorded and discussion with staff it was apparent that service users are encouraged and enabled to live a full life and to partake in age related activities such as having meals out, attending college of further education, art classes, picnics, canoeing, rock-climbing and going Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 13 horse racing at Ascot. Service users spoken to gave examples of activities that they had recently enjoyed. Service users participate in the local community. They attend local facilities including shopping centres, pubs, restaurants, cafes, theatres, local sports centre and local parks. Service users have good family connections and most service users parents are fully involved in their care. The registered manager was able to give numerous examples of how staff had facilitated constructive and fulfilling family contact, such contact included staff accompanying service users for meals out with their families. The inspector saw several letters of thanks from relatives following such visits. Visitors are welcomed and the home has unrestricted visiting times. Conversation with staff and service users evidenced that the service users are encouraged to be as independent as possible and to make their own choices, such interactions were observed. Staff were observed to treat the service users in a calm and confident manner and with respect. To promote and encourage service users participation in meal preparation, all menus are laminated with a coloured picture of the meal on the front and stepby-step guide for staff to assist and support service users in producing a healthy, balanced meal. The service users take it turns to chose the main meal of the day. This is discussed at the service users meetings; samples of the minutes were seen during the inspection. Alternatives to the main meal choice are always available. Staff recounted days when every service user in one of the houses had a different mail meal. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive the support they require. Service users health needs are met. Medication within the home is stored securely and systems are in place for its safe administration. EVIDENCE: Staff spoken to were aware of the guidance and support required by the service users. Service users received additional specialist support including behavioural specialists. Daily statements are made on each service user, samples of which were seen at inspection. These statements were comprehensive in nature and related to the service user care plans. They clearly evidence how the healthcare needs are met. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 15 The registered manager stated that all staff responsible for the administration of medication were suitably trained, samples of training files were seen. The home had a robust policy for the administration of medication especially in view of the service users challenging needs and behaviours. Written guidelines were in place which clearly state how each service user prefers to take their medication. These guidelines also include reference to the service users method of communication and aids used to enable service users to make choices. Particular attention is given to the ritualistic behaviour of many of the service users, this information is shared with the service users GP to ensure that medication is prescribed in such a way as to gain compliance. For example one service user does not like green tablets. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple and accessible complaints procedure. Systems are in place for the protection of vulnerable adults. EVIDENCE: The home had a simple and accessible complaints procedure. No complaints had been received since the last inspection. All appropriate safeguarding adults policies and procedures were in place and readily available to staff. All staff spoken to were aware of these policies and procedures and their whistle blowing responsibilities. All staff had had training in the protection of vulnerable adults. There were many policies and procedures in place regarding challenging behaviour. There was a comprehensive policy regarding physical intervention; however the registered manager stated that restraint was not used, as it is not required. The home deals with any challenging behaviour by using a low arousal approach that they find very effective at calming aggression from service users. The accident book was seen and satisfactory. conducts a monthly audit of any accidents. The registered manager Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides an environment suitable for the needs of it’s service users. The home is clean and hygienic. EVIDENCE: The inspector toured areas of the home. Due to the complex and challenge needs of the service users it was not felt to be appropriate for the inspector to see any of the service users rooms. Staff informed the inspector that service users had a sense of ownership of their home, and that their personal space reflected their individual lifestyles as recorded in their care plans. Comments from service users included, ‘yeah, I like my room’. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 18 The home was suitable for the needs of the service users. The décor was domestic in nature and general standards of maintenance were good. It was seen to be clean, tidy and free from offensive odours. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by competent and qualified staff. Service users are protected by the homes recruitment policy and practices. EVIDENCE: Samples of the staff’s training files were seen. This evidenced that training of staff is given high priority. Staff spoken to felt that they received adequate training. One staff member commented that ‘one good thing about the home is the number of opportunities for staff development’. Staff had received training in health and safety, first aid, infection control and food hygiene as well as service user specific training. Service user specific training included; prevention of challenging behaviour, autism, Aspergers, low arousal approaches, and communication methods such as makaton and teach. Recruitment of staff is carried out under the homes policy and procedure on Staff Recruitment that incorporates the equal opportunity policy and procedure of the home. Three staff files were seen and found to contain the required Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 20 information and documents specified in paragraphs 1 – 9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000(Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). Staff morale appeared high and the workforce dedicated. All staff spoken to stated how much they enjoyed their jobs. One staff member stated that ‘there is a brilliant atmosphere, all the staff get along’ Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users benefit from an open, positive and inclusive atmosphere. The home has effective systems in place to monitor the quality of care and services provided. Systems are in place to protect the health, safety and welfare of service users. EVIDENCE: The registered manager demonstrated a thorough knowledge and awareness of the service users needs, a sound grasp of her managerial responsibilities, regulations and legal requirements. All staff spoke highly of the registered manager and service users were seen to interact readily with her. An open and inclusive atmosphere was evident within the home. All staff and service Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 22 users appeared happy, contented and relaxed with the inspection process. The atmosphere within the home during the inspection was lively and cheerful. The registered manager stated that various quality audit systems were in place. These included weekly service user meetings, relatives’ questionnaires and meetings, weekly staff meetings and staff supervision, health and safety audits and a safety action group. These records were randomly sampled. The registered manager is aware of the need to maintain a safe environment for service users and staff. Required policies, procedures and safety checks were in place; samples of which were seen. Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 23 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 4 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 X 4 X 3 X X 3 X Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Stonepit Close (42-44) DS0000013501.V333399.R01.S.doc Version 5.2 Page 26 - 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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