Inspection on 07/06/07 for The Cedars (11)

This inspection was carried out on 7th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Cedars (11) 17/01/06

The Cedars (11) 05/01/05

The Cedars (11) 22/07/04

The Cedars (11) 12/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 The Cedars (11) Ashbrooke Sunderland SR2 7TW Lead Inspector Miss Andrea Goodall Unannounced Inspection 7th June 2007 10:00 The Cedars (11) DS0000015786.V344132.R02.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 The Cedars (11) DS0000015786.V344132.R02.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. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cedars (11) Address Ashbrooke Sunderland SR2 7TW 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) 0191 567 2886 0191 567 2886 greendaydreem@aol.com Autism North Limited (a wholly owned subsidiary of Glenpath Holdings Limited) Michael Green Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: The house at 11, The Cedars is a large detached Victorian building in a treelined road near the City centre. There are several other similar properties in the same road that provide care services. This home provides 6 places for young adults with Autism Spectrum Disorder and is operated by Autism North Limited, a private company. The house provides 6 bedrooms and a good range of sitting areas. There are 2 spacious lounges and a large dining room. The home has extensive rear gardens, and a small patio area at the front of the house. The home does not provide accommodation for people with significant mobility or physical disabilities. The Provider is mindful of the implications of the Disability Discrimination Act 1995, and employed consultants to assess the premises to consider ways in which the it can offer access to visitors who may have physical disabilities. Level access can be achieved by providing a portable ramp to the door to a rear lounge. There is good access around the ground floor and a communal toilet. The house is opposite a park, and is only a short walk to local shops. The city centre and transport routes are also close by. The Provider declined to report the weekly fees for this service. The Cedars (11) DS0000015786.V344132.R02.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 and evening. A couple of months before the inspection the manager sent back some information about the home. The six people who live here filled in picture comment cards about their home with help from staff. Three relatives also sent in comment cards. During the visit the inspector talked with the manager about how the home helps the people who live here, and about staff and records. Most parts of the house were looked at, and one person showed the inspector their bedroom. The people who live here have Autism Spectrum Disorder. This makes it very hard for them to say what they think of the service they get at this home. There have been no complaints or concerns about the home since the last inspection. What the service does well: The home makes sure it can help people in the right way before they move here. The home keeps good records to show how they help people. People here go out to lots of different activities that they enjoy. Relatives said that people are more “happy” since they came to live here. Relatives said that the home has really helped people to learn how to do things for themselves. Staff understand the different ways that residents need help. Staff understand the different ways that residents talk. The house is warm, comfortable and safe. There is lots of room for the young people here to move around. The bedrooms are all different and residents can use their own bedrooms whenever they want to be private. The staff have lots of training to make sure that they know how to help people in the right way. The manager and staff make sure that the home is very well run. The Cedars (11) DS0000015786.V344132.R02.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. The summary of this inspection report can be made available in other formats on request. The Cedars (11) DS0000015786.V344132.R02.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 The Cedars (11) DS0000015786.V344132.R02.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): 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive assessment procedures make sure that only those residents whose needs can be met are offered a placement at the home. EVIDENCE: Before a prospective resident moves here, social and health care professionals assess their needs. The prospective resident, their relatives and Autism North Limited staff are fully included in making a decision about whether the home could meet people’s needs. Since the last inspection one new resident has moved to this home. He was previously living at another home operated by Autism North Limited, so a full assessment of his needs had already been carried out. Again, his relatives and social worker were fully involved in the decision about his move to this home. The transition to the home at 11, The Cedars is carried out at the person’s individually preferred pace. This may be after many visits and overnight stays or, as in the case of the newest resident, without any pre-visits as this would have confused and upset him. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 9 Instead, the manager and male staff from 11 The Cedars visited him at his former placement to build up a relationship with him before his move here. They then worked with him to support his orientation to his new home. Staff feel that his move to this home has been very successful for him and that he has settled very well into his new accommodation. The Cedars (11) DS0000015786.V344132.R02.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support plans are detailed so that staff work consistently in supporting residents towards their individual goals. People are supported so that they can make their own decisions, and take acceptable risks as part of an independent lifestyle. EVIDENCE: There are individual care plans in place for each of the young people who live here. A photograph in each file shows the care plan being verbally explained to residents. Care plans include details of people’s individual spiritual needs and how these can be supported. However due to the nature of their Autism residents do not have the capability to understand the concept of care planning. The sample of care plans examined included very detailed assessments of people’s strengths, capabilities and skills as well as their needs. Goals aim towards greater independent, social inclusion and leisure activities. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 11 However the care plan of the newer resident was out of date as it only contained goals, risk assessments and behavioural guidelines from 2005 during his previous placement. Staff stated that the resident’s needs and behaviour had changed and improved since his move to this home last year, and the new information was being typed at the head office. However as it was not available in the home during this visit, it meant staff did not have this information to hand. None of the care plans has pictorial symbols or photographs to support residents’ communication or comprehension of their care plans. However the care files are currently very detailed and bulky so this may not be practicable. The manager discussed proposals to separate these into a smaller ‘working’ care file with immediate and pertinent information, and an archive care file where assessments, reviews and other historic information. The nature of autism means that most service users can become very anxious when presented with too many choices. However residents are supported to make their own decisions from a small number of known preferences. People are encouraged to choose their own appearance, clothes, and style. Residents can choose from menus, and choose groceries when out shopping. For example, during this visit one resident chose not to have either of the lunchtime options so staff made an alternative meal for him. Some of the people who live here have limited speech but can make choices by using photographs, picture, gestures and pointing. The home keeps a record of any significant choices that they have made, such as holiday destinations, décor for their bedrooms, and group decisions about the décor of the house. The people who live here are supported to take acceptable risks as part of an independent lifestyle, wherever this appropriate and manageable. There are risk assessment records in place about activities that people carry out that might incur an element of risk, such as medication, managing money, and trampolining. Risk assessments clearly show how the risk can be minimised, with staff support, in the least intrusive way. The Cedars (11) DS0000015786.V344132.R02.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): 11, 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are well supported so that they can develop independent living skills. Residents can choose from a good range of suitable activities so that they have fulfilling, purposeful occupations. Residents have good support to keep in contact with family members and enjoy community facilities so that they have opportunities to meet others at social events. Residents are respected in a way that promotes their rights and responsibilities. Residents enjoy nutritious, healthy meals so their choices and dietary needs are met. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 13 EVIDENCE: It is clear from several relatives comment cards that residents have improved their life skills since moving to this home. One relative wrote, “The improvement in all aspects of (their) life is amazing since (they) moved to 11 The Cedars. (They) are happy…and treated as a 21 year old should be.” Another relative wrote, “Since he moved to 11 The Cedars I have witnessed a remarkable change in him. He is happy, settled and a lot more independent in certain aspects.” Staff have a good understanding of each person’s communication needs. Staff encourage and promote conversations with the residents to help their language and communication skills, but also to involve and include them in discussions about their home. The people who live here have completed specialist college education and now engage in various community-based activities and daily living skills occupations. Everyday each resident has the chance to go out to communitybased activities either individually or in small groups. This can include swimming, cycling, horse riding and walks. In discussions with staff it was clear that they use their knowledge of residents’ preferences, and their compatibility, to arrange a choice of activities. Staff are keen to broaden residents’ experiences by taking residents to see new activities so that they can make an informed choice about whether they would like to take part. It was also clear from discussions with staff that activities are designed to be purposeful and meaningful for the people who live here. For example, personal shopping trips provide an opportunity for residents to make choices and decisions and also to support their understanding of money. Grocery shopping trips are combined with preparing meals and learning cookery skills. As well as community-based activities, residents can also make use of Gorse House which is an activity centre operated by Autism North Limited. This provides an additional facility for people to use, and includes a gym, art and craft sessions, a small cinema, and swimming pool. The home is a short distance from the city centre so residents have a good range of shops and leisure resources nearby. The people who live here make good use of local facilities in the community including shops, sports centres, pubs, restaurants and cinema. In this way residents are included in the local community. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 14 None of the residents are from the Sunderland area so the home makes sure that there is good contact with relatives by telephone, email, text messages and cards. It is very good practice that the home is now helping residents to set up a web-camera so that they can keep in touch with those relatives who also have computer and web-camera. Most people also go for occasional holiday breaks to their family home, and some relatives visit the home. Two relatives indicated on their comment cards that they do not know how to access inspection reports about this home. Residents have opportunities to meet other people at community-based activities, such as pubs and social events. However the nature of Autism makes it difficult for them to form new relationships. All of the people who live here are involved in daily household tasks, such as cleaning their bedroom and doing their own laundry, with staff support. Despite some peoples occasional dislike of doing these things, this promotes their responsibility and ownership within the home. Staff were seen to be respectful and supportive when talking with residents. Care files have records and photographs to show when residents have had their rights explained to them. Residents are asked if they would like support to read their mail, and this is done in private. All the residents are involved in shopping, preparing meals and clearing up after meals. Weekly menus are suggested, based on residents’ known preferences, although this is just used as a shopping guide and residents can choose alternatives to each meal. Most residents go to supermarkets with staff, one or two at a time, to get the weekly grocery shopping. A couple of residents find the noise and crowds in large supermarkets intolerable so choose not to go, but still have opportunities to go shopping in smaller, quieter shops. Residents and staff dine together in the pleasant, large dining room. One person prefers to dine alone in a lounge and this is respected and supported. Meals are nutritious, healthy and suit the age and preferences of the young people who live here. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 15 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, 19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive the right support to access health care services where necessary so that their health and welfare is very well met. EVIDENCE: The people who live here are young and physically fit. Most need only guidance and verbal prompts to help them to carry out their own personal care. One person needs some physical support with personal care needs. The staff rota is managed to ensure that there is always female and male staff on duty at all times, including through the night. In this way there is always gender-appropriate support for the people who live here. The residents are registered with a local GP practice. They also have access to community dental, optician and chiropody services if required. The home can support residents to access specialist health services if required. Autism North Limited has access to clinical psychologist, clinical psychiatrist, and speech and language therapy services, whenever required. In this way the home ensures that residents health care needs are met by the appropriate health care services. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 16 None of the people who live here have been assessed as capable of managing their own medication. At this time, all medication is managed by trained, designated staff. Medication is delivered to the home by a local pharmacy in suitable containers. Medication is securely stored in a locked, alarmed metal medication cupboard away from residents accommodation. Appropriate records are kept of the administration of medication. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 17 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 and 23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People have good information so they know how to make a complaint. Staff have had improved training in supporting people to manage their behaviour so residents are better protected. EVIDENCE: Each resident has a copy of the complaints procedure which is in plain language and pictorial symbols to support the communication needs of the people who live here. The procedure is kept at the back of their personal files, which they regularly look at with their key worker. There is a written record to show when staff have explained their rights, including the complaints procedure, to them. Due to the nature of their Autism some people find this information very difficult to comprehend. However it is clear that the home makes every effort to support residents with their rights. The residents do use signs, gestures and noises to express their dissatisfaction with immediate situations, and staff are very knowledgeable about the individual communication skills of each resident. The manager plans to develop a record of residents’ individual ways of expressing happiness or dissatisfaction. This will help new staff to understand the communication methods used by residents. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 18 Due to the nature of their Autism the people who live here need occasional staff intervention during episodes of behavioural needs to prevent them from harming themselves or others. Since the last inspection all staff have now received appropriate training (NAPPI) in physical interventions that supports people to manage their behaviour. These methods use minimal restraint, and are used only to prevent harm to the resident or to others. It is good practice that two senior staff of the organisation are now trained trainers in these methods so that they can provide immediate training for new staff and refresher training for all staff. There are behavioural guidelines in place for each of the residents and these are shared with parents. There are also Intervention Records in place that record any occasions where intervention techniques have been used. These include good narrative information about the event, behaviour, action by staff, and outcome. At the time of this visit the behavioural guideline for one resident was well out of date and related to a previous placement. The updated version was not available in the home so there was no written information about how to support this person for staff to work consistently. It is very clear from records that the number of behavioural incidents have vastly reduced for people after moving to this home. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 19 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, 26 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The house provides good quality accommodation so that residents live in a homely, comfortable, safe and clean home. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 20 EVIDENCE: 11, The Cedars is a large 3 storey Victorian house that is warm, comfortable and spacious, and allows great freedom of movement for the young people who live here. The house is very well maintained. Since the last inspection the roof has been repaired, and modern wooden flooring has been provided in lounges and dining rooms. The kitchen has been fully refurbished in a modern style and now provides lots of worktop space for residents to be involved in meal preparation with the support of staff. As with all older buildings the house occasionally requires some minor repairs, redecoration and routine maintenance input. This is arranged as and when it is required with the Provider’s maintenance team. Despite the youthful exuberance of the people who live here, the home remains well decorated. During discussions one resident said that he “liked” his room, and enjoys spending time in it when he wants. Each room is very individual to the taste and needs of the people who live here. It was clear from records that there are plans to involve residents in choosing new décor for their own rooms, and some residents have already got new sofas in their room. There were few premises issues noted during this visit. As reported at the last inspection, the carpet to the risers on the main staircase remain worn, which could become a tripping hazard. It was stated that the budget for a new carpet has been agreed. There is a cracked pane to the window in one bedroom and most door handle covers are missing. The home employs a housekeeper who manages most of the communal domestic tasks and the cooking. Residents are supported by staff to be involved in cleaning their own rooms and helping with their laundry. All staff have training in infection control. All parts of the home were clean and hygienic. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 21 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, 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are very good staffing levels so residents receive sufficient support to meet their needs. Staff are well trained and competent so residents receive the right support. EVIDENCE: Staffing levels remains very satisfactory for the number and needs of the people who live here. The home aims for one-to-one support wherever possible, so there are usually at least 6 staff on duty. The staff rota is flexible to allow for greater staffing support for particular social events, and occasionally fewer staff when some residents are away from the home. Relatives were very positive in their comment cards about the level of staff support people receive at this home. One relative wrote, “(He) has come on leaps and bounds since being here. Due to the support of carers with special The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 22 training in autism and having high expectations, he is now starting to reach all the goals any parents would be proud of.” Another relative wrote, “We have nothing but praise for the staff, and know that our (relative) has a happy, fulfilled life with people who care.” The Provider’s recruitment and selection policies are robust. However earlier this year one member of staff was appointed in advance of a CRB (criminal records bureau) clearance. In discussions with the manager it was indicated that this may have been an isolated accident. The Provider is reminded of the procedure for appointing staff in exceptional circumstances whilst awaiting their CRB disclosure. The Provider has a brief equal opportunities statement. The manager indicate that all policies are being reviewed in light of recent changes to the ownership of Autism North Limited, and that a more detailed equality and diversity policy will be developed. It is good practice that 10 staff have achieved NVQ levels 2,3 or 4 (these are social care qualifications) and the remaining 8 staff are training towards these qualifications. All staff receive training in autism awareness. All staff receive mandatory health & safety training. All staff receive training in adult protection protocols. Staff and the manager stated that there are good opportunities for training. All new staff receive induction training that includes input from a number of different training agencies. The home maintains individual training and development records for each staff to show their prior training and to identify any training needs. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 23 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 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents and staff benefit from a well managed, well organised service. Systems, procedures and practices promote safety and welfare so residents are safe. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 24 EVIDENCE: The registered manager is responsible for the day-to-day management of the home. He has several years experience of working with younger adults with Autism Spectrum Disorder. He has attained care and management qualifications that are suitable for his role. He is supported by a Regional Manager of Autism North Limited. A representative of the organisation visits the home at least monthly and reports on its operations. In this way the home is well run for the people who live here. Since the last inspection there have been changes to the ownership of the Provider, Autism North Limited. Autism North Ltd is now a wholly owned subsidiary of Glenpath Holdings Ltd. (Glenpath now owns the actual building as well as the shares in the care company.) In turn, Glenpath is a wholly owned subsidiary of Swanton Care & Community Ltd. In discussions, staff stated that there have been few subsequent changes to the day-to-day running of 11 The Cedars. The registered manager and responsible individual remain the same. The manager and staff stated that there have been some positive changes to administrative processes and feel that the home can benefit from being part of, and supported by, a larger organisation. A number of monitoring tools are used to review the quality of the service at 11 The Cedars. The views of relatives are sought through annual reviews that involve the residents, relatives and Social Workers from the placing authority. Due to their Autism, most residents would find the concept of questionnaires about the service difficult to comprehend. Instead, residents views are sought through individual discussions, and as a group at choice and consultation discussions. Staff records demonstrate that all staff receive statutory training in all health & safety matters, and there are records of health & safety checks and audits by external consultants. All staff receive in-house fire instruction every 3 months. There were no health and safety matters identified during this visit. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 25 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 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 4 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 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 4 X LIFESTYLES Standard No Score 11 4 12 4 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 X The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 26 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 YA34 Regulation 19(5)(d), Schedule 2(7)(a) Requirement The Provider must contact CSCI for approval of the exceptional circumstances when appointing staff with a POVAFirst check whilst awaiting a CRB response. Timescale for action 01/08/07 The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 27 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. 2. 3. 4. 5. 6. Refer to Standard YA6 YA6 YA15 YA23 YA24 YA24 Good Practice Recommendations Care plans and risk assessments should always be available within the building at all times. Copies can be used to send out for retyping. Consideration could be given to the use of photographs or pictures of the activity next to progress reports about care plan goals as a visual clue for residents. The home should help relatives to access inspection reports about the service at 11 The Cedars. Behavioural guidelines should always be available within the home for staff to work consistently when supporting a resident to manage their behaviour. Plans to replacement the worn stair carpet should continue to ensure that this does not become a tripping hazard. The minor premises issues should be addressed, that is replace cracked window pane and replace door handle covers. The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 The Cedars (11) DS0000015786.V344132.R02.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!