Inspection on 18/07/05 for The Court

This inspection was carried out on 18th July 2005.

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

The Court 16/12/08

The Court 10/05/07

The Court 07/02/06

The Court 20/01/05

The Court 13/07/04

The Court 03/02/04

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 Court 22 Thornholme Road Thornhill Sunderland SR2 7QG Lead Inspector Andrea Goodall Unannounced Monday, 18 July 2005 : 14:00 th 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 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 Stationary 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 Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Court Address 22 Thornholme Road, Sunderland SR2 7QG Telephone number Fax number Email 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 5264 Tyne & Wear Autistic Society Mrs Christine Graham Care home only 3 Category(ies) of 3 x LD registration, with number of places The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th January 2005 Brief Description of the Service: The Court is a care home for 3 younger adults with Autism Spectrum Disorder. It is owned and managed by the Tyne & Wear Autistic Society (TWAS), a voluntary body, which also owns and operates specialist educational facilities for children and young adults with Autism and 5 other care homes for adults in the nearby area. The house has an open hallway, off which there are a comfortable main lounge, dining room and well-equipped kitchen. There is another smaller lounge leading off from the kitchen. On the first floor there are 3 generously-sized bedrooms, a bathroom, toilet, and the small staff sleep-in room.The quality of furnishings and decoration are of a very good standard throughout the house. The house does not offer accommodation for people with mobility needs, though the facility can be made for visitors with such needs to access the ground floor. The Court is a family-sized detached property in a quiet area near the City centre of Sunderland. It is indistinguishable from similar surrounding family houses, including the neighbouring 2 houses which are also small care homes operated by TWAS and managed by the same registered Manager. It is on the same road as the Thornbeck College that some of the service users attend. The house has a short driveway and a car porch for the home vehicle. There is a small front garden and an enclosed, private back garden. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one afternoon and evening in July 2005. Time was spent with the 3 young ladies who live here, looking at their bedrooms with them, and joining them for a teatime meal. The rest of the time was spent discussing the progress of the home with staff and examining care records and health & safety records. The people who live here stated that they prefer to be referred to as residents, and this report will respect their preference. The report will also refer to the Tyne & Wear Autistic Society as TWAS. What the service does well: The home is very well decorated and furnished. There is lots of room for the 3 residents to spend time in different lounges or their own bedrooms. Residents said, the house is lovely and I really like my own room. One person said that they had the best bedroom they had ever had here. It is a comfortable, family house and looks just like all the other nice houses in this road. The house is close to the City centre and close to the college, so its in a handy place for the people who live here. The house is safe and well maintained. Residents said that one of the best things about living here is doing fun things in the evenings. Residents said that they go out nearly every evening and all day at weekends to do different things. The home also helps the 3 young people to learn how to do things for themselves. They said, I like to do my own cooking and one person said that they had learnt to do their own laundry and ironing. Residents said they like the staff, they are really helpful. The residents and staff said that they get on well. The Manager and most of the staff have worked with 2 of the residents for some years so they understand how to support them in the right way, and they know what the residents like and dislike. Most staff have got qualifications that show they have been trained to do their jobs. The Manager has lots of experience and residents said that they would feel comfortable about talking with her if they were worried about anything. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 standard(s) 2. Residents needs have been assessed and are continually reviewed to ensure that the service continues to meet their needs. TWAS has clear written guidelines about Referral and Assessment to its services. EVIDENCE: Before they move here, prospective residents’ needs are assessed by social and health care professionals. Relatives and TWAS staff are also included in making a decision about whether the home could meet people’s needs. Some people who live here previously received educational and residential services through the TWAS Children Services. Their needs have been regularly assessed and reviewed throughout their formative and adult years. One newer resident moved here last year. As with all potential residents who are new to TWAS services, she had a one week trial stay at a TWAS home as part of the assessment process. This helped to determine whether TWAS could meet her needs and which of the small homes would be most suitable for her in terms of compatibility. A review is held after 3 months to make sure that the service is suitable for new residents. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 9 Annual reviews are held by TWAS for each resident to ensure that the home continues to meet their needs. The reviews include their relatives, Social Worker, and any other party involved in their care. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 & 7. Support planning systems ensure that staff work consistently in supporting residents towards long term independent living goals. Residents are encouraged and supported to make informed choices and decisions about their lives. EVIDENCE: New support plans are being put into place for the 3 residents. These give details of what skills residents already have, and also identify specific goals for each person in 3 main areas of their lives, that is domestic, leisure and self development. The plans set out detailed instruction to staff about the level of support each person needs with their goals. Due to their Autism some people find it difficult to understand the support plans. Staff stated that photographs are to be used to help residents understand the different goals that they are working towards. Residents are often present when staff are completing their support plan records. However the support plans have not been signed by residents or their The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 11 representatives, and there is no written record to show how residents are involved in their own care planning. Many people with Autism Spectrum Disorder find it difficult to cope with too many choices, so residents tend to be offered a small number of choices from a range of their known likes. Discussions with residents and examination of care records show that residents are encouraged to make their own choices. For example, residents choose their own clothes, the décor for their bedrooms, and are involved in choosing meals for the menus. One resident said I like going shopping and choosing the food that I like. Residents are also encouraged to make suggestions at the regular Residents Meetings, such as holiday destinations and leisure activities. In this way the people who live here are involved in decisions about the lives and in the running of their house. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 17 TWAS provides residents with fulfilling, purposeful daytime occupations. Meals are nutritious and appropriate for the people who live here. EVIDENCE: Throughout the week the 3 residents all attend day services provided by TWAS. These include vocational courses at the nearby Thornbeck College, such as IT, meal preparation and arts & crafts. Residents also have opportunities to gain practical skills at the TWAS Workshop where they make garden furniture, cards and jewellery, which is sold locally (on a not-for-profit basis). This provides residents with purposeful, fulfilling outcomes to their activities. The 3 people who live here are all involved in setting menus, shopping at local supermarkets, and preparing their meals. The Inspector joined residents for the tea-time meal, which 2 residents had prepared with staff support so that their independent living skills are promoted. Menus show that meals are healthy, nutritious and meet the age and lifestyles of the young people who live here. Residents said that they like the meals at the house and also enjoy occasional take-away meals. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 13 Staff and residents dine together in the dining rooms where staff encourage residents to talk about their day and this helps to promote their communication and social skills. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19. Residents get appropriate personal support. Residents health care needs are met by community health care services. EVIDENCE: The people who live here are young and physically fit. None of the residents need physical support. Some people need some verbal prompts and supervision to help them to carry out their own personal care, such as washing and brushing their teeth. All the staff are female and this ensures that the residents get gender-appropriate support at all times. Discussions with staff confirmed that they are very knowledgeable about each residents support needs. The 3 residents are registered with a local GP practice. There is a visiting optician service, and residents also have access to suitable dental treatment. At this time two people have specialist input from a Consultant Psychiatrist to help them with anxiety. In this way the home ensures that residents health care needs are met. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 standard(s) 22. TWAS has a very thorough Complaints Policy and procedures for relatives and other care professionals. Residents, relatives and care professionals have information from the service about the method of making a complaint. Information is provided to residents in pictorial form to support their understanding of the complaints procedure. EVIDENCE: Also each resident has been given a copy of a short clear complaints procedure that is in plain language and in pictorial form to support their communication skills. This information is included in their files and in the Service Users Guide, so that residents have access to it at any time. Residents are periodically reminded of the complaint procedure at Residents Meetings and are asked for their views of the service. During discussions residents said that if they were not happy they would tell the Manager. Residents said that they were sure the Manager would sort out any problems. The home has a recording system for dealing with any complaints so that any concerns are dealt with in the correct way. There have been no complaints received about this service since the last inspection. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 standard(s) 24 & 26. Residents live in a homely, comfortable and safe environment. The house is decorated and furnished to a very good standard and in a modern style that suits the people who live here. Residents bedrooms are spacious, and support their rights to independence and privacy. EVIDENCE: The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 17 The Court is a family house that is decorated and furnished in a modern bright style that suits the age and lifestyles of the 3 people who live here. The house is well-maintained, and over the past year has been further upgraded in a number of areas. A new fitted kitchen has been installed, and the kitchen, lounge, dining room, and hallway have been redecorated. Since the last inspection a new bathroom suite and shower cubicle have been fitted and the bathroom and toilet have been redecorated. The house provides a very comfortable and safe environment for the 3 residents. The 3 young ladies who live here chose their own colour schemes for their bedrooms, and one service user also chose to have laminate flooring in their bedroom. The room of the most recent resident to move here has been redecorated. However the carpet has not been replaced and this looks rather stained and not in keeping with the rest of the rooms décor. The 3 bedrooms are spacious and comfortable, and residents spend quiet time in their own rooms. All the bedrooms doors are lockable from the inside for residents privacy if they wish. One resident also has a key for her bedroom, and makes good use of this to keep her room private when she is out of the house. The other 2 residents have had several keys in the past but found it difficult to manage them. There are risk assessments in place to show this, which have been signed by the residents and copies sent to their relatives. The risk assessments are reviewed every year and so the possibility is not ruled out that those residents may learn the skills to manage their key in the future. During the visit one bedroom door was fully open, even before the residents had come home from college. In this way that persons right to privacy was not supported and they may need staff help to keep the door closed when they are not in the house. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 33. Residents are supported by who are both qualified and competent to do the work. The home has an effective staff team with sufficient numbers and skills to meet the needs of residents. EVIDENCE: The small staff team comprises of the Registered Manager, Assistant Manager and 3 senior or support staff. There is a good mix of skills and experience amongst the staff team. All staff have had Autism Focus training to help them understand the needs of people who live here. All but one staff have achieved NVQ level 3 in care. This qualification is accredited by the Learning Disability Award Framework, so relates directly to their care of people with disabilities. The remaining member of staff is currently training towards this qualification. The staffing levels are sufficient to meet the needs of the 3 people who live here. There are 2 support staff on duty during the times that the residents are in the house. All residents are at their vocational or college placements during the week at term times, and at home all weekend. Staff are on duty from 1pm to 10pm during the week and from 10am to 10pm during week-ends, so that they can provide support at times when residents most need it. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 19 There is one member of staff on sleep-in duty each night and these duties are carried out by the Assistant Manager and senior support staff. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 42 & 43. The views of residents and their relatives are included in the reviews of the service. Systems, procedures and practices promote the safety and welfare of the people who live here. Residents benefit from competent financial management of the service. EVIDENCE: The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 21 TWAS has a comprehensive quality assurance system in place, which includes a full audit of the service. TWAS also involve residents and relatives views to monitor whether the service is meeting their needs. This includes annual reviews with residents and their relatives, and a relatives questionnaire. Residents are encouraged to give their views at the Residents Meetings, which are held about once a month. From time to time the home also uses resident’s questionnaires to gain their views of what they like and dislike. However these do not ask what they think of the home or the service they receive, and so it is not clear if the responses are included in the quality assurance process. A rolling programme of training is in place to ensure that all staff receive statutory training in health & safety matters including fire safety, first aid, food hygiene and Infection Control. In this way staff understand their responsibilities in terms of safe working practices. The Assistant Manager carries out a monthly health & safety audit of the premises and risk assessments are in place for activities carried out by staff and residents that may involve a minimal risk to health, for example use of kitchen and laundry equipment. There were no health & safety hazards observed in the building during this visit. Residents and staff carry out a fire drill on a monthly basis so that resident would know what to do if the fire alarm sounded. The Assistant Manager and a senior staff take responsibility for most sleep-in duties. However there are times when other staff carry out sleep-in duties so they need to have fire instruction at least every 3 months. The fire instruction records indicated that not all staff had signed to demonstrate that they had received instruction and one staff had not received instruction for several months. TWAS was recently registered to provide another similar service nearby. As part of the registration process satisfactory financial clearances and checks were obtained. In this way TWAS demonstrates its on-going financial viability. Although no accounts are held at this small home, these would be available for scrutiny if necessary from the organisation. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x x Standard No 11 12 13 14 15 16 17 x 3 x x x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Court Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 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 6 Regulation 15 Requirement Support plans must demonstrate how residents have been included in their own care planning, or record the reasons why they are unable to be involved. Fire instruction records must demonstrate that staff have received fire instruction at the required intervals. Timescale for action 1.10.05 2. 42 23(4)d 1.10.05 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. Refer to Standard 26 26 Good Practice Recommendations Residents who are unable to lock their own doors should be supported by staff to keep their bedroom doors closed when they are out of the house. The stained carpet to one room should be replaced to match the residents chosen colour scheme. The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Court B52-B02 S15782 The Court V217628 18 Jul 05 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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