Inspection on 17/07/06 for Tobias Centre For Autistic Support Services

This inspection was carried out on 17th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tobias Centre For Autistic... 16/07/08

Tobias Centre For Autistic... 16/07/07

Tobias Centre For Autistic... 02/03/06

Tobias Centre For Autistic... 31/08/05

Tobias Centre For Autistic... 03/02/05

Tobias Centre For Autistic... 23/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 Tobias Centre For Austistic Support Services 8 St. Margarets Road Torquay Devon TQ1 4NW Lead Inspector Sam Sly Unannounced Inspection 17th July 2006 11:00 Tobias Centre For Austistic Support Services DS0000018443.V289155.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 Tobias Centre For Austistic Support Services DS0000018443.V289155.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. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tobias Centre For Austistic Support Services Address 8 St. Margarets Road Torquay Devon TQ1 4NW 01803 312867 01803 323891 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) Modus Care Limited Ms Kelly Melrose Care Home 11 Category(ies) of Learning disability (11), Mental disorder, registration, with number excluding learning disability or dementia (11) of places Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 2006 Brief Description of the Service: The Tobias Centre provides care for up to eleven adults with autistic spectrum disorder and additional sensory disabilities. At present five residents are accommodated. The home is a large detached house situated in a residential area of Torquay close to local amenities. There is an enclosed garden to the front and rear of the premises with grassed and patio areas. The basement is set out as a flat for one resident with a lounge, quiet room, kitchen, bathroom and spare room. There is also an office in the basement and a staff toilet. The main house has a communal kitchen, lounge and dining/activity room, with two quiet rooms used by specific residents. All bedrooms are single and some en-suite, with several additional bathrooms and toilets. Two communal rooms are currently under-used as a storeroom and computer room. The Owners are reviewing this situation. The fee levels for the Tobias Centre are: £1800 - £3750 Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit was unannounced and took place during the day in July. It included discussion with one resident and observation of the others due to their communication needs. Interviews and discussion also took place with the staff on duty, the registered manager Kelly Melrose, and a representative of Modus Care Limited Neil Jones. The care of three residents was tracked, which included talking to key workers and looking at records. Care records, and health and safety records were examined and progress on the implementation of a Quality Assurance system was discussed. Staff records were stored at a central office, so a second visit was made the following day to examine these. A tour of the building was carried out during the site visit. The inspection process also included a review of contact the Commission has had with the Tobias Centre since the last key inspection, information contained in a pre-inspection questionnaire sent by the registered manager, and comment cards received by the Commission from nine staff, two relatives, one doctor and two care managers. All the required key standards were assessed during the inspection process. What the service does well: The needs of residents are very well understood by staff, well documented and staff work towards increasing resident’s skills. The Owners provide good mandatory and specialist training which is well received by staff and equips them to meet resident’s needs. One staff member commented that there was: ‘good training, a great atmosphere and caring staff’ and that managers were ‘open to ideas with regard to service users activities’. The registered manager was using knowledge she had gained to improve the behavioural plans for two residents, so that behaviour was not just managed but also proactively worked with to improve their life opportunities. The staff team are enthusiastic, dedicated, showed genuine affection for the residents and were able to communicate effectively with all of them. All staff reported that they were never asked to work outside their experience. Relatives said that they were kept informed and satisfied with overall care and professionals felt the staff understood resident’s needs, had plans in place to meet these needs and kept them informed. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tobias Centre For Austistic Support Services DS0000018443.V289155.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 Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive written information is available about the Tobias Centre, but it is not in a suitable format for the resident group to understand. Resident’s needs are well assessed before admission. EVIDENCE: There had been no new residents for several years. However, three resident’s care records were examined and needs are regularly reviewed. Two resident’s behavioural needs had recently been thoroughly analysed by the registered manager and behavioural plans implemented to proactively improve behaviours and therefore life experiences. It was envisaged that all residents would have the same plans in place in the near future, but the timescale for this was unknown by the registered manager. The accessibility of information for residents was discussed and no progress had yet been made in making it more accessible. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their needs and goals are documented, understood by staff and action is taken to make them as independent as possible. EVIDENCE: Three resident’s care planning files were examined and found to contain detailed information on their needs and areas of risk. Relatives and professionals are invited to regular reviews and a newsletter is also sent to the resident’s representative to keep them informed of changes in their relative’s life. Key workers are involved in writing the newsletter. Two residents had detailed behavioural plans in place, with records demonstrating that these plans are helping to reduce behavioural incidents. An analysis of behavioural incidents had initially been carried out to prepare these plans but generally there is no systematic review and analysis of incidents to inform resident’s plans. There is also no systematic debriefing after behavioural incidents, which have involved staff using physical intervention. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 10 Risk assessments are detailed with clear plans for staff. Records are kept of activities residents participated in, appointments and daily routines. These records are used to inform care plans, and to inform reviews. Daily records are also kept, and a daily planner is used to inform staff of their jobs each day including who they are working with and what activities are planned for each resident. It was observed that staff encouraged residents to make decisions during the site visit, and within daily records there was evidence that this is widespread practice. Staff have the skills and training to enable them to communicate with residents who have a range of communication needs. There is evidence that symbols, pictures and photo’s are being used more often as part of resident’s daily living and to aide communication. All staff are booked to attend training on equal opportunities for residents in September 2006, and a policy had recently been written. The Owners have developed a draft policy outlining their responsibilities in relation to residents benefit entitlement, however more detail is still required to demonstrate what happens to resident’s Disability Living Allowance benefit. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff, and a range of activities available to enable residents to choose what to do in and out of the Tobias Centre. Meals are appropriate to the dietary needs of residents. EVIDENCE: Residents all have high levels of staffing support, which enables them to get out into the community regularly. Staff interviewed understood the needs of residents that sometimes put constraints on where residents can go and what they can and want to do. Staff receive training and work towards increasing experiences and opportunities for residents. Within the home residents are encouraged to participate in household chores and do a range of activities. Some residents use a computer, and a new computer suite is planned to be installed by the Owners. One resident is very keen to buy a shed and some hand tools to carry out a hobby. This activity had been risk assessed by his care staff, quite a considerable time ago but as yet the Owners have taken no action. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 12 Residents take part in activities they value in the community. Most residents like going for walks, trips out and residents regularly eat out and visit local shops. New activities are continually explored and offered, although sometimes declined by the residents. Family links and involvement is promoted at the Tobias Centre. Newsletters are sent to families to keep them in touch with their relatives, and families are invited to review meetings. Residents are also taken to visit family and friends on a regular basis, as well as keeping in touch by phone and letter. Relative’s feedback was that they were kept informed, felt involved in planning and were overall satisfied with the care their relative received at the Tobias Centre. Staff, with some resident involvement, cook meals. The kitchen has been redesigned to make it more accessible to residents. Lunch was shared with residents and staff during the site visit, and was enjoyed by all. A dietician approves menus and demonstrated residents have a balanced diet. One resident has meals prepared in his own flat, and is involved in shopping for his food. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive support with personal and health care in ways they prefer and require. Deficits in the recording of medication administered by staff potentially put residents at risk. EVIDENCE: All residents have medication administered by staff due to their needs. The procedures for receiving, storing, administering, recording and returning medication were examined at the site visit. The receipt and returning of medication is carried out appropriately, and medication is stored in a locked cupboard in a locked room. The registered manager said a new medication cupboard had been ordered, as it was found that medication was stored in well-used box files. This practice had been commented on, with a recommendation to replace the box files, at the last site visit. There were gaps found in the written records of medication administered by staff. All staff that administered medication have received appropriate training. The personal support provided involves some hands-on care as well as prompting, motivating, guidance and supervision. Care plans detail how staff should provide this support, and staff were observed to be following guidelines. During interview staff also demonstrated a good understanding of resident’s Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 14 care and health needs. Staff were clear about their key worker roles in making sure residents views are heard, they had appropriate clothing, personal hygiene products and keep in touch with family and friends. Daily routines are flexible around the needs of residents. Professional support is provided appropriately, and regular health care checks are carried out. Professionals employed by the Owners give specialist autistic spectrum support and training, which encourages positive interaction by staff. Comments received by professionals stated that they felt staff understood resident’s needs, there was senior staff available to talk to when they visited, they were notified of incidents and they were satisfied with the overall care of their client. One comment from a professional about equipment and a Home procedure giving a negative message to visitors, staff and residents, was discussed with Kelly Melrose and Neil Jones. They were already aware of this comment as the professional had also advised them, and were actively looking at changes to the environment. It was also recommended that the monthly Owner visits monitor this issue. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that their concerns and complaints will be listened to and acted upon, although the resident group would not understand the current written procedures. Staff have the knowledge, and procedures are in place to protect residents from abuse. EVIDENCE: A recent Adult Protection issue was reported correctly by the Owners, however, there was a problem about the time it took the referral to reach the Adult Protection co-ordinator. The Owners have since taken action to ensure this problem would not happen again. The majority of staff have received Adult Protection training, and all but one staff member interviewed was able to demonstrate a clear understanding of what constituted abuse, and the procedure for reporting it. There was a clear Adult Protection procedure and a copy of the Alerter’s Guidance available. The Tobias Centre or CSCI has received no complaints since the last Key inspection. The complaints procedure is appropriate, however the communication needs of residents means they would not be able to understand it in its current format. Neil Jones said the Owners had thought about this issue, but were struggling to find a solution. Discussion took place on different ways of gaining resident’s views including analysing behaviour and staff being alert to changes in behaviour potentially indicating a concern, discontent or dissatisfaction with a situation. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is homely, well furnished and decorated however, deficits in fire protection could potentially put residents at risk. EVIDENCE: Due to residents needs the environment requires continual maintenance and renewal to ensure it remains safe and homely. Regular maintenance checks and environmental risk assessments are carried out, however, an example was found during the site visit of a maintenance issue being recorded by staff in January 2006 and not being dealt with. Neil Jones discussed big scale changes to the environment that would improve it for the residents. Some big improvements like the kitchen have already been completed, with the dining room starting to be redeveloped on the day of the site visit. The plans for the future proposed changes were not available during the site visit. Fire records of the last fire alarm test on 3/7/06 showed that three fire doors did not close completely. No action had been taken to remedy this. The fire risk assessment required review and the evacuation plan could not be located. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 17 The environmental health department had visited in October 2005, and recommendations had been acted on. Records showed that 19 out of 33 staff had attended or were booked to attend Infection control training, and there were policies and procedures in place to control the spread of infection. The laundry facilities are appropriate for the needs of residents. 20 staff have attended or are booked to attend Food Hygiene training. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient numbers of staff with the qualities, skills, and qualifications to meet the needs of residents. EVIDENCE: The Owners employs a training co-ordinator and there is a training plan available for the whole staff team. Staff had a range of training that is mandatory including health and safety, food hygiene, manual handling, positive behavioural management, infection control, care of medication, fire safety, first aid, protection of vulnerable adults and equality and diversity. Staff also attend training specific to resident needs such as signing, autism and Aspergers syndrome specific training and total communication. Staff attend NVQ training as well. The registered manager has received training from a provider accredited by the British Institute of Learning Disabilities (BILD) to enable her to train staff in safe physical interventions. New staff complete an induction programme. All staff interviewed or who sent in written comments gave good feedback about the training provided to them and said it helped them do their jobs. The recruitment procedures and records of four staff members were examined and found to be appropriate, with all the correct fitness checks being carried Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 19 out, and procedures in place for dealing with employee conduct issues. Staff comments received showed a lack of understanding of the staff disciplinary process. Neil Jones provided a copy of a revised grievance and disciplinary procedure that was about to be given to all staff. Observation of staff/resident interaction during the site visit plus feedback from relatives and professionals gave evidence that staff were motivated, approachable, interested and showed a commitment to improving the lives of residents. Rotas showed that sufficient numbers of staff were on duty at any one time to meet the needs of residents. One issue identified from comments received by the Commission, was that on occasion there was no registered manager or senior staff on duty, leaving care staff with responsibilities above their role. Neil Jones said this did sometimes happen but he would ensure it did not. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. To benefit from a well run home residents need a stable management providing good support for staff, with quality at the Tobias Centre systematically monitored and improved. EVIDENCE: Comments from staff indicated that there were issues around the management and support of the staff team. Neil Jones confirmed he was aware that staff did not benefit from consistent leadership and support from the management team at the present time. This issue had been raised at the last Key inspection also. Comments from staff were that: ‘There is no forms of communication on the vertical layers of the company set up’. ‘Staff sometimes dictate how things are, not the manager’. ‘I do require a lot more support, my supervisors are always of other matters’. Other staff had no issues with the support offered by the Owners. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 21 These management problems are developing into a pattern, with the last two managers being registered and then taking on additional roles within the Company, which has distracted them from their management commitments. At the site visit the Commission was informed that Kelly Melrose, the present registered manager, is taking another position in the Company. Neil Jones said a new manager is being advertised for and he will be acting manager until the position is filled. Records show that the required monthly visits by the Owners have not been carried out in recent months. The Quality Assurance system for the Tobias Centre is still at a draft stage, although it has progressed since the last site visit. Requirements have been made by the Commission now four times to have it in place and implemented, with the first timescale being December 2004. Staff were receiving a range of health and safety training including food hygiene, basic health and safety, first aid, fire safety, manual handling and infection control. They also received training in dealing with aggression from residents in positive ways. The Fire logbook was up to date, but deficits in the fire doors identified in a fire alarm test had not been acted on, the fire risk assessment needed reviewing and the evacuation plan could not be found. There are policies and procedures in place to ensure the health and safety of residents and staff, and regular servicing of electrical and heating systems is carried out. All water sources are regulated and all radiators are guarded. There are good risk assessments carried out for each resident. Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 23 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. 2. Standard YA20 YA37 Regulation 13 (2) 26 Requirement Medication administered by staff must be recorded correctly, with no gaps. The Owners must carry out the required monthly visits to the Tobias Centre. The Owners must work towards improving communication and support of the staff team and provide a stable management. The draft quality monitoring and quality assurance system must be implemented. An annual development plan must be developed and a report produced and made available for the Commission, residents and other interested people (Previous requirement 30/12/04, 16/03/05, 5/12/05, 30/4/06 not met). The Home’s fire risk assessment must be reviewed and the fire evacuation plan must be available at all times. Deficits identified during Fire alarm checks must be acted on immediately. Timescale for action 17/07/06 27/09/06 3. YA39 24 27/10/06 4. YA42 23(4) 27/08/06 5. YA42 YA24 23(4) 17/07/06 Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Behavioural incidents should be systematically analysed to inform a resident’s behavioural plan and risk assessment. Debriefing should happen systematically, and be recorded. Ensure the policy on Disability Living Allowance contribution towards transport is comprehensive. The Home should have a policy on the promotion of equality and diversity. The resident’s request for a shed to carry out his hobbies/work should be considered and action taken. Replace the box files, which hold residents medications. Develop the complaints procedure into a format that is understandable to residents, or implement a more creative way of systematically ensuring residents views are understood. All day-to-day identified maintenance issues should be fed into the maintenance programme and acted on swiftly. Long terms plans should be available at the Home. The required monthly visits by the Owners should assess the impact of any equipment or procedures that may give a negative image to the Tobias Centre and its residents. 2. YA7 3. 2. 3. YA12 YA20 YA22 4. 5. YA24 YA37 Tobias Centre For Austistic Support Services DS0000018443.V289155.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tobias Centre For Austistic Support Services DS0000018443.V289155.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. 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!