CARE HOME ADULTS 18-65
Wessex Autistic - 13-15 Barnes Lane 13-15 Barnes Lane Beaminster Dorset DT8 3LS Lead Inspector
Marion Hurley Unannounced Inspection 21st December 2005 10:00 DS0000026741.V283689.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000026741.V283689.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000026741.V283689.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Wessex Autistic - 13-15 Barnes Lane Address 13-15 Barnes Lane Beaminster Dorset DT8 3LS 01460 77033 01460 75003 as@twas.org.uk www.twas.org.uk Wessex Autistic Society Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Michelle Louise Maglo Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000026741.V283689.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3rd March 2005 Brief Description of the Service: The Wessex Autistic Society is a regional charitable organisation, which operates a number of residential, day and support services. 13-15 Barnes Lane is a long-term care home for up to 6 adults who have an autistic spectrum disorder. It comprises of three inter-linked terraced houses, each accommodating 2 service users. It is situated relatively close to the centre of Beaminster, which is a small town that has facilities, including shops, post office, GP surgery and pubs. Barnes Lane is owned by the New Era Housing Association and is managed by the Wessex Autistic Society under a licence agreement. It is staffed on a 24 -hour basis, with one waking and one sleep-in member of staff throughout the night. The home provides close support to the service users who live there. The organisation aims to enable service users to live as independently as possible in the community. DS0000026741.V283689.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Barnes Lane was assessed according to the Care Home for Adults (18-65) National Minimum Standards. The overall time spent to complete the inspection process was a total of six hours; two of which were spent at Barnes Lane. The Registered Manager and Adult Services Manager were present throughout the inspection visit. Members of the staff team were met only briefly at this inspection and on this occasion no service users were present. However, the next inspection will be arranged to ensure both staff and service users if they wish may provide feed back/comments to the inspector and therefore contribute to the inspection. Please note this was the first inspection visit for the year 2005/06 and for this reason only a limited number of standards were assessed at this first visit however all key standards and those specifically relating to the welfare and lifestyle of the service users will be addressed at the next inspection visit What the service does well:
Despite not meeting any of the service users on this occasion, it was evident from the discussions with the Registered Manager that there is an excellent understanding and knowledge of the needs of the service users living at Barnes Lane. Externally the home is well maintained and has nothing to distinguish it as a residential home and fits side by side with other properties in the close. Health & Safety issues are well managed and the specific policies and procedures are informative and provide staff with clear practical information. Records relating to Health & Safety, regular checks were clearly recorded and up to date. Staff training is comprehensive and ensures all new staff complete both a service specific and generic induction course. Further training and refresher courses are available for existing staff and ensure all staff maintain their statutory training requirements and good practice. Regular staff meetings ensure staff are well informed of the changing needs of service users and this contributes to the flexible and reactive service provided to everyone living and working at Barnes Lane. Procedures for accessing other professionals were clear and all information with contact details readily available for staff.
DS0000026741.V283689.R01.S.doc Version 5.1 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. DS0000026741.V283689.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000026741.V283689.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: DS0000026741.V283689.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: DS0000026741.V283689.R01.S.doc Version 5.1 Page 10 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): These standards were not assessed at this inspection. EVIDENCE: DS0000026741.V283689.R01.S.doc Version 5.1 Page 11 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): These standards were not assessed at this inspection. EVIDENCE: DS0000026741.V283689.R01.S.doc Version 5.1 Page 12 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 • Wessex Autistic Society has a comprehensive and clear complaints procedure, and the home’s Manager & staff working at Barnes Lane, when required, would implement these procedures and policies. • Adult Protection is appropriately and well addressed in staff training. The Wessex Autistic Society have detailed but positive policies and procedures for all staff to follow which help safeguard service users from potential abuse and harm. The Registered Manager demonstrated a good awareness of policies, procedures and strategies regarding the Protection of Vulnerable Adults. EVIDENCE: The Home has not received any formal complaints since the last inspection. All the service users are encouraged to use either the Home’s Complaints Book or write in the Comments Book. Staff and in particularly the service user’s key worker will support the service user to express any concerns they may have and will write in the books on “their behalf” and then read back exactly what has been written. All new staff receive in their induction training information on the key issues surrounding Adult Protection, and Whistle blowing. This initial training is followed up with a further day of specialist training entitled “Protection from Abuse”. In addition senior staff are nominated to attend the local multi agency training courses run by Dorset Health & Social Care Services. The home uses a monthly incident/ monitoring form, which is used to record any change in a service user’s routines or patterns of behaviour. This information is then cross referenced against the services provided to ascertain if any changes maybe affecting the service user and to ensure their needs are being reflected and met in their lifestyle.
DS0000026741.V283689.R01.S.doc Version 5.1 Page 13 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 • Barnes Lane provides a homely warm and clean environment for service users and staff to live and work in. • The bathrooms in both houses are in urgent need of refurbishment and it is extremely difficult for staff to maintain the high standards of cleanliness found in the rest of the home in these two bathrooms, which need considerable work. EVIDENCE: During the inspection visit all communal areas were viewed. Barnes Lane is comfortably furnished and all the communal rooms well decorated. However, the standard found in both bathrooms was very poor. It is recognised that some service users do not totally respect the fabric and furnishings in the bathrooms and this has increased the “wear and tear”. It should also be noted that the responsibility for refurbishing the bathrooms is with the social registered landlord and not with the tenants Wessex Autistic Society. All staff share responsibilities for maintaining the cleanliness of the homes. The grounds and external fabric of the buildings looked to be well maintained. Comprehensive risk assessments are regularly completed and reviewed for the communal areas. Each house has a “shift plan file” which includes the basic work/routine for staff and acts as an a aide memoir for all staff ensuring all
DS0000026741.V283689.R01.S.doc Version 5.1 Page 14 regular domestic tasks and health & safety checks are completed i.e. checking the temperate of appliances, ensuring cleaning routines are maintained. DS0000026741.V283689.R01.S.doc Version 5.1 Page 15 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 & 35 • The employment procedures and the staff training programme, which is comprehensive and covers all aspects of the statutory training contribute to the overall protection of the service users living at Barnes Lane. • Staff care for service users in a sensitive and professional manner. • NVQ training is positively encouraged and many of the staff team have successfully been award NVQs. EVIDENCE: All staff files are retained at the Wessex Autistic Society local administrative office at Crekerne. However, copies of essential information were available at the home. Training for new staff is very thorough and combines off site generic training modules with specific practical sessions at the home. The induction / foundation course may take from 6/12 weeks. This training evolves from a basic broad-brush introduction to the Wessex Autistic Society and the work place to more complex training in understanding behaviour management. The training incorporates all the required statutory training i.e. fire prevention procedures, health & safety, security and emergencies and food hygiene. The first two weeks for all staff is spent “shadowing” other experienced staff and this is beneficial for both new staff and for the service users to gradually become aware of a new member of the team working in their home. A total of 14 staff are employed at Barnes Lane. The manager discussed the work rota, which always ensures there is a minimum of 3 staff working each
DS0000026741.V283689.R01.S.doc Version 5.1 Page 16 shift. Annual staff appraisals are comprehensive. Newly appointed staff have an initial appraisal after six months and this links with their induction training being successfully completed and signed off. Staff appraisals for existing staff are used positively to reflect on the past year’s work and contribution to Barnes Lane but equally look to the next twelve months to set new professional and personal targets. An important aspect of the appraisal process is self-directed and staff are encouraged to complete their own report before discussing it with their line manager. A staff file was reviewed and the records were found to clear and comprehensive. Please note staff were only briefly met at this inspection visit and more time will be arranged to receive staff feed back at the next inspection visit. DS0000026741.V283689.R01.S.doc Version 5.1 Page 17 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 &42 • The Manager and staff ensure safe working practises to safeguard and protect the service users as far as practical in all aspects of daily living. Staff ensure the environment is maintained to a safe standard and support is appropriately provided to each service user according to their needs and abilities. EVIDENCE: Records seen in the course of this inspection indicated that health and safety monitoring and checks were regularly undertaken. Records showed that services and equipment were being inspected at the required intervals and this information was further verified during the tour of the home. From discussions with the manager it was evident that the responsibilities for the practical dayto-day health and safety issues for both service users and the staff are carefully adhered to. The visitors’ book was clearly used with regular entries. DS0000026741.V283689.R01.S.doc Version 5.1 Page 18 Risk assessments of working practices within the home were recorded and reviewed. All accidents and incidents are recorded. The records, staff development and monitoring systems all reflect a good and practical management structure. DS0000026741.V283689.R01.S.doc Version 5.1 Page 19 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 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x 3 x x x x 3 x DS0000026741.V283689.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000026741.V283689.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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