Inspection on 27/07/07 for Wessex Autistic - 13-15 Barnes Lane

This inspection was carried out on 27th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wessex Autistic - 13-15 Barnes... 11/10/06

Wessex Autistic - 13-15 Barnes... 27/02/06

Wessex Autistic - 13-15 Barnes... 21/12/05

Wessex Autistic - 13-15 Barnes... 03/03/05

Wessex Autistic - 13-15 Barnes... 28/09/04

Wessex Autistic - 13-15 Barnes... 25/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Wessex Autistic - 13-15 Barnes Lane 13-15 Barnes Lane Beaminster Dorset DT8 3LS Lead Inspector Marion Hurley Key Unannounced Inspection 27th July 2007 10:00 Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.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 Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.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. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 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) Mandy Elizabeth Gibson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th October 2006 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 provides personal care and accommodation for up to six young people, who have an autistic spectrum disorder. The home 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 but busy town. The staff support the residents to access the local amenities, which include GP surgery, Churches, Post office, pubs, cafes and several shops. Barnes Lane is owned by West Country Housing Association and is managed by the Wessex Autistic Society under a licence agreement. It is staffed on a 24 hour basis, with a 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. Copies of the last Inspection Report are kept at the home or may be obtained from the Regional Administration offices in Crewkerne. Fees range from £1,391:00 according to the individual’s assessed needs and abilities. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken as part of the statutory inspection process in accordance with the Care Standards act, 2000. All key standards were assessed according to the Care Home for Adults (18-65) National Minimum Standards. Five service users were being accommodated at the time of this inspection. This report will refer to those residents as service users as this is their preferred means of reference. This was an unannounced inspection, which included two visits to Barnes Lane, the first facilitated by three members of staff and five service users and then a further visit to meet and provide feedback to the Registered manager. An additional visit was made to Church Street, Crewkerne, which are the administrative and regional offices for the Wessex Autistic Society and where the service user business files and staff personnel files are stored. Records and documents were examined, including two service user files, and two staff files. A tour of the premises took place and staff and service users were observed working side by side throughout the visits. Due to the complex communication abilities of the service users it was difficult to gain detailed feedback on the quality of services provided, although all the service users appeared happy and quite relaxed in the homely environment. What the service does well: What has improved since the last inspection? Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 6 The home has continued to progress under the guidance of the Registered Manager and the changes made in the working practices and administration of the home have benefited both staff and service users. Service users no longer attend a centre based day services and this appears to have greatly reduced individual stress levels. The implementation of the 24-hour service with an emphasis on personalised day programmes allows for much greater flexibility in meeting all the individual needs and interests of the service users. Equally staff reported that the new style of working has been challenging, stimulating and very rewarding to observe the confidence and self esteem of service users develop as they have been supported to access and enjoy community resources. Each house is gradually developing their “own personality and style” and each now has their own housekeeping budget, individualised furniture and fittings based on the service users’ choice. Each household does their own shopping and the manager feels this has improved the standard of cleanliness and quality of meals provided in each household. (previously bulk buying was done for the houses) New flooring has been laid throughout the ground floor in house No 15 and in the hallway and dining area in number 13 and in the hallway of 14. Each house now has their own washing /tumble drier, which creates further independence for each household. One bedroom is under going refurbishment and the decoration of the communal areas is on going. The staff rota has been developed and now includes specific time for ensuring household chores are completed and this was reflected in the cleanliness of each house viewed. What they could do better: A start date for work on the new extension has just been agreed (20/08/07) and this will enhance the communal space by creating a new en suite sleep in facility for staff, an office and meeting room and a utility room for outdoor equipment. This will free up existing space in all the houses. The extension is being built at the side of number 15 and will be an L shape extension. The registered manager, with staff support needs to transfer Individual Service Plans into the well produced new style documents which include good use of graphics and photographs to provide more meaning for the service users. The registered manager must ensure that senior staff complete all tasks delegated to them, this refers to fire safety training which they had been given responsibility for but failed to maintain as required. All mandatory training must be carefully monitored and renew dates entered to ensure all staff training is kept up to date. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 7 Improvements to the monitoring and recording of serving hot food ( to ensure it is fully cooked and served at the correct temperature) and records relating to the correct temperature of storage of food needs to eb completed to further ensure and evidence service users health and safety. 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. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 8 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 Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 9 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): 1, 2 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People, who use this service and their representatives, have sufficient information about the home and services in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse need are identified and planned for before they move in. EVIDENCE: There have been no new admissions since the last inspection and recently a vacancy has become available. The registered manager was able to explain the process and admission policy to ensure future prospective service users needs would be fully assessed prior to any admission. Further evidence was established from reading two Individual Service /Care Plans, both of which contained detailed assessments outlining the needs and abilities of the two service users. All aspects of health and social care were covered allowing staff to have plenty of information to assist the service users appropriately. The Wessex Autistic Society has a generic and specific Statement of Purpose and Service User Guide available for each of their services. These documents are currently being reviewed and revised to reflect the new 24 hour services Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 10 that now incorporate community based and individualised day services for each service user. The Wessex Autistic Society has a service level agreement with each service user, and their funding authority, these need to be revised to reflect the change in service delivery and the society needs to ensure all funding authorities sign the agreement. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 11 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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user’s health and social care needs are set out in individual service /care plans. Service users are provided with opportunities to maintain and develop their practical living skills within an appropriate management of associated risk in accordance with individual abilities. EVIDENCE: Information taken from the Statement of Purpose and discussion with staff demonstrated that the concept of individual life style planning is used to ensure that service users are at the centre of planned care. Each service user has an Individual Service Plan and two such plans were read during the visit. The relevant keyworker involved in one of the plans read, provided practical examples to illustrate how the plan is implemented. The service plan is updated on a yearly basis and is drawn up where possible with the involvement of the service users and also other family members and significant others e.g. social worker, community nurse. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 12 Daily records provided accounts of how service users had spent their day and the level of support and participation each had required pursuing their chosen activity. Service users observed on the day had the freedom to make decisions of their own and were supported to do so. Detailed risk assessments were available and included health and well being, activities within the home and out and about in the community. The assessments identified the risk, how the risk could be reduced and the staffing ratio required to achieve this. The management of risk also takes into account the age, the specialist needs of the service user, balanced with their wish for independence and choice. Where restrictions are in place the decisions have been made with the service user and or their representative, for example over issues relating to the amount of food consumed. None of the present service users manage their own finances and the Wessex Autistic Society has clear procedures in place to assist and protect both the service user and staff when handling money. Records of two service user’s money were checked and were up to date with the cash held balanced accurately against the written records. Staff described the process for the safe handling of service user’s money and clearly were implementing the Wessex Autistic Society’s procedures. It is recommended that the home provide written evidence that the plans are reviewed regularly and that this information is incorporated into the individual’s yearly review where other agencies are involved. All the documentation relating to the individual service users is detailed and is currently being transferred into new style Service plans which clearly illustrate the service users needs, abilities likes and dislikes and the written information is backed up with graphics, photographs and symbols. Individual Service Plans are kept in the office however each service user has access to their own file known as “My Personal Passport” which are kept in their rooms or in the communal room/cupboard. The file contains a summary of their daily routines, their named keyworkers and when and how specific support is required throughout the 24-hour period, risk reduction strategies, primary health care and specific goals. Each service user is allocated two members of staff as their keyworker. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 13 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): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are fully supported to have an enjoyable and fulfilling lifestyle, which includes suitable activities and opportunities to follow leisure pursuits. The daily life in the home is relaxed and inclusive with service users support needs always taking priority. The home i.e. each house provides a planned menu of meals including a range of choices to cater for special likes and dislikes of the service users. The service users have their rights and freedom of choice and movement recognised. EVIDENCE: All five service users were observed throughout this visit and were seen to be relaxed and pursuing their own interests. One service user was able to describe taking part in craft activities and was looking forward to doing more craft related activities. There was evidence, from the records and in discussion Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 14 with staff that all service users living at the home are provided with a range of activities and community contact However due to staff shortages on the day of the inspection visit service users were not able to go swimming as planned Whilst this caused concern to the staff the service users were quite relaxed by the change in plans and hoped at least to get out later in the day. Most of the service users’ manage to go shopping, visit relatives and some enjoy going on holiday whilst others prefer to stay at home and enjoy days out. One service user is particularly interested in motor sports, and his bedroom reflected this interest. Each service user is allocated two members of staff as their keyworkers and each person has dedicated keyworker time which involves going out to a place of their choice and generally this will include having a meal out. In addition to the staff rota, which allocates members of staff to the different houses, there is a two a week activity programme which indicates the different activities /service users allocated to the staff. In addition the home transport is also identified on this rota to ensure that appropriate transport is available for accessing the community resources/ activities e.g. horse riding, recycling, swimming. Each service user has an Activity Plan, which details the purpose of the activity, the materials needed, a task analysis and personal log. Where possible service users are encouraged to write their own log however there is no pressure for this completed if it causes any level of anxiety to the service users. Meals are prepared by support staff, though service users when appropriate and safe are encouraged to help, one person likes setting the table, another will prepare vegetables. Each “house” has its own housekeeping budget and meals are prepared and served in each house though occasionally service users ask someone from another house to join them. The menu suggests that service users are provided with a varied and nutritious diet. The main meal is served in the evening. All the kitchens were seen to be clean and tidy and hygienic on the day of this inspection. Observations throughout the inspection visit evidenced that service users have unrestricted access throughout their home/ specific house and are well integrated into the daily routines. Staff support service users to maintain family links and the home has an “open” visiting policy. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported in their personal hygiene and healthcare. The support the service users receive is appropriate and provided in a private and dignified way. Service users have their physical and emotional well being monitored. The Wessex Autistic Society has clear procedures for the safekeeping and administration of medication and these were being fully implemented at Barnes Lane. EVIDENCE: Service users each have Individual Service Plans, which set out details of the level of support required, including those around personal care. The Plan also highlights how the service users would like to receive support to manage their personal hygiene and specifically any likes, dislikes and preferred routines e.g. for one service user this refers specifically to the level of support and time spent in the bathroom. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 16 The home was able to demonstrate from discussion with staff and records that the physical and emotional needs of the service users are monitored and they have access to community health facilities when required. There is a clear section in their plans devoted to health care needs with details of how these are met. A log of all hospital, GP, dental and other related appointments is maintained. The manager stated the service benefits from an excellent working relationship with members of the Community learning disability are service users are able to access assessment and treatment services from this team and other associated members e.g. GP, consultant. Health and dietary requirements are recorded in each service users Individual plan. The home encourages service users to determine their own patterns in respect of daily routines however, staff feel a change is required, other professionals such as Community Nurse, Occupational therapist or social worker are informed so that a multi agency approach can be taken to support the individuals concerned. The emotional needs of service users are cared for and carefully monitored to record any significant patterns in their emotional well being. The Wessex Autistic Society has a policy and clear guidelines for the safe handling and administration of medication and these were being fully implemented by staff at Barnes Lane. However some staff had not completed basic training in the safe handling and administration of medication, other records relating to the handling and administration of all aspects of medication were checked and all entries were satisfactory and being maintained. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families can expect to be provided with sufficient information to enable them to make a complaint about the service. Service users can expect the home’s policies and procedures to protect them from abuse, neglect and self-harm. Good communication with service users and their representatives generally pre-empts complaints. EVIDENCE: The Wessex Autistic Society has a robust complaints procedure, which is available to all service users and their families. Barnes Lane has a copy of the procedures and from records and discussion with staff it was apparent the home in general follows the guidelines. The procedures also form part of the information provided to all new service users and their families. One complaint has been received since the last inspection and even though this had been comprehensively and sensitively dealt with by the manager and staff the records in the complaint log had not been completed though records relating to the issues were recorded in other documents. The home will also implements, when necessary, the Wessex Autistic Society procedures on the protection of vulnerable adults, including the whisltleblowing procedure. These documents are included in the staff handbook and are part of the induction training. Staff confirmed they are made aware of adult protection issues during their induction and the manager and staff demonstrated their Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 18 knowledge and understanding of the procedures for Safeguarding Adults and will always attend multi-agency meetings or provide information to external agencies when requested. The home was also able to evidence that it had a copy of and adhered to the local Protection of Vulnerable Adults Procedure, which is a multi agency document. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users live in a safe, homely and clean environment. Several areas of the home are in the process of redecoration and refurbishment. Service users have access to both private and communal accommodation, which meets their needs and lifestyle. EVIDENCE: During the tour of the houses it was evident that some areas of the home have been redecorated and others are due. There was new flooring throughout one of the houses (Number 15) and new flooring in the hallways of the other two houses (13 & 14). New washing /drier machines were being delivered for each house, one had arrived and the other two expected. This will make each house more domestic and independent instead of sharing a communal laundry. Two bedrooms were viewed and had been personalised and adapted for the individual lifestyles and interests of the service users. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 20 The communal space is adequate including kitchen and lounge/dining room. There is a pleasant rear garden with a summerhouse. All areas of the three houses were clean and felt homely and there were no unpleasant odours. The support workers duties include house care /cleaning this will also involve supporting each service user to participate at some level in managing their own room and laundry. Included in the staff rotas are up two hours every two weeks of “none contact time” and this is to ensure staff have adequate time to read policies and procedures and that their records are up to date. House care duties are also identified on the rota with specific tasks allocated. Service users looked happy and relaxed in their home and were observed in the communal lounges, kitchen. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.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, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are well supported by trained and experienced staff. Staff receive appropriate training and have the knowledge and skills to carry out their roles and responsibilities. EVIDENCE: At the time of the inspection there were two staff members and one Wessex Autistic Society member of the bank staff on duty with five service users. Four people were in two houses and the fifth in the other house. Unfortunately there was an unexpected staff shortage, which restricted the service users accessing as planned their swimming session. Some service users when participating in community activities require a high staff ration e.g. 2:1 and the minimum staffing levels available on the morning of the inspection prevented this level of support. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 22 Staffing rotas seen at the time of the inspection clearly indicated that two more staff should have been on duty, and this would have been very sufficient for the daily programme of community activities to be completed. When staff are not available the Wessex Autistic Society in the first instance uses their own bank/relief staff and if this` source does not supply adequate numbers then Agency staff will be used. The Society links with two agencies to ensure consistency for the service users and to be reassured that agency staff have a knowledge of the service users specific needs and their different communication preferences and styles. All Bank / relief staff complete the Wessex Autistic society induction training and are required to shadow staff on a shift before commencing any duties. It is recommended that the manager requests training documents from the agencies to ensure all staff working at Barnes Lane have completed the basic mandatory training. A second recommendation is that the home has copies of CRB checks currently it is understood these are held by the central recruitment team for the Wessex Autistic society however, it is important the manager is reassured that all staff including agency staff have completed all the recruitment checks. During the inspection staff appeared to undertake their roles in a confident and professional manner and were clear about their responsibilities. From observations on the day there was very good communication between staff and service users and individuals were treated in a professional but warm manner and it was evident that good working relationships existed. Staff had a clear understanding of the service user’s individual needs. Training records clearly evidenced that staff had attended appropriate training. Training included challenging behaviour, protection of Vulnerable Adults, Manual handling, food hygiene, and first aid. The staff spoken to stated they felt well supported by the management and were enthusiastic about their work in the home, which they enjoyed. Staff meetings are held every four weeks and the manager stated these are positive and practical team meetings, all minutes from these meetings were available. The Service has a clear recruitment policy, which safeguards both staff and service users. Two staff files were checked and these evidenced that all necessary checks were in place before staff stared work in the home. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and there is an open and inclusive management style, which has the interests of the service users foremost. The home promotes the health, safety and welfare of service users and staff. EVIDENCE: The home is managed in an open and positive atmosphere, which benefits not only the staff but also the service users. There is evidence from previous inspections that the home has consistently promoted the health, safety and welfare of service users and that risk assessments on the building and equipment are in place, together with fire Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 24 safety records and risk assessments. The service has policies and procedures relating to the health and safety and welfare of staff and service users. Regular checks on appliances, fire alarm system, water temperatures and electrics were seen and most were up to date however some food temperatures were not being regularly checked and the fridge and freezer temperatures had a few omissions. An accident/incident records were viewed and in order and incidents cross-referenced with Regulation 37 reports and daily service user reports. It is recommended the manager record when all mandatory training is completed and when the training is due for renewal e.g. basic food hygiene. The manager has delegated the responsibility of fire training and safety checks to the two senior staff however, they had failed to ensure these records were up to date and there were omissions in the fire training. This has resulted in a requirement, which stipulates that all fire training and checks must be up to date. The service has a quality assurance system in place and where possible the service users are involved and all relatives and other professionals are invited to contribute and give their opinions of the services provided. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.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 2 2 3 3 X 4 X 5 2 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 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 3 3 2 x Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 26 YES 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 YA20 Regulation 13(2) Requirement All staff handling and administering medication must receive appropriate training to ensure safe handling and administration of medication. All staff must receive regular training in safe working practices. All fire training must be completed as required. This requirement is carried forward from the last inspection completed in October 2006. Timescale for action 31/08/07 2 YA42 24(d)(e) 31/08/07 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 YA1 YA5 Good Practice Recommendations The Statement of Purpose & Service User Guide need to reflect the change in the delivery of services and need to refer to the 24 hour provision of services. The individual service level agreements need to be updated to reflect the change in the delivery of services and where possible the Wessex Autistic Society must DS0000026741.V342567.R01.S.doc Version 5.2 Page 27 Wessex Autistic - 13-15 Barnes Lane 3 YA22 endeavour to get these signed by the funding authorities. Documents referring to complaints or issues relating to Adult Protection should be recorded in the specific files and not only in the related service user documents. Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Wessex Autistic - 13-15 Barnes Lane DS0000026741.V342567.R01.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. 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