Care Home: Autism Initiatives (85 Beatrice Street)

What the care home does well This is a service specifically designed for one person. The manager and many of the staff have worked with her for a number of years and show commendable dedication to supporting her. The service meets all of her needs and enables her to take part in activities and lifestyle that she chooses. The house is clean ,homely, well furnished and, in the main, well decorated. The service user is especially pleased to have moved, her last home having been in an unsuitable building. What has improved since the last inspection? This is a new service and this was therefore its first inspection. What the care home could do better: Some of the care plans need to be updated now that the service user is in a new location. The service user needs to be involved in choosing decor and furnishings. Key inspection report Care homes for adults (18-65 years) Name: Address: Autism Initiatives (85 Beatrice Street) 85 Beatrice Street Bootle Merseyside L20 2EG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Peter Cresswell     Date: 0 9 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 20 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 20 Information about the care home Name of care home: Address: Autism Initiatives (85 Beatrice Street) 85 Beatrice Street Bootle Merseyside L20 2EG Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Mary Jeanette Finn Type of registration: Number of places registered: care home 1 Autism Initiatives Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered provider may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either. Whose primary care needs on admission to the care home are within the following category: Learning Disability - Code LD. The maximum number of service user that can be accommodated is: 1 Date of last inspection Brief description of the care home 85 Beatrice Street is a care home established specifically for the care and support of one individual with Aspergers syndrome. It is a two bedroom terrace house in Bootle, just off Stanley Road. It is near to community and shopping facilites in the centre of Bootle and to bus and train routes to Liverpool or Crosby. 1 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 20 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: As part of the inspection we visited the home. We rang the house just before visiting to make sure that someone was in when we called. During the visit we talked to the person who lives at Beatrice Street, the manager and another member of staff. We looked at a range of records including care plans, risk assessments and staff files. Before we visited the manager sent us an Annual Quality Assurance Assessment (AQAA). The AQAA includes the services own assessment of how well it is meeting the needs of the service user as well as some useful statistical information. Care Homes for Adults (18-65 years) Page 5 of 20 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 20 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 20 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user has all of the information needed about the service. Evidence: This new service is specifically designed for one person. It replaced a house in another part of Merseyside. The move to the new property was done in full consultation with the service user and the service was set up to meet her needs. In the unlikely event of it ever being used for another person, Autism Initiatives admission procedures would be used. The section on complaints in the statement of purpose refers to the CSCI which has now been replaced by the Care Quality Commission. The contract on file referred to the former property and should be replaced by one for this service. Care Homes for Adults (18-65 years) Page 8 of 20 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users needs are reflected in care plans, though they do need to be updated. Evidence: There are well established care and support plans in place. They are reviewed regularly but some need to be revised in the light of the move to a new house. The same applies to risk assessments, some of which were specific to the former property. Daily reports are made by the service user herself which is innovative and useful. However there should also be a daily report made by staff to keep an up to date record of how the care plan is being met and to provide evidence for reviews. The owners should consider, in consultation with the local authority, if an assessment under the Mental Capacity Act 2009 is appropriate. The person who lives at Beatrice Street does not have access to an advocate and there has been some confusion about who should pay for such services. This needs to be resolved between the owners, Autism Initiatives, and the funding authority. There may be advocacy services run by service users and their families who will provide support free of charge. Records are Care Homes for Adults (18-65 years) Page 9 of 20 Evidence: stored securely in a locked office. The service user did not play an active part in choosing the decor in the house and she should be fully involved in future decisions, such as the decoration of the main lounge. The service user manages her own finances with the support of the staff. Care Homes for Adults (18-65 years) Page 10 of 20 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user takes part in a range of appropriate activities of her own choice. Evidence: The service user has a part time job and takes part in various activities in the community with the support of staff. She chooses her own meals and helps staff to get them ready. Her menu is varied and wholesome. Staff are supporting her in trying to find finances for a holiday. Staff also support her in keeping in touch with her family. Care Homes for Adults (18-65 years) Page 11 of 20 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users health needs are met. Evidence: The person living at Beatrice Street receives all the support that she needs. She is registered with a local GP and has access to all community and specialist health care. This is recorded in detail in the case file. Medication is securely stored and safely administered. The manager is seeking Medication Administration Record sheets from the pharmacist to make recording easier. At the moment staff prepare MAR sheets themselves. This is not ideal but if staff do it they must make sure that the sheets are signed. Care Homes for Adults (18-65 years) Page 12 of 20 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users interests are protected by the owners policies, procedures and practices on safeguarding and complaints. Evidence: The owners - Autism Initiatives - have satisfactory policies on safeguarding and dealing with complaints that protect the service users interests. policies and procedures on safeguarding and complaints. She knows how to make a complaint should she want to do so and has a copy of the procedure. Care Homes for Adults (18-65 years) Page 13 of 20 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building meets the needs of the person who lives there. Evidence: The house is large enough for the service users needs, with a dining room, lounge, well equipped kitchen and two bedrooms. One of the bedrooms is used as an office and staff sleep in room. There is a back yard with plenty of space for garden furniture and the manager told us that they are going to buy garden furniture for the summer. The service user told us that she was really pleased with the new house and was looking forward to sitting out reading in the back yard in the warmer weather. Most of the house has been recently decorated but the front lounge/TV room needs to be decorated. The service user needs to be involved in the choice of decor here, in line with the Statement of Puropse which says we offer the service user the chance to be fully consulted and to provide input into the running of the home. The minor items of work that our registration officer required have been completed. Care Homes for Adults (18-65 years) Page 14 of 20 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing arrangements meet the needs of the service user at Beatrice Street. Evidence: The home is well staffed and the staffing ratio meets the needs of the person who lives there. Staff are well trained and nearly all have the relevant NVQ. The owners have an extensive in-house training programme and staff identify the training they need during one to one supervision with the manager. A member of staff keeps a record of the training people have received and when refresher training is due. No new members of staff have been employed in the last year. When people are recruited the owners have well established recruitment procedures to make sure that only suitable people are employed. Staff show a high level of commitment to the service user and she plainly appreciates this. The staff team has been very stable for some years which is important in providing a stable, caring environment for the individual concerned. Care Homes for Adults (18-65 years) Page 15 of 20 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, meeting the needs of the person who lives there. Evidence: The manager is qualified and experienced. She has worked with the service user for a number of years, providing much appreciated stability and support. As to be expected in such a small home there was a very open and relaxed atmosphere when we called in. The staff group have a strong commitment to their work and a strong team work ethic. Senior staff from the owners, Autism Initiatives, visit every month to check on standards in the home. One such visit had taken place on the morning of our site visit. Care Homes for Adults (18-65 years) Page 16 of 20 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 17 of 20 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 18 If staff make entries in medical records such as Medication Administration Record sheets they must be signed. It is important that an accurate record is kept of all medication administration. 01/03/2010 2 24 23 The front lounge needs to be 30/04/2010 redecorated. All parts of the home must be kept clean and reasonably decorated. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 5 6 6 The person living in the home should have an up to date contract. The care plans need to be updated and where necessary revised following the move to new premises. Staff should make a daily written report as to how the care Page 18 of 20 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations plans are being met. 4 5 6 7 7 7 8 14 The owners should make arrangements for independent advocacy for the person who lives in the home. The responsible individual should consider whether an assessment under the Mental Capacity Act is required. The person living in the home should be able to choose how the home is furnished and decorated. The owners should discuss with the funding authority how to arrange for the service user to have a holiday of at least a week each year. Care Homes for Adults (18-65 years) Page 19 of 20 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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