Care Home: Autism Initiatives Respite Services

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• Clover House
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• Park Lodge
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• Hudson Road
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What the care home does well During their stay at the home residents are supported to live independent and safe lives in a way that they choose. Residents health and personal care needs are well recorded and they are well supported and monitored during their stay to ensure they stay well. Staff treat residents with respect and their privacy and dignity is observed all the time. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 The residents are given opportunities to take part in the things they like to do both at home and in the local community. Procedures, which were in place at the home, make sure that residents are protected from abuse or neglect and people are confident about complaining if they need to. Staff have been properly recruited to make sure they are right for the job. What has improved since the last inspection? Residents are given more opportunities to go out socially and to use the local community. Residents that stay at the home now have a health care plan so that staff have all the information they need to ensure they stay well. Staff turnover at the home has been low since the last inspection providing greater stability for the residents that stay there. Since the last inspection a new manager has been appointed and he has put in an application to the CQC to become the registered manager of the home. The home has been consistently managed for over 18 months to the benefit of the residents and staff. Systems are now in place for measuring the quality of the service to make sure it is running in the best interests of the residents that stay there. What the care home could do better: Consideration should be given to adapting the support plans so that they are more appropriate for the type of service which the home provides. All staff must receive protection of vulnerable adults training (POVA) so that they know exactly how to deal with an incident of abuse. Plans should be put in place to decorate the lounges and for the new Televisions (TVs) to be installed so that residents have the full use of equipment they need. The uneven flags on the driveway must be repaired or replaced to minimise the risk of trips and falls. All staff that work at the home, including bank staff, must be provided with training so that they have the knowledge and skills they need to meet the needs of the residents and the aims and objectives of the home. All staff must attend relevant training to enable them to meet the needs of the residents and so that they are up to date with new ways of working and changes in the law. Key inspection report CARE HOME ADULTS 18-65 Autism Initiatives Respite Services 8 & 10 Barnsbury Road Walton Liverpool Merseyside L4 9TS Lead Inspector Mrs Janet Marshall Unannounced Inspection 30 September 2009 09:30 th Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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 home adults 18-65 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. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 2 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 Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Autism Initiatives Respite Services Address 8 & 10 Barnsbury Road Walton Liverpool Merseyside L4 9TS 0151 226 8604 F/P 0151 226 8604 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) www.peterhouseschool.org Autism Initiatives Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection 18th April 2008 Brief Description of the Service: 8 and 10 Barnsbury Road is registered to provide a service for up to 5 adults who have a learning disability. No. 8 provides accommodation for 2 service users whilst No. 10 provides accommodation for 3 service users. The service is provided by Autism Initiatives. Autism Initiatives was formerly called the Liverpool and Lancashire Autistic Society and it was established in 1971. The organisation provides a variety of services to adults and children who have autism. These include residential care, day care, supported tenancies, outreach, domiciliary care, respite and educational services. Autism Initiatives is a voluntary organisation with charitable status. The accommodation at Barnsbury Road comprises of two adjoining semidetached properties. Each house offers single bedrooms, a shared bathroom, kitchen, dining and lounge areas. Local amenities include a sports centre and leisure facilities, entertainment complexes, various shops and access to public transport. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 2 star. This means the people living at the home experience good outcomes. This was a key inspection. We consider 22 out of the 43 National Minimum Standards for this type of service, Care Homes for Adults (18-65) as the key standards, which have to be inspected during a key inspection. The key standards are highlighted in bold in the different outcome sections of this report. A key inspection is a planned inspection, the report has been put together using information gathered in a number of different ways, which helps us decide the overall rating of the service. We keep all information we receive about the home in a file, we looked at all the information we have received since the last inspection. We sent out a form to the home called an Annual Quality Assurance Assessment (AQAA). The AQAA has to be filled in and returned to us by a set date usually before the site visit takes place. The AQAA was filled in by the manager and returned to us on time, it provided us with information we asked for about the service and was used to support some of the judgments we have made. We carried out an unannounced visit to the home, this is when we visit the home with out any body knowing and is called the site visit. One resident was staying at the home when the site visit started, another resident arrived for a short stay just before the visit ended. The residents, the manager and support staff that were on duty all helped with the inspection. Also during the site visit a selection of records and certificates, which have to be kept in the home by law were looked at and checked to make sure they were up to date and accurate. Two residents were case tracked. This is a process we use to find out whether the people that live at the home are receiving good quality care that meets their individual needs. It is done by talking to people, looking at results of surveys and reading the records of a sample of people that live at the home to give us a good idea of what it is like for them. Before the site visit took place we sent out Have Your Say surveys to people asking them about what it is like to live and work there. No surveys were returned at the time of writing the report. What the service does well: During their stay at the home residents are supported to live independent and safe lives in a way that they choose. Residents health and personal care needs are well recorded and they are well supported and monitored during their stay to ensure they stay well. Staff treat residents with respect and their privacy and dignity is observed all the time. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 6 The residents are given opportunities to take part in the things they like to do both at home and in the local community. Procedures, which were in place at the home, make sure that residents are protected from abuse or neglect and people are confident about complaining if they need to. Staff have been properly recruited to make sure they are right for the job. 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 Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 7 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. Autism Initiatives Respite Services DS0000025222.V374899.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 Autism Initiatives Respite Services DS0000025222.V374899.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures followed for assessing and admitting a new resident to the home ensure it is the right place for them to stay. EVIDENCE: The AQAA told us about the different types of need assessments which are routinely carried out before it is agreed that a person can stay at the home. They include assessments carried out by a manager of the service using the companies standard assessment forms and assessments carried out by other qualified people such as social workers and nurses. Assessments cover things about the persons life such as communication, mobility, health and personal care, social interaction, behaviour and relationships. Once completed the assessments are used to decide if the persons needs can be met at the home and also so that they can be sure it is the right place for them to live. The manager said residents and their family/carers are fully involved in the assessment process. Residents care needs are assessed on a regular basis, usually before each stay, to make sure that they can continue to be met at the home. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 10 The manager said that people who are interested in staying at the home are given information about it to help them with their decision. The information was available in both written and picture format. Autism Initiatives Respite Services DS0000025222.V374899.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents individual needs and choices are well recorded so that staff have the information they need to help them live independently and safely. EVIDENCE: A working file has been put together for each of the residents. Files for two residents were looked at in detail as part of the case tracking process. The files which were kept safely at the home are used by staff on a daily basis to support residents individual needs and choices. A document titled ‘about me’ was available at the front of each of the working files. The document included information about the resident such as, how they communicate their hobbies and interests, behaviours, health and personal care, relationships and health and safety. The working file also contained a set of support plans. Support plans, which are used across all the companies residential services are put in place to help staff support residents with certain behaviours and to help them develop a particular task or activity, with an overall aim to promote their independence. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 12 Each support plan provided staff with instructions about how they need to support and monitor a resident with a task, activity or behaviour and they include daily reports on the residents progress. There was written evidence to show that plans are reviewed each month and actioned appropriately. Consideration should be given to adapting the support plans so that they are more appropriate for the type of service, which the home provides. Some tasks and activities, which support plans currently cover are unrealistic because of the short period of time that a resident stays at the home. Residents that stay at the home communicate in a number of different ways. Some use spoken words, those with limited use of words communicate in other ways such as by using pictures, symbols, facial expressions and gestures. On the day of the inspection visit a member of staff helped a resident to communicate using a picture board. The resident who had just arrived at the home for a short break used the board to choose activities for that evening. A resident spoken with during the site visit said, “Yes, I always make my own decisions and choices, I choose where I want to go and what I want to do. I decide what I wear each day. The staff are very good they never make me do anything I don’t want to do, some times they help me make choices if I am unsure”. Residents care files included information about how they communicate. There was also information about the choices and decisions they can make themselves and any help they need with others. Some residents have support plans in place to help them improve their communication skills. Care files, which were looked at showed that risk had been assessed before the resident moved into the home and any risk or hazard identified has been risk assessed. Risk assessments which were in place detailed the action which needs to be taken so that residents can safely take part in a task or activity. They were also in place to help staff manage certain behaviours in a positive way. Autism Initiatives Respite Services DS0000025222.V374899.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): This is what people staying in this care home experience: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to live the kind of lives they choose. EVIDENCE: The AQAA told us that residents are supported to take part in activities of their choice and they are part of the local community. Care files that were looked at included information about the residents preferred interests and hobbies and they had an activity timetable which has been put together around their preferences. The manager said were possible residents are fully involved in putting together their timetable and they are reviewed and updated at the beginning of each stay. Support plans were also in place to support and guide residents with things such as social interaction and community based leisure activities. One resident spoken with said they get out and about a lot. The resident talked about their particular interests and hobbies and said staff help them with them. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 14 Another resident who had just arrived for a short stay was seen planning their evening activities with the help of a member of staff. Daily records which were looked at showed that residents are given opportunities to take part in a variety of experiences and opportunities both at the home and in the local community. Residents have visited parks, shops, clubs, pubs and cafes. The manager said residents are encouraged to help with the up keep of the home including cleaning, laundry and cooking. A resident said,” yes I help with cleaning, I have certain jobs that I do each day”. The AQAA told us that residents are supported to put together menu plans. Menus which were seen included a variety of meals, which were well balanced and nutritious. Menus have been put together using written words, pictures, photographs and symbols. Residents are encouraged to eat their meals at the family sized dining table which is in the kitchen/diner, although if they want they can eat their meals in the lounges or in their own rooms. A resident said, they shop for food with staff help and they get to choose the food they like. The resident also said they help to cook their meals and can have a snack during the day if they want. Information about the types of food, which residents like and dislike, was recorded in their care file. Autism Initiatives Respite Services DS0000025222.V374899.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal care needs are well met and staff treat residents with respect. EVIDENCE: A requirement was given as part of the last inspection report to make sure that residents records include information on how to meet their healthcare needs. This requirement was discussed with the manager who said since the last inspection he has introduced healthcare plans for each of the residents that use the service. Health care plans were included in the two care files which were looked at. The plans provided information about the residents health and personal care needs and how they are to be met. If residents need to attend healthcare appointments during their stay staff support them with this. Details of appointments such as with doctors, opticians and dentists were well recorded. Care files, which were looked at included information about residents preferred routines around personal care. Staff spoken with had a good understanding of the residents personal and healthcare needs and gave examples about how they respect their privacy and dignity. Examples staff gave included, “I always Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 16 make sure doors are closed when helping a resident to bath and when helping them with other personal care”. “I always knock on the residents door before entering their bedroom”. “I talk to residents and explain what I am helping them with”. During this inspection visit all medication and medication administration records were examined. Medication and records were stored securley. Discussion with staff and examination of records showed that staff have completed medication awareness training. A policy for the safe handling and administration of medication was availble at the home. The manager showed a good awareness of the homes medication polices and procedures. Autism Initiatives Respite Services DS0000025222.V374899.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures at the home aim to ensure residents are protected from abuse. Some staff who work at the home have not been provided with protection of vulnerable (POVA) training which puts the residents at risk because they are not completely sure about how to deal with incidents of abuse. EVIDENCE: The AQAA told us that there have been no complaints made at the home in the last year. The Commission has received no complaints regarding the service since the last inspection. There were written and pictorial complaints procedures on display at the home. There was also a complaints book to record any complaints made at the home. The Service User Guide and the homes Statement of Purpose also included a summary of the homes complaints procedure. One resident spoken with said they know about the homes complaints procedure and would complain if they were unhappy about something. The manager said that resident’s representatives have also been given a copy of the procedure. A member of staff spoken with said that they knew about the complaints procedure and would be confident about raising any concerns or complaints if they needed to. A Protection of Vulnerable Adults (POVA) procedure was available at the home. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 18 The AQAA told us that most of the staff have received POVA training and that the topic is covered in the induction programme for new staff. Instead of POVA some people say abuse training or training about safeguarding people. Two members of staff who were spoken with during the site visit were asked what they would do if they saw or thought a resident was being abused, they said they would report any incident of abuse but they were not completely sure about how to go about it. Both members of staff said they have not received POVA training because they are bank staff. Records showing training already completed by staff and training which has been planned for the future did not include POVA training. All staff who work at the home must be provided with POVA training so that they know how to recognise and deal with incidents of abuse. Autism Initiatives Respite Services DS0000025222.V374899.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents welfare and safety is compromised by parts of the environment, which need repairing and redecorating. EVIDENCE: The home is split in to two separate houses each with its own front door. One of the houses can accommodate up to 3 people and the other accommodates up to 2 people. There is no direct access through from one to the other. Each side of the home has a separate lounge, dining room, kitchen and bathroom. The home is located in a residential area of Walton Liverpool and is in keeping with the local community. There are gardens at the front and back of the houses and driveways at the sides providing off road parking for several cars. On the day of the inspection visit there was a lot of litter on the driveways and front gardens outside both houses making them look untidy. The manager said this is an ongoing problem because of the open position of the houses, he was advised to ensure the litter is picked up on a daily basis to stop it building up and making the outside of the home look untidy. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 20 There were some uneven flags on the driveway at the side of one of the houses, which increases the risk of trips and falls. The flags must be relayed or replaced if required so that they are safe to walk on. There was a large amount of weeds growing between the uneven flags which also looked untidy. The weeds should be removed to improve the appearance of the driveway. A requirement was given as part of the last inspection report. This was because resident’s comfort and dignity was undermined by parts of the home, which were in need of some improvements. The AQAA told us that some improvements have been carried out to the environment since the last inspection, including the redecoration of some rooms. The manager said other parts of the home are due to be decorated. Large screen televisions were provided for the home several months ago but have not yet been installed. Discussion with the manager and information provided in the AQAA showed that the TVs can be linked to other equipment to provide learning programmes for residents that need them. The manager explained that the TVs will be installed once the lounge areas have been redecorated. Plans should be put in place for this to be done as soon as possible so that residents have the full use of equipment they need. On the day of the inspection visit a resident was seen moving freely around the home. The resident’s bedrooms was nicely decorated and furnished to a good standard. It was warm, bright and well ventilated. The bedroom was personalised to suit the residents own tastes. All parts of the home were clean and tidy and there were no hazards found inside. The AQAA showed that the required policies and procedures for control of infection and cleaning routines are in place at the home. It also showed that soiled laundry is washed appropriately and clinical waste is disposed of in the correct way. Autism Initiatives Respite Services DS0000025222.V374899.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are properly recruited but some need to attend training to update their knowledge and skills which are required to meet the needs of the residents. EVIDENCE: As a respite service the needs of the residents change on a regular basis therefore the amount of staff that work at the home depends on the residents that are staying there at the time. Some residents that stay at the home need one to one support from staff, the manager said residents receive one to one support when they need it. Residents staying at the home at the time of the inspection were receiving the right level of support on that day. Discussions took place with three staff that were on duty at the time. Two of them said they are bank staff. Bank staff are not permanent they work at the home on a temporary basis when needed, usually to cover shifts for permanent staff who are off sick or on holidays. The other member of staff has recently started work at the home. The AQAA told us that staff morale is good and the turnover of staff is low. Discussion with the manager also showed this, he said most of the current staff team have worked at the home since the last inspection in April 2008. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 22 Staffing rotas, which were looked at showed that there is the right amount of staff on duty during the day throughout each night. This was also confirmed by a member of staff spoken with during the site visit. The member of staff also said there is always enough staff on duty to support the residents to do the things they want to do. Staff recruitment, selection and equal opportunities policies and procedures were available at the home and the AQAA told us that strict processes are followed before a person is allowed to start work there. A new staff member said they were given a job description and understand fully what is expected of them, they also said they were given induction training when they started work. Two staff files, which were looked at during the site visit showed that those people were properly recruited and took part in induction training. Training records also seen showed that staff are provided both mandatory and specialist training, which they need to meet the needs of the residents. For example, manual handling, health and safety, medication, fire awareness, food hygiene, epilepsy and understanding autism. However the records showed that it has been over three years since some staff have attended training, which is required of them. The manager produced a training programme showing courses, which the company are providing between October and December 2009. The schedule includes training courses, which staff require to meet the needs of the residents. All staff must attend relevant training to enable them to meet the needs of the residents and so that they are up to date with new ways of working and changes in the law. Bank staff spoken with showed good knowledge and understanding of the needs of the residents and were seen treating them patiently and with a lot of respect. Both staff said they have a lot of personal experience but have not been provided with any training from the company. All staff that work at the home, including temporary staff, must be provided with the required training which they need to meet the needs of the residents and the aims and objectives of the home. The AQAA told us that more than half of the staff team have got or are working towards a National Vocational Qualification (NVQ) in Care level 2 or above. Autism Initiatives Respite Services DS0000025222.V374899.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 more consistently managed to the benefit of the residents. EVIDENCE: A new manager has started work at the home since the last key inspection. The new managers name is John Lloyd. John has applied to us the CQC for approval as the registered manager of the home, our records show that his application is being processed. Records looked at and discussion with the manager during the site visit showed that he has the right skills, knowledge and experience to manage the home. The manager has successfully completed NVQ level 4 in Care and the Registered Managers Award. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 24 Staff spoken with were complimentary of the manager and the way he runs the home, they made the following comments to support this, the manager is very good with the residents, the manager is supportive . The manager has set up a number of new systems, which he monitors and reviews on a regular basis to make sure the home is properly run. A requirement was given as part of the last inspection report to ensure that the right systems are put in place and maintained for the reviewing and improving the quality of care provided at the home. This was because at the last inspection visit there were no records to show that quality checks were being carried out. This was discussed with the manager who said he carries out regular quality checks on things such as residents care plans, health and safety records and residents finances. A representative of the organisation also visits the home each month to check that the home is running in the best interests of the residents. They write a report following the visit and a copy of it is kept at the home. The AQAA told us that the home has available all the health and safety policies and procedures, which they have to have by law to ensure the health safety and welfare of the residents and staff. It also told us that the required checks have been carried out on the gas and electricity systems and equipment used at the home to make sure they are safe and in good working order. Discussions with staff during the inspection visit and information provided in the AQAA showed that staff have received training in subjects of health and safety such as fire awareness, lifting and handling and first aid. Autism Initiatives Respite Services DS0000025222.V374899.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 X 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 3 23 2 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 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 3 X 3 X 3 X X 3 x Version 5.2 Page 26 Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA23 Regulation 13 Requirement Arrangements must be made to provide all staff that work at the home with POVA training so that they know how to recognise and deal with incidents of abuse. The uneven flags on the driveway must be repaired or replaced to minimise the risk of trips and falls. Timescale for action 30/11/09 2. YA24 23 30/11/09 3. YA35 18 All staff must attend relevant 30/11/09 training to enable them to meet the needs of the residents and so that they are up to date with new ways of working and changes in the law. 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 YA30 Good Practice Recommendations Litter outside the home should be picked up on a daily DS0000025222.V374899.R01.S.doc Version 5.2 Page 27 Autism Initiatives Respite Services basis keeping the outside of the home clean and tidy. The weeds between the flags on the driveway should be removed to improve the appearance of the outside of the home. Autism Initiatives Respite Services DS0000025222.V374899.R01.S.doc Version 5.2 Page 28 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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