Care Home: Carlton Autistic Care Centre

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What the care home does well Supporting people to maintain their individuality and chosen way of life is central to the home`s ethos and approach. Everyone`s differences are valued and the people who live at Carlton Autistic Care Centre are helped and encouraged to understand and live with everyone else. There is good and friendly interaction between the people who live in the three houses and the staff. One person said `I like the friendly atmosphere.` There seemed to be enough staff on duty to make sure they have time to spend with people in conversation, as well as offering any support people need to take part in individual and group activities. One person who lives at the home told us that `Everything is fine` and another said `I like the way things are in the home and feel comfortable`. Before moving in, people`s needs are thoroughly assessed to make sure that the home is able to meet their needs, and people can really make sure they want to live at the home. Everyone said that staff listen to them, and act on what they say. People said they like the meals and enjoy the activities, days out and holidays. There are regular residents` discussion meetings and people are involved in making the decisions about their home and how it is run. The home`s recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home. All the staff said they enjoy working at the home and felt they were well supported by their manager. They said the training is good and helps them to do their job well. The staff all said they have plenty of training, including some specialist training, to help them support the people who live at the home. The staff that handle medication have been trained and the medicines are administered safely and accurately. The complaints and adult protection systems work well and people said they know and understand what to do if they have are not happy about something. The home is clean and everyone we spoke to said that the home is always kept fresh and clean. After their last inspection, the Environmental Health Officer gave the home`s kitchen a score of four stars, for hygiene and good kitchen practice. What has improved since the last inspection? The medicine cabinet in one of the houses has now been moved to a more suitable place, away from the living areas of the house. Some parts of the houses have been re-decorated during the last year and some new carpets have been fitted. Half of the support staff have now achieved a National Vocational Qualification (NVQ) in care at level 2 or 3. What the care home could do better: It is important that all the staff take in depth, specialist training in understanding the range of autism and aspergers conditions, in order to help them provide the best support they can for the people who live at Carlton Autistic Care Centre. There is a lot of valuable information in the care plans, but they need some work to make sure they fully reflect people`s choices. Any unnecessary information should be left out, as this can obscure the important details that the staff need. After our last inspection, we asked the home to look at changing some of the door locks. This had not been done when we visited. The home`s manager has now contacted the fire safety officer, who has recommended a different type of lock that is more easily opened in the event of an emergency. The home are to have these locks fitted. Key inspection report Care homes for adults (18-65 years) Name: Address: Carlton Autistic Care Centre 23 Greenway Milnsbridge Huddersfield HD3 4RZ     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: Liz Cuddington     Date: 2 9 0 9 2 0 0 9 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 31 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 31 Information about the care home Name of care home: Address: Carlton Autistic Care Centre 23 Greenway Milnsbridge Huddersfield HD3 4RZ 01484649899 01484649899 carltonhouse@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Carlton Nursing Homes Ltd care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Carlton Autistic Care Services is a care home providing personal care and accommodation for up to sixteen younger adults with a learning disability and autistic spectrum disorder. Carlton Autistic Care Services is a purpose built home that comprises three separate houses. Carlton House provides accommodation for up to eight people. Carlton House has two small communal lounges and a separate dining room and there is also a sensory room. A passenger lift to the first floor is provided in Carlton House, ensuring that anyone with mobility difficulties can reach the first floor if necessary. Opposite Carlton House, separated by a driveway, are two houses for four people each; Greenway and Sycamore. All the bedrooms are single and have en-suite facilities. Both Sycamore and Greenway have large kitchens with space for dining, separate dining rooms and good-sized lounges. There is a small laundry room in all three houses. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 16 Brief description of the care home The home now also has a large separate laundry with commercial machines to wash larger items and bedding. There is also an office and store room in this new building. Carlton House has its own secure garden, and a shared garden is available to the rear of Sycamore and Greenway. A driveway with parking separates Carlton House from the other two houses. The home is situated approximately five miles from Huddersfield town centre. There are some local shops within a two minute walk. Milnsbridge and Golcar offer a range of amenities and are within easy reach. There is a bus stop opposite the home. Information about the service and inspection reports are available from the main office. Care Homes for Adults (18-65 years) Page 5 of 31 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: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The weekly fees the home charges are those agreed with the authorities who are responsible for funding the persons placement. They are between £1,100 and £2,000 per week, depending upon the level of support the individual requires. The purpose of this inspection was to assess the quality of the care and support Care Homes for Adults (18-65 years) Page 6 of 31 received by the people who live at the home. The visit was carried out over one day by one inspector. The last key inspection was in September 2007. The methods used to gather information included conversations with the people living at the home and the staff, as well as looking at care plans and examining other records. Before the inspection visit we received the homes self-assessment questionnaire, surveys from six people who live at the home and seven staff. These gave us a lot of useful information about the home and helped us plan the visit. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? The medicine cabinet in one of the houses has now been moved to a more suitable place, away from the living areas of the house. Some parts of the houses have been re-decorated during the last year and some new Care Homes for Adults (18-65 years) Page 8 of 31 carpets have been fitted. Half of the support staff have now achieved a National Vocational Qualification (NVQ) in care at level 2 or 3. 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 9 of 31 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 10 of 31 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. Before people move in the staff carry out a thorough pre-admission assessment and there is an introduction procedure, to make sure the home can meet peoples individual needs. Evidence: When someone is considering living permanently at the home they are given information to help them make a decision, including an illustrated Service Users Guide. The initial assessment of a persons needs is carried out by the organisations advocate, followed by a further assessment by the homes manager. People are also invited to visit as often as they like, stay for a meal and have as many short stays at the home if they wish. This can vary from one night to three months of visits. This gives the person the opportunity to make an informed decision and helps the home decide if they are able to meet the persons needs. There is also a settling in period, to make sure that everyone is happy that the persons needs can be met at Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: the home. This procedure, along with other professional assessments, helps the staff to start developing a suitable plan of care and support. Care Homes for Adults (18-65 years) Page 12 of 31 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. Peoples right to maintain their individuality is central to the way the home is run. To maintain their autonomy and independence, staff support people to make choices and decisions about all aspects of their daily lives. People are involved in planning and agreeing the level of care and support they need and how this is to be provided. The plans are being developed to become more person-centred and some plans include illustrations, where this is helpful to the individual. Evidence: Three individual care and support plans were looked at. They showed that people are involved in developing and reviewing their plans. The plans have improved since our last inspection; they reflect the individuals preferences and needs and demonstrate the persons involvement in making the decisions that affect them. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: If the person wishes, other people also contribute to the care plan, to make sure a full picture of the individual is obtained. These people could include the persons relatives, the homes management, their social worker and someone from any other services he or she is involved with. The plans are up to date and contain sufficient detail to guide staff and help them understand each person. The plans are being developed to become more personcentred. Some plans include illustrations, to assist people who manage better with pictorial information. There is a lot of valuable information in the plans, but they need some work to make sure they fully reflect the individuals current preferences. Any unnecessary information should not be written down routinely, as this can obscure the important details that the staff need. Everyone is supported and encouraged to make their own choices about how they lead their lives. The support plans reflect this and show that people are supported to achieve their goals. Those people who commented confirmed that the service supports them to live the way they choose and agreed that the service meets their different needs. The plans and risk assessments are updated regularly. The people we spoke with said they felt the staff understand their needs and support them to live their own lives and maintain their individuality. Where any activity involves a potential risk, an assessment is made and plans are agreed to minimise the risk, while still supporting peoples right to independence and choice. These assessments are reviewed regularly, along with the rest of the plan. All the evidence we saw indicated that the homes staff support people to maintain their independence and improve the quality of their lives. Our observation, and conversations with the staff, confirmed that the staff know and understand the needs of each person who lives at the home. The staff do all they can to promote peoples right to autonomy and everyone is treated as an individual. From talking to the people who live at the home and the staff, and reading the notes, it was clear that everyones personal choices are respected and supported. People Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: seem to be supported to meet their own cultural, social and spiritual needs. All the written information is securely stored and confidential information about people is only shared with those who need to know. Care Homes for Adults (18-65 years) Page 15 of 31 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. Where needed, people are supported to follow the activities they choose, to make sure their needs and expectations are being met. People are offered a good choice of meals, and other foods, to make sure their dietary needs and preferences are met. Evidence: The care and support plans include information about each persons choice of work, recreational and leisure pursuits and their goals. The activities people follow depend upon what people want to do. This section of the plans that we looked at was not completely up to date. The plans should be revised, to make sure they fully reflect each persons choices. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: All the staff are involved in supporting people to follow the acivities they have chosen. Some people have part-time jobs which they said they enjoy. There is a drop in centre nearby that some people like to visit. People also said they enjoy going out for walks, on trips to garden centres and the theatre, visiting the pub for karaoke and having meals out. Some people like to go swimming and horse riding and others enjoy painting. Days out to places such as Chester Zoo and The Deep are arranged as well as holidays to places people choose, both in the UK and abroad. One person said they enjoy Going to football and playing pool with the staff. There are regular residents discussion groups and people are involved in making the decisions about their home and how it is run. The manager and staff make sure peoples views are central to any decisions that are made and make sure that everyones views are heard. People said that they are supported to lead their lives in the way they choose, and there are enough staff available to give them any support they need. The staff are aware of peoples preferences and the home is run in the best interests of the people who live there. The staff we spoke with had a good understanding of peoples needs and how each person likes to be supported. They understood the ethos of the home and the importance of respecting peoples right to self-determination and their right to be left in peace if they wish. One person confirmed to us that the staff respect their privacy when they wish to be alone. Individual choices about spiritual and cultural matters are reflected in the plans. The staff all know and understand each persons needs and preferences and how to support people to maintain their dignity and self respect. One member of staff said I believe the home allows individual differences to flourish. The home has a relaxed.....environment. This comment confirmed our views. At mealtimes there are always alternatives available if people do not want the choices on the menu. As well as a cooked meal at lunchtime, there is a choice of hot and cold dishes at teatime. People said that they enjoy the meals and the portions are generous. One person said the staff are Always cooking well good meals. People are offered hot and cold drinks and snacks throughout the day. Care Homes for Adults (18-65 years) Page 17 of 31 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. Peoples personal and healthcare needs are met. People are protected by the homes medication systems. Medicines are stored safely and appear to be administered accurately. Evidence: Peoples health and wellbeing is observed and monitored, and any concerns are followed up with relevant health or social care staff, and the family where appropriate, and their advice is followed. The plans are evaluated monthly, to make sure they reflect peoples needs. The plans contain detail about the individuals physical, psychological and emotional health. The plans, and conversations with staff, confirmed that peoples cultural and individual preferences are understood by everyone and are central to the care and support they are offered. Each plan is individual and reflects the persons choices for all aspects of their life. They show the way people prefer their care and support to be provided. This makes Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: sure that staff know exactly how each person likes their support to be provided and understand the routines they like to follow. The people we spoke with said that the home and the staff meet peoples needs. People said that the staff are very good. One person said that the staff Support the individuals who live here and another person said The staff work well together. Everyone said the staff provide the care people need, in accordance with their wishes. Peoples healthcare needs are reviewed regularly and recorded in detail. There was evidence that specialist healthcare professionals are involved in providing the support people need to maintain their health and well-being. Risk assessments are in place, where a potential risk to an individual has been identified, and there is information about how such risks are to be managed. The daily records give a picture of the support each person has needed that day. The plans are currently being improved to make them more person centred. When this is completed it should be possible for a new member of staff, for example, to read someones plan and have a vivid picture of that person and how they want to live their life. They should be able to gain an understanding of what is important to the person and what they can do to support them achieve their goals. The staff that administer medication have received suitable training. This helps to make sure that medicines are administered safely and that staff understand this area of their work. Since the last inspection visit the medication cabinet in one of the houses has been moved to a more suitable location, away from the living areas of the house. The medicines appeared to be administered and recorded accurately. There were signatures to confirm that staff had administered the medicine. Where people manage their own medication, risk assessments are completed to make sure that the process is safe. The medicines are all stored securely. Medicines that are carried forward from one recording period to the next should all have a brought forward system in place, so that an accurate audit can be kept. This is particularly important for medicines such as paracetamol, that are only taken occasionally when the person requires them. Observations during the inspection confirmed that the staff always respect peoples Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: privacy and dignity. Care Homes for Adults (18-65 years) Page 20 of 31 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 people who live at the home said they are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people staying at the home are safe. Evidence: The staff training records showed that the majority of the staff have taken adult protection training. Some staff have also had training in how to manage challenging behaviour. Conversations with the manager and staff showed that they understand their responsibilities towards people with regard to protecting them from any risk of abuse or poor practice. Staff are made aware of the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. They are expected to have read and understood the policies and procedures concerning adult protection. Staff said they understood about whistle blowing, handling complaints and safeguarding and had taken training in these areas of their work. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: People we spoke with said they feel safe and know how to make a complaint or raise a concern if they need to. One peerson said If I have a problem I feel I can approach any staff member and they help me. The complaints procedure is illustrated, to assist people to understand its content. The evidence we saw confirmed that improvements are made as a result of complaints investigations. There is an independent advocacy service to support people to express their views; this is especially important if there is no family or friend who can do this. Care Homes for Adults (18-65 years) Page 22 of 31 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 home provides a safe, clean and comfortable environment. Evidence: The home has an ongoing refurbishment programme and this year the lounges in two of the houses have been re-decorated. New carpets have been fitted in one house and a third house is having new carpets and is being re-decorated in the coming year. The people who live in each house choose the decor and furnishings they prefer. We were told that the home shares one maintenance staff member with other nearby homes in the group. This could explain why a significant number of people said that the main thing the home could do better is to Keep up with maintenance. One person said that Repairs need doing sooner and another said they would like to see repainting, replacement of, for example, bathroom flooring and other repairs carried out more speedily. The gardens are spacious and suitable for use by everyone, including people who use wheeled transport for moving around. There is an attractive seating area, which people said they had enjoyed using during the better weather. A vegetable garden has also been created and people can help with choosing the vegetables and do some of the planting, if they wish. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: The house is clean and fresh throughout. One person said that the home is kept Clean and tidy and they have a Nice clean bedroom. Protective gloves and aprons are available for staff to use when necessary, as part of the homes infection control measures. Care Homes for Adults (18-65 years) Page 24 of 31 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. Sufficient, suitably trained staff are employed to meet peoples needs. People are protected by the recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Evidence: The staff rotas confirmed our observations that there are enough staff on duty to meet the care, social and leisure needs of the people who live at the home, and additional staff are employed when needed. There is a mix of male and female staff, to help make sure people can have a choice of who supports them. As well as an interview, all new staff complete an application form and provide two written references, as well as completing satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks before they start work New support staff take the mandatory health and safety training and they all follow accredited induction training. One member of staff described the induction process and all the training that went with it. This prepares them for moving on to take a National Vocational Qualification (NVQ) course. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: From a total of forty-eight support staff, half of them have now achieved the NVQ qualification at either level two or three. Other training is available to make sure staff skills and knowledge is kept up to date. These courses include infection control, equality and diversity, nutrition and health and epilepsy awareness. One staff member did feel that it can take a long time from requesting training to going on the course. The staff all said they have plenty of training, but it is important that all the staff take in depth, specialist training in understanding the range of autism and aspergers conditions to help them provide the best support they can for the people who live at Carlton Autistic Care Centre. The manager said that suitable training is not readily available at an affordable cost. However, as this training is central to their work it is essential that new staff receive the training and continuing staff have regular refresher training. The manager and team leaders do attend seminars on the subject and, if possible, other staff also attend. The records, and the staff, confirmed that all the staff are having regular one to one supervision meetings with their line manager. This supports staff to plan their personal and professional development and gives them the opportunity to discuss any areas of concern in a confidential setting. One member of staff said I have good support from seniors, my work team is great too. Care Homes for Adults (18-65 years) Page 26 of 31 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 safe and run in the best interests of the people who live there. Evidence: The manager has the necessary experience and qualifications to manage the home effectively and in the best interests of the people who live there. To maintain confidentiality, peoples personal information is stored securely when it is not being used. Where the home helps people to manage their personal finances, accurate records are kept of all transactions. Regular audits are carried out to make sure the records and amounts are accurate. The policies and procedures are kept up to date to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner and staff have basic health and safety training. Fire drills are held, to make sure everyone knows what to Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: do in an emergency. All these measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. Following our last inspection, we asked the home to look at changing some of the door locks. This had not been done when we visited. The homes manager has now contacted the fire safety officer, who has recommended a different type of lock that is more easily opened in the event of an emergency. The home has now had all but one of these fitted. The other lock, which is for a different type of door, will have a new one fitted as soon as a suitable type of lock has been found. Following their most recent inspection, the Environmental Health Officer has awarded the homes kitchen a score of four stars, for hygiene and good kitchen practice. The home asks people, their relatives and professional visitors to complete quality assurance questionnaires, in order to find out what people think about the care and support the home offers. Regular residents meetings are held, in order to discuss what people would like to see happening in their home and how they want it to be run. The staff said they felt supported by the management team and enjoyed working at the home. One member of staff said I enjoy working here. Another staff member said the manager has an open door policy. A senior manager from the organisation visits the home regularly and compiles a report each month on their findings. The homes manager lets us know about any significant incidents that affect the well-being of people who live at the home. At present there are no people living at the home who are subject to a deprivation of their liberty authorisation, under the Mental Capacity Act 2005. We received the homes annual quality assurance self assessment. It contained information about the home and the services that are provided, the improvements they have made and their plans for the coming twelve months. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 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 35 All the staff should take in depth, specialist training in understanding the range of autism and aspergers conditions in order to help them provide the best support they can for the people who live at Carlton Autistic Care Centre. Care Homes for Adults (18-65 years) Page 30 of 31 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. 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