Care Home: Parkbourn (Autism Initiatives)

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What the care home does well The home has availabe detailed information about the service as well as procedures for assessing and admitting new residents to ensure that they choose a home which is right for them . Support plans and communication profiles provide staff with up todate information about how best to support people to be independent in a safe way and which gives them oppertunities for personal development. Staff support residents to eat healthily and take part in activities of their choice so that they live active and healthy lifestyles. Residents personal and healthcare is well understood, monitored and recorded to ensure they stay well and their privacy and dignity is respected by staff. This was supported by the following comments made by staff during the site visit: "I always knock on doors before entering a residents bedrooms and bathrooms", It is important to make sure rooms are clean and warm and doors are shut when helping a person with personal care". The home has a complaints procedure to ensure that people are protected and their views and concerns are listened to and acted upon. Recruitment and training procedures and practices ensure the protection of residents. Staff are provided with ongoing training to ensure they have the knowledge and skills to meet residents needs, develop within their role and are up to date with current care practices. The home is well managed to the benefit of the residents. Systems, which are in place, ensure that their health, safety and welfare is protected and promoted at all times. Staff were complimentary of the Registered Manager and confirmed she was approachable and supportive. Staff made the following comments about the manager: "The manager has a lot of experience and is very good with people" "She listens and is very approachable" "You can discuss anything with her in confidence" Record keeping and administrative procedures, which are in place, ensure that people`s health, safety and welfare is promoted. What has improved since the last inspection? At the last inspection the manager was advised of a number of improvements, which were required to the premises to ensure the comfort and dignity of the residents, most of the improvements have been made since the last inspection making the home more comfortable. Medication record aministration (MAR) sheets are signed at the appropriate times to show that residents are receiving prescribed medication at the correct times. What the care home could do better: Units and work surfaces in both kitchens, which are showing signs of wear and tear, would benefit from refurbishment making the environment and facilities better for residents. All reports should be kept at the home and made available for inspection to show that the appropriate quality monitoring checks, which are required by law, are taking place. CARE HOME ADULTS 18-65 Parkbourn (Autism Initiatives) 1-4 Parkbourn Maghull Liverpool Merseyside L31 1LH Lead Inspector Janet Marshall Key Unannounced Inspection 4th December 2007 09:30 Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkbourn (Autism Initiatives) Address 1-4 Parkbourn Maghull Liverpool Merseyside L31 1LH 0151 527 1009 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) parkbourne@autisminitiatives.org www.peterhouseschool.org Autism Initiatives Mrs Lisa Hankin Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 8 LD Date of last inspection Brief Description of the Service: Parkbourn is registered as a care home for eight people who have a learning disability. The service is provided by Autism Initiatives, which is an organisation, which specialises in providing services to people who have autism. The property is owned by Riverside Housing Association. The home is located in a residential area in Maghull. The home was originally four domestic sized properties. These have been converted to create one building. The building is divided for practical purposes into two separate living areas. Each living area has a lounge, kitchen and dinning area and two bathrooms. Five members of staff are on duty throughout the day when all of the residents are at the home and there is also two waking staff available throughout the night. The fees charged are agreed with the placing authority and are dependant upon the assessed needs of service user to be placed. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The Commission considers 22 standards for Care Homes for Adults as Key Standards, which have to be inspected during a Key Inspection. The report has been put together using information gathered from a number of sources including information that the Commission have received about the service since the last inspection and details provided in the Annual Quality Assurance Assessment (AQAA). The AQAA, which is in two parts, a selfassessment and dataset, has replaced the pre-inspection questionnaire. The document, which was sent out to, the service was completed and returned to the Commission before the site visit took place. A number of surveys were sent out to people as part of the inspection none of them were returned at the time of writing this report. The inspection also involved an unannounced visit to the home (site visit). The manager was on annual leave on the day of the visit the inspection was carried out with staff that were on duty at the time. Records that were examined, staff comments and observations made during the visit have also been used as evidence for the report. All the residents that live at the home have limited verbal communication skills so were unable to express their views and opinions about the service. However, a number of residents were case tracked. This process involved observations, talking to staff, looking at the environment and a selection of residents records such as assessments, care plans and daily notes to get an idea about peoples experiences and to find out if they are receiving the care and support that they need and which have been agreed by their representatives. What the service does well: The home has availabe detailed information about the service as well as procedures for assessing and admitting new residents to ensure that they choose a home which is right for them . Support plans and communication profiles provide staff with up todate information about how best to support people to be independent in a safe way and which gives them oppertunities for personal development. Staff support residents to eat healthily and take part in activities of their choice so that they live active and healthy lifestyles. Residents personal and healthcare is well understood, monitored and recorded to ensure they stay well and their privacy and dignity is respected by staff. This was supported by the following comments made by staff during the site visit: Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 6 “I always knock on doors before entering a residents bedrooms and bathrooms”, It is important to make sure rooms are clean and warm and doors are shut when helping a person with personal care”. The home has a complaints procedure to ensure that people are protected and their views and concerns are listened to and acted upon. Recruitment and training procedures and practices ensure the protection of residents. Staff are provided with ongoing training to ensure they have the knowledge and skills to meet residents needs, develop within their role and are up to date with current care practices. The home is well managed to the benefit of the residents. Systems, which are in place, ensure that their health, safety and welfare is protected and promoted at all times. Staff were complimentary of the Registered Manager and confirmed she was approachable and supportive. Staff made the following comments about the manager: “The manager has a lot of experience and is very good with people” “She listens and is very approachable” “You can discuss anything with her in confidence” Record keeping and administrative procedures, which are in place, ensure that people’s health, safety and welfare is promoted. What has improved since the last inspection? What they could do better: Units and work surfaces in both kitchens, which are showing signs of wear and tear, would benefit from refurbishment making the environment and facilities better for residents. All reports should be kept at the home and made available for inspection to show that the appropriate quality monitoring checks, which are required by law, are taking place. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Parkbourn (Autism Initiatives) DS0000005310.V357198.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 Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the service and the homes assessment and admission procedures ensure that people choose a home that will meet his/her needs. EVIDENCE: The AQAA and discussion with a senior support worker showed that there have been no new residents admitted to the home since the last inspection. The senior support worker clearly described the processes that would be followed for assessing and admitting a new resident to the home. This included giving people information about the home such as the Statement of Purpose and a Service user Guide. Both documents, which were looked at, included all the information that people need to know about the services and facilities, which are available at the home. They also provided other information such as details of the staff team, emergency procedures and the arrangements made for dealing with complaints. The AQAA showed that the homes Statement of Purpose has been updated since the last inspection and in the next year the service intend to improve the format of the document using a communication format which is more accessible for people that have difficulties reading. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 10 Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and appropriately supported to make decisions regarding their daily lives and risk is managed in a positive way to encourage them to lead a full and as independent life as possible. EVIDENCE: Each of the residents at the home had their own working file which contained a number of documents which are used by staff to support residents on a daily basis. Support plans which were part of the working file are used each day, they identify particualr goal/s and the support that staff need to provide to help the person reach that goal. Staff also use the plans to record any developments that the person has made and to communicate any further action that is needed to help the person to further develop or maintain their goal. A selection of support plans which were viewed included personal goals such as cooking, personal care and communication. Also included in the working files were an About Me section which set out in detail all the residents current care and support needs, they are used along Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 12 side support plans so that staff have all the information they need to help the person to succeed, develop and maintain independendent living skills. This section also covered in detail things such as what is important to the person, what they are good at doing, what they like and dislike, what they need help with and what they want to happen with their lives. The AQAA showed that this information is very useful for new and temporary staff as it provides them with important information about how best to support each person consisitently which is most important when supporting people with Autism. Examination of a number of files showed that all the information kept in them is regualry reviewed and updated with the invovlement of the resident, their family/representative, staff at the home and the practice support team. The practice support team, which is part of Autism Initiatives, is made up of speech and language specialists. The AQAA, discussion with staff and observations made during the inspection visit showed that staff have the training and skills necessary to support residents to make decisions regarding their daily lives. Throughout the visit staff were seen offering people choices and encouraging them to make descions by use of their preferred method such as pictures, symbols and signs. The AQAA showed that all residents are consulted on how the home operates and are involved as much as possible in decisions affecting the home and its future running. This was also confirmed during discussion with staff that said: “The residents always come first and are given as much choice as possible” “All the staff treat residents very well and as individuals and encourage them to do as much as they can for themselves”. Staff demonstrated an understanding of how to ensure resident’s rights are promoted and how limitations are only put in place for their safety and welfare. Some residents present with challenging behaviour. Written information was in place giving staff clear guidance on how to support certain behaviours and situations in a positive way. Records showed that staff have received training in positive intervention. The AQAA showed that risk is managed in a positive way to encourage residents to lead full and independent lifstyles. A selection of risk assessments and support plans which were viewed during the visit showed that residents are encouraged to take responsible risks which ensure their independence is promoted and they are protected from the risk of harm. The assessments clearly described the action that staff must take to minimise risks. Risk assessments, which were viewed and showed that they are reviewed and updated at regular intervals. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to live active and healthy lifestyles. EVIDENCE: The AQAA showed residents social care needs have been assessed and there is a range of activities available inside and outside the home to meet people’s needs and promote their personal development. This was also evidenced through the use of individual support plans and activity programmes which showed that residents are given opportunities for personal development that are closely monitored and well supported. None of the residents are currently involved in any employment, training or educational programmes, however some residents attend sessions at various day centres within the community. One resident’s activity programme included gardening, outward bounds (walking), and swimming and health and beauty sessions. Staff help residents Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 14 make choices about an activity or places to go using pictures, photographs and symbols. Available at the home were a selection of pictures and photographs, which are used to help residents choose an activity or a place to go. The ‘About Me’ section of residents files and support plans provide staff with information about the help that the person needs to communicate their choice of activity. As well as recreational and leisure activities residents are also encouraged and supported to help with small tasks around the house such as cleaning their bedrooms, cooking, polishing and shopping for personal items and food. On the day of the visit staff were seen encouraging and appropriately supporting residents with some of these tasks. Laminated cards with step-by-step instructions using photographs, pictures and symbols have been put together to help residents with tasks such as cooking. A member of staff reported that with the support of staff one resident is now able to make an omelette using this method. Residents do not have keys to the home. This is because assessments showed that this is not safe for them. This information and the reasons why was recorded in their plans of care. Daily records showed that residents are encouraged to maintain contact with family and friends and personal relationships are respected and appropriately supported by staff at the home. Menus which where viewed at the home showed a variety of healthy meals. Staff said menus are often changed at a resident’s request. During discussion a number of staff showed a good awareness of the importance of nutritious and balanced diets. Records showed that staff have undertaken training in food hygiene. Residents have the use of a number of small dining tables, which are situated in a dining area next to the kitchen. Staff were observed offering residents drinks and snacks and supporting others to make them. On the evening of the inspection staff were seen encouraging and supporting residents to prepare their evening meal. Care plans included information about resident’s likes and dislikes with regard to food. A good stock of fresh, frozen and tinned food was seen at the home. There were also sufficient crockery, cutlery pots and pans, which were of good quality. There was a fridge, freezer and microwave which were all of a domestic style and in good condition. Kitchen units and work surfaces were showing signs of wear and tear information provided in the AQAA and discussion with staff showed that plans are in place to refurbish the kitchens. A member of staff confirmed that residents are always involved in the main weekly shop for food as well as shopping daily for essentials such as fresh bread and milk. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 15 Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents personal and healthcare needs are understood, well recorded and monitored ensuring that they stay well. EVIDENCE: Care plans, which were viewed, included detailed information about the type and level of support that each person requires with personal care as well as their preferred routines. Health action plans, which were kept in each persons working file are part of each person’s plan of care. They covered in detail the person’s healthcare, needs and the support that they need to stay well. Records within this section showed that residents are offered minimum annual health checks. As well as visits to primary healthcare services such as dentist, opticians and doctors residents are also supported to attend specialist services. Records detailing the visits were available in good detail as was information about specialist health care appointments. Where appropriate visits to the home by healthcare professionals are arranged. Communication profiles show how a person communicates if they are in pain or unwell and the action staff should take in response. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 17 The service operates a key worker system to enable residents to develop a closer relationship with a specific staff member particularly in the areas of health and personal care. The key worker is responsible for reviewing the resident’s monthly plan and for to arranging their healthcare appointments etc. During discussion several members of staff described clearly their role and responsibilities as a key worker. Staff also showed a very good understanding of each person’s personal care routines and health care needs. During the inspection visit staff were observed assisting residents in a gentle and polite way. Through discussion staff showed that they understood the importance of ensuring residents privacy and dignity. This was supported by the following comments made by staff during the inspection visit: “I always knock on doors before entering a residents bedrooms and bathrooms”, It is important to make sure rooms are clean and warm and doors are shut when helping a person with personal care”. A requirement was given as part of the last inspection report for Medication Administration Record (MAR) sheets to be signed at the time of administering medication. This was because at the last inspection there was evidence that some records had not been signed at the time medication was prescribed. This put the residents at risk because there was no guarentee that the person had received their prescribed medication. Details provided in the AQAA and discussion with staff showed that medication stocks and MAR sheets are now checked on a regular basis and regular staff training takes place to make sure that medication procedures are follwed correctly. During this inspection visit all medication and medication administration records were examined and found to be in good order. A policy for the safe handling and administration of medication was availble at the home. Discussion with a number of staff showed that they have a good awareness of the homes medication polices and procedures. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives have the information that they need to make a complaint and procedures carried out at the home ensure that they are protected from abuse. EVIDENCE: Records held by the Commission showed that we have not received any concerns, complaints or allegations about the service since the last inspection. The service has however investigated a complaint made to them against a member of staff. Records of the complaint, the action taken and outcome of the investigation showed that the complaint was fully investigated and the necessary action was taken in ensuring the protection of the residents. There was a complaints procedure and a complaints book on display at the home. The Service User Guide and the homes Statement of Purpose also included a summary of the homes complaints procedure. The information was available in large clear print supported by pictures and photographs. It was not possible to assess residents understanding of the complaints procedure due to their limited understanding. The AQAA showed that all residents are issued with a copy of the complaints procedure and it is explained to them at a pace and manner they are able to understand. They are advised of who they can speak to if they have any concerns or issues in the hope that that these can be openly discussed and action taken before a complaint is raised. The AQAA also told us that resident’s advocates and representatives are aware of the homes complaints procedure. Staff interviewed said that they knew about the complaints procedure and would be confident about raising any concerns or complaints if they needed to. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 19 During discussion staff showed a good awareness of what to do if they suspected or witnessed abuse. A Protection of Vulnerable Adults procedure was available at the home. The AQAA showed that staff have received Protection of Vulnerable Adults training. This was also confirmed by a number of staff during discussion with them. Other policies, which were available at the home, that aim to protect people included whistle blowing and staff recruitment. None of the residents manage their own finances. They all have an account in there own name and address, which is managed and held centrally at head office. Small amounts of residents personal money and records of all transaction made were kept at the home. Money and records for four residents were examined during the visit they were all in good order. There were strict rules in place at the home for managing residents money and financial affairs, which ensure that people are safeguarded from financial abuse. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a comfortable and pleasant environment, which was free from hazards, although some improvements would benefit the residents. EVIDENCE: The home is four semi-detached houses converted into one making it a large detached property. The home is split into two units each having four bedrooms a shared lounge, kitchen/diner, utility room, two upstairs bathrooms and two down stairs toilet/shower rooms. It is located in a popular residential area of Maghull, Merseyside close to transport links and local shops. It is in keeping with the local community and provides with a comfortable and homely environment for the people that live there. There are gardens at the front of the house and a large enclosed back garden. The back garden, which was well kept, has a large lawn and patio areas. Parts of the garden were planted out with mature bushes and shrubs. A driveway at the back of the house provides off road parking for several cars. Parking is also available on the road directly outside the front of the house. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 21 A number of requirements were 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 poor condition. The AQAA and a tour of the home showed the following improvements to the environment since the last inspection. • The carpet in a lounge and the main hallway which were thread bear have been replaced • Walls in and outside a resident’s bedroom, which were damaged, have been repaired and re-plastered. • A damp patch in downstairs bathroom has been repaired and redecorated. On the day of the inspection visit residents were seen moving freely around the home. Each of the resident’s bedrooms was attractively decorated and furnished to a good standard. They were warm, bright and well ventilated. All bedrooms were personalised to suit each person’s own tastes. Discussion with staff and information provided in the AQAA showed that there are plans to carry out further improvements including: • The redecoration and new flooring to a shared lounge. • Refurbishment of both kitchens. On the day of the inspection visit the home was clean and tidy and there were no hazards identified. A cleaner is employed to work at the home Monday to Friday and is responsible for most day to day general cleaning duties as well as larger cleaning tasks such as cleaning windows and interior woodwork. All cleaning materials and products were stored in a locked cupboard. Laundry facilities are sited in a utility room separate to the kitchens. Laundry areas, which were looked at, were clean, well organised and equipped with sufficient washing, drying and ironing machines and equipment. 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. The AQAA, discussion with staff and examination of records showed that staff have completed training in relation to infection control. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment and training procedures ensure the protection of residents. EVIDENCE: The staff team is made up of the manager, two senior support workers, support workers and a cleaner. The AQAA showed that there is a mixed staff team made up of people of various age, gender and culture and that all rotas are put together taking into account the residents care and support needs so that they are able to lead full and active lives. Information about each member of staff including their experience and qualifications can been found in the homes Statement of Purpose file. Staff spoken with during the inspection visit showed a clear understanding of their roles and resposibilites and were very knowledgable about each of the residents and their specific needs particuarly Autistic Spectrum Disorder. There was five staff on duty at the time of the inspection visit when all residents were home. The senior support worker reported that there are generally five care staff on duty throughout the day when all the residents are at home and two waking night staff on duty throughout the night. Staffing rotas for a period of four weeks that were examined also showed this. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 23 Details provided in the AQAA and discussion with the senior support worker showed that a number of staff have left the home since the last inspection and have been replaced with new staff. He confirmed that some new staff have not yet started work because their police checks have not yet been received he said vacant shifts are being covered by other staff at the home and regular bank staff within the organisation. Approximately half the current staff team who are dedicated and experienced, have worked at the home for a number of years, however there has been a high turn over of new staff over the past two years. The AQAA showed that the service are putting in place plans to improve recruitment and retention, with an aim to reduce the turnover of staff. No staff files could be examined during this inspection visit, this was because the manager who was not on duty at the time of the visit locked them away. However, previous inspections and information given in the AQAA showed that strict recruitment procedures are followed at the home including police checks for all new staff before they are allowed to start work at the home. The senior support worker reported that all new staff have to complete a six month probationary period and complete a professional development portfoli and induction pack. The AQAA showed that the registered manager is involved in all areas of recruitment to ensure that the staff recruited meet the needs of the residents. All staff spoken with confirmed that they receive a lot of training including protection of vulnerable adults (abuse), health and safety, medication awareness and other specialist training which is specific to the residents needs such as communication, positive intervention and understanding Autism. The AQAA showed that all staff have an individual training plan and most staff have completed a National Vocational Qualification (NVQ) in Care level 2 or above and others are working towards the award. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to the benefit of the residents. EVIDENCE: Lisa Hankin has been the registered manager of the home for a number of years. Records held by the Commission and information given in the AQAA show that she is qualified and experienced to manage the service her qualifications include City & Guilds Advanced Managment for Care and the Registered Managers Award. The AQAA also showed that the Registered Manager has undertaken periodic training to update her knowledge and skills whilst managing the home. Staff spoken to during the inspection were complimentary of the manager, comments they made included: “The manager has a lot of experience and is very good with people” “She listens and is very approachable” Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 25 “You can discuss anything with her in confidence” “The manager is very good and fair” The AQAA and a selection of records viewed during the inspection visit showed that systems are in place to ensure the ongoing monitoring and improvement of the service. This includes supervising staff, reviewing administrative procedures and reviewing resident’s care plans to ensure their care need requirements are being met at the home. A manager within the company carries out regular audits of the homes systems and procedures. However not all the reports were available at the home for these visits which have taken place since the last inspection. These should be kept at the home and made available for inspection to show that the appropriate quality monitoring checks that are required by law are taking place. Autism Initiatives is an equal opportunities employer, discussion with staff and information provided in the AQAA showed this. The AQAA also showed that all other policies, procedures and codes of good practice, which are required for this type of service, are available at the home. There was evidence to show that most of the documents have been reviewed and updated in the last three years so that residents and their representatives have accurate and up to date information about their health safety and welfare. The AQAA showed that all the required checks have been regularly carried out on equipment used at the home. They include electrical circuits, portable electrical equipment, heating system and gas appliances. A selection of certificates and records, which were seen, supported this information. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 26 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 3 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 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 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 4 3 3 X 4 X 2 X X 3 X Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA24 YA39 Good Practice Recommendations Kitchen units and work surfaces should be replaced to improve the environment and facilities for residents. All reports should be kept at the home and made available for inspection to show that the appropriate quality monitoring checks, which are required by law, are taking place. Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Parkbourn (Autism Initiatives) DS0000005310.V357198.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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