Inspection Report on

The Old Vicarage

Church Lane Marshfield Cardiff CF3 2UF

Date of Publication

Tuesday, 23 January 2018 Welsh Government © Crown copyright 2017. You may use and re-use the information featured in this publication (not including logos) free of charge in any format or medium, under the terms of the Open Government License. You can view the Open Government License, on the National Archives website or you can write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] You must reproduce our material accurately and not use it in a misleading context. Description of the service The Old Vicarage is located in Marshfield Cardiff and Newport. The service is owned by Orbis Education and Care Ltd and the registered manager is Deborah Tonkin. The home provides care for up to ten people aged 18 and over; who have care and support needs associated with Autistic Spectrum conditions.

Summary of our findings 1. Overall assessment Overall, the well –being and the quality of the care and support of people living at the home is very good. People lead active and fulfilling lives and make choices about a wide range of activities they take part in. They are encouraged to maintain relationships with family members and to make new friends. The culture employed at the home is empowering of the rights of people to be happy and fulfilled and to achieve their potential within the home and in the community. The home is committed to working closely with people’s families and to the ongoing improvement of the service.

2. Improvements The recommendations made for improvement at the last inspection have been undertaken and there was evidence of improvement at this inspection in quality assurance processes and in systems for assessment and planning and for reviewing people’s progress. A new ‘deputy manager’ position has been introduced since the last inspection and the motivation and confidence of staff continues to be good.

3. Requirements and recommendations No areas of noncompliance were identified and Section 5 of this report sets out our recommendations for improvement.

1. Well-being

Summary People living at the Old Vicarage are content and fulfilled and experience a sense of belonging. They are encouraged to make choices in their daily lives; to voice their wishes and feelings and to make and maintain relationships.

Our findings People make choices and lead fulfilling lives. People are supported to make choices about how they spend their time and complete weekly planners of their outings and activities. These include attending ‘The Orb’ which is a community based service provided by the home, which provides opportunities for people to develop social and practical skills. One person living at the home told us that they enjoyed meeting people when they are working at the shop and the café at ‘the Orb’ and that they also worked at a café in Newport. They said they had recently had a great time on holiday with staff and that they had visited Oakwood Park and Folly Farm. The statement of purpose made reference to the following activities people could take part in: swimming, pedal power, touch trust (a programme which is holistic, sensory and expressive experience and incorporates music , colour, scent and touch), trampolining, climbing, dancing and visiting places of interest including St Fagans, Roath Park Lake, coastal drives and walks and attending Church.

We were informed that several people sang in the local church choir and that plans were in place for choir members to visit the home after the Christmas carol service; as they did last year, for mince pies and mulled wine. Staff told us that service users enjoyed going to the cinema and that some held ‘special nights’ for people with autism. They said that ‘adverts’ were not shown on these nights so people could maintain concentration and that people with special diets could take their own snacks. One staff member said they had met up with a cinema owner to help them better understand the needs of people with autism and that the ‘special sessions’ they provided were now well attended.

People contribute to the running of the home and self responsibility is encouraged. Staff told us that people took turns to help staff to choose and cook evening meals and that they used menu choice boards to choose and then prepare their own breakfasts. They said that service users chose whether to eat with others or separately in their rooms and that they enjoyed eating out regularly. The manager told us that all service users had dietary plans that were compiled in conjunction with the home’s dietician and that some managed their own medication. They showed us that lockable cabinets had been fitted in their rooms and told us that staff ensured that service users took their medication and completed the necessary records.

People make and maintain relationships. The manager told us that a ‘buddy’ system had been developed where people were encouraged to develop friendships with people living at another home and that they looked forward to meeting their ‘buddies’ at discos and cafes and that they e mailed and wrote letters to each other.

Most people’s families live relatively locally and visit the home regularly. We saw lots of photographs of people’s family members in their rooms and commonly heard staff referring to their family members within their conversations with them. There were also photographs of family members in photograph albums and some residents had scatter cushions with pictures of their family members on. Families provided feedback that they were always made welcome when visiting the home and that they felt confident they could raise any issues or concerns if that was necessary.

Overall; we conclude that the well being of people living at the home is very good. They are actively engaged in relationships and activities that fulfil them and that they are supported to be independent and to fulfil their potential in the home; in the community and as individuals. 2. Care and Support

Summary People receive consistent and responsive care and support from motivated staff that know them well.

Our findings People are supported by staff that know them well. People are allocated a core support team to promote consistency which includes a key worker and co keyworker from each of the two staff teams. Feedback from families about the care provided at the home was very positive though one said that any staff changes could be unsettling. They said this was because residents’ relationships with staff were important to them and that they missed people when they moved on. The manager said there had been a small number of staff changes; though mostly this had been as a result of promotion and staff supporting people in transition to other homes. They said that some staff were due to leave the home to support a person moving to a new ‘Orbis’ home.

People receive targeted care to meet their individual needs. The manager said that MDT (multi disciplinary team) plans had been further developed to ensure people’s individual needs were known; that individual goals were set and that they received any care and support necessary to achieve these. They told us that ‘networking days’ were held so that people’s keyworkers and any specialists involved could review their care and support plans and their progress. Documentation in service user’s files was seen to be comprehensive.

People have good relationships with staff. We observed that people enjoyed being with the staff supporting them. We observed that they had confidence to relax; to have fun and ‘to be themselves’. We saw that staff were intuitive in understanding and responding to their particular needs and sensitivities and that they treated them with respect and emotional warmth and affection. Staff said that they enjoyed being able to support people to fulfil their potential.

We received feedback from two families. This included: ‘we see the people caring for our son as ‘an extension to our family’ and that they are much more than ‘just people who work at the home’. Their feedback about all aspects of the home was positive and one said that ‘the service is of top quality’. When we asked if any areas could be improved; one said that there had once been a transport problem because staff may not have checked the home’s diary. They said this was resolved swiftly when they contacted the home and they reiterated that they were extremely happy with all aspects of the service.

A visiting ‘complementary therapist’ told us that they worked at a number of care homes where they provided therapies to support relaxation, including massages for service users. They spoke especially positively about the Old Vicarage and said that service users always looked well when they visited and that they always received the support they needed from a stable and well motivated staff group. They said that the ethos of the home was very service user led and they made very positive comments about the management of the home as well as the quality of the accommodation. They said ‘the staff are brilliant’ and ‘if I had a relative that needed to be in a home like this; ‘I would be happy for them to live here’. Overall; we conclude that the care and support of people living at the home is very good and that they have relationships with staff that enable them to relax; to be confident and to lead fulfilling lives in the home and in the community. 3. Environment

Summary People live in accommodation that keeps them safe and supports their well –being.

Our findings The accommodation is spacious and of good quality. The accommodation was set out over two floors with each having bedrooms and social areas and kitchen, dining and laundry facilities. The accommodation was well proportioned and the layout enabled managers to ensure people’s rooms are close to people they are compatible with.

All bedrooms were of a good size and were self contained with en- suite facilities. Bedroom doors had service users’ names on them and a ‘weekly planner’ to remind them of their activities and routines. Bedrooms were seen to be very well presented and personalised to reflect people’s particular tastes and interests. For instance, one person’s room had pictures and models of trains and we were told this was an interest they shared with their dad and one had a specially made cabinet to house a considerable collection of video films and equipment. Another had ‘cats’ as its theme and most bedrooms had cuddly toys and pictures of family members on display.

The quality of furniture and fittings is very good throughout the home and there were no signs of damage or disrepair. There was plenty of space for people to mix and mingle or to be separate and bedrooms had space and furniture for people to be independent and to meet with visiting family members privately if they choose. Crockery and drinking glasses were made of ‘unbreakable’ materials and appeared to be of good quality. There was an abundance of craft and other materials available and new Christmas decorations were being bought when we visited.

There was a small bike track in the grounds as well as a go-kart and a three wheeler trike and ‘birds nest’ swings and picnic benches for people to relax and have fun. The manager told us that a weekly garden group was facilitated by an ‘occupational technician’ during the summer and that people had created a garden shed out of plastic bottles which highlighted their creativity.There were locks on external doors and electronic gates provided security to prevent people from leaving alone and potentially placing themselves at risk. Notifications of DOLs (deprivation of liberty safeguards) applications have been made as necessary.

Overall, we conclude that the home is domestic in style and that the quality of furnishings and fittings throughout are of a high standard. The home enables people to feel safe; valued and respected and to have fun and to enjoy positive relationships with people they live with and that care for them. 4. Leadership and Management

Summary People live in a home that is well managed and committed to continuous improvement. Its ethos is person centred and people’s families contribute to its ongoing development. The registered manager has been responsible for the home since its registration in 2014 and a new position of ‘deputy manger’ has been created since the last inspection.

Our findings The purpose and objectives of the home are clear. The statement of purpose dated May 2017 included comprehensive information about the operation and resourcing of the home. This included its mission statement: “Working together to give our young people the best possible life!” which was developed in the parents’ forum. It included the objectives to be attained in regard to people living at the home; information about the activities, hobbies and interests that are promoted and detailed information about the home’s approach to promoting positive behaviour. Whilst general information was included about consultation with service users and others about the care provided at the home we recommend that it also includes information about how people will be involved in consultation to inform the annual quality of care review and how they can access reports of its findings.

Staff retention and motivation is good. Information provided for the inspection indicated that the home employed a minimum of 20 support workers and that all people were supported with at least 1:1 staffing during day time hours. It stated that all ‘team leaders’ and ‘senior support workers’ held QCF Level 3 qualifications and that all ‘support workers’ either held or were working toward QCF Level 3 qualifications. The home also employed the services of a dietician; complementary therapist, speech therapist; occupational therapist and behavioural specialists. One team leader was on maternity leave when we visited and an ‘acting team leader’ had been appointed in their absence. The acting team leader spoke very positively about their new responsibilities and said that staff retention, staff motivation and staff morale was very good as well as the home’s commitment to staff development.

Quality assurance systems are well developed. The system for monitoring, reviewing and improving the quality of care provided at the home had been improved since the last inspection. The quality of care review report dated March 2017 included good evidence of the home’s monitoring and consultation activities as well as a detailed improvement plan. The quality of care review report is available upon request; where appropriate, from the home. A ‘parents’ forum’ has been established so that people living at the home and their families can discuss any aspects of the running of the home and contribute ideas about its ongoing development.

Overall; we conclude that people living at the home feel secure in themselves and confident in the staff caring for them. Their rights are promoted and managers are committed to the ongoing improvement of the service. The home is effective in understanding and meeting the needs of people; effective in engaging with their families about the ongoing improvement of the service and effective in supporting and motivating staff to ensure people fulfil their potential. 5. Improvements required and recommended following this inspection

5.1 Areas of non compliance from previous inspections There were no areas of non compliance identified at the last inspection

5.2 Recommendations for improvement We recommend that the statement of purpose includes information about how people will be involved in consultation to inform the annual quality of care review and how they can access reports of its findings. 6. How we undertook this inspection

This was a full inspection undertaken as part of our inspection programme. We made an unannounced visit to the home on 22/12/2017 between 11am and 5 pm.

The following methods were used:

 We spoke with people living at the home and consulted with their family members and a visiting professional  We consulted with staff and observed their engagement and their relationships with service users  We requested feedback from two case responsible social workers but they did not respond  We looked at selected records: including the statement of purpose and quality assurance reports and assessment and care planning records  We viewed the premises and spoke with the registered manager and the responsible individual

Further information about what we do can be found on our website www.cssiw.org.uk About the service

Type of care provided Adult Care Home - Younger

Registered Person Orbis Education and Care Ltd

Registered Manager(s) Deborah Tonkin

Registered maximum number of 10 places

Date of previous CSSIW inspection 8/08/2016

Dates of this Inspection visit(s) 22/11/2017

Operating Language of the service English

Does this service provide the Welsh No Language active offer?

Additional Information: