Inspection on 12/01/09 for Rugby House Project

This is the latest available inspection report for this service, carried out on 12th January 2009.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rugby House Project 03/03/06

Rugby House Project 03/11/05

Rugby House Project 10/02/05

Rugby House Project 27/05/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

City Roads Crisis Intervention

Long Yard

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rugby House Project 21 Ravenswood Road Walthamstow London E17 9LY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter Illes     Date: 1 2 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Rugby House Project 21 Ravenswood Road Walthamstow London E17 9LY 02085214486 02085215235 pcox@rharp.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Philip Cox Type of registration: Number of places registered: A Rugby House Project care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence Additional conditions: Date of last inspection Brief description of the care home Ravenswood Road is a registered care home that provides support and rehabilitation to people recovering from drug and alcohol abuse. The premises are two neighbouring purpose built houses with a central garden and patio. Each house has four bedrooms, all with en-suite facilities. Opened in February 1999, it is run by the Rugby House Project, a small charity that operates residential homes and other support services for those recovering from addictions. The properties are owned and maintained by Circle Anglia housing association. The practice approach is based on an intensive programme of group meetings and individual counselling. Residents make a commitment not to use alcohol or drugs, and accept the restrictions and sanctions that are part of the recovery regime. People that use the service successfully usually spend between three and six months living at the project. At the time of this inspection, the weekly fee was Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 6 6 Brief description of the care home £695 per week. Information about the service, including inspection reports, is available from the registered manager and registered provider. Care Homes for Adults (18-65 years) Page 5 of 29 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: three star excellent 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 last inspection on this service was completed on 15th January 2007. This unannounced key inspection took approximately seven hours with the registered manager being present or available throughout.There were seven people living at the home and an eighth person was admitted on the afternoon of the inspection. The inspection was undertaken by the lead inspector although terms such as we, our and us are used where appropriate within this report to indicate that the inspection activity was undertaken on behalf of the Commission. The inspection activity included: meeting and speaking to the majority of the people Care Homes for Adults (18-65 years) Page 6 of 29 living in the home, including speaking to three of them independently; detailed discussion with the registered manager; independent discussion with the senior practitioner who deputises for the registered manager, another practitioner and the aftercare worker; independent discussion by telephone with a care manager from L.B. of Hackney and a care manager from from L.B. of Croydon, both of whom had recent contact with the home. Further information was obtained from a current Annual Quality Assurance Assessment (AQAA) submitted by the home, a tour of the premises and documentation kept at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of detailed information is available to inform prospective residents and others whether the rehabilitation services on offer are likely to meet the individuals needs. Peoples needs and wishes are properly assessed by the home, prior to formal admission, to allow the home to decide whether it can meet those needs and wishes. Residents benefit from detailed housing and care agreements when they are admitted so that they understand their rights and responsibilities while living at the home. Evidence: The home has an up to date statement of purpose and service user guide, called Ravenswood Road Handbook, the latter document being described as the residents handbook where referred to elsewhere in this report. Both of these documents were up to date and the registered manager informed us that they contained current information about the service, including what it can offer and what it cannot offer. Residents spoken to independently stated that they were given a copy of the residents handbook as part of the homes assessment process and found it useful. Two care managers for existing residents were spoken to by telephone as part of the inspection Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: activity, one from L.B. of Hackney and another from L.B. of Croydon. Both indicated that they were satisfied with the information supplied by the service and both felt the home was working well in assisting their resident with their rehabilitation. The homes Annual Quality Assurance Assessment (AQAA) states, The home carries out comprehensive assessments prior to admission for all referrals, and ....We believe that a properly carried out assessment is a major factor in developing a therapeutic alliance and key to a successful outcome. We looked at the pre-admission assessment information for three existing residents and assessment information for another person, who was being admitted on the day of the inspection. This information was current, comprehensive and should evidence that the individual was fully involved in the process. The information showed that the admission process includes: the home receiving a completed copy of their referral form from the prospective residents care manager, which is then discussed within the staff team; a comprehensive in-house assessment and risk assessments by staff from the home; the opportunity for the person referred to visit the home and for the completion of an agreed initial care plan for the person on admission. one resident told us, Couldnt wish for better staff, especially when I first got here. All the residents files inspected contained a signed Housing Licence Agreement that explained their rights and obligations from Circle Anglia, the Housing Association that provides the accommodation. Files also contained a Care Contract Agreement that detailed residents rights and responsibilities regarding the the care and support they received. The home produces a quarterly quality monitoring report for the registered provider. A recent report sampled contained feedback and quotes from previous residents including I felt welcomed and Ravenswood Road does feel like home to me. I am very comfortable here. Care Homes for Adults (18-65 years) Page 11 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and wishes are clearly set out in their care plans to assist staff support each individual in achieving these. Residents agree to a range of limitations in their day to day lives as part of the rehabilitative process. At the same time they are supported to develop their confidence in making overall decisions about their lives, which they appreciate. People are also supported and guided to take appropriate risks in their daily lives to assist them to safely achieve their aspirations. Evidence: The files of three residents were inspected and each contained an Initial Action Plan that had been agreed with the resident on admission. This set out out the persons needs and guidance to staff on meeting this while the person settled in. Within one or two weeks of admission a more comprehensive care plan, called a personal development plan, is agreed and this sets out the persons rehabilitative goals and how staff are to support people in meeting these. The personal development plans for three residents were inspected and found to be detailed and up to date. Residents told us Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: that they were fully involved in what went in their development plans and in reviewing them on a regular basis. Staff spoken to were knowledgeable about the needs of the residents and were able to give examples about how individual residents were supported in a personalised way. Where appropriate this included developing an additional therapeutic contract to assist an individual resident with a specific assessed need. An example was seen where this was linked to an individualised risk management plan with evidence that this had been agreed by the resident, the home and the residents care manager from their funding authority. Peoples rights and responsibilities are clearly set out in the residents handbook. As the the home is a specialist short stay therapeutic service these are more specific than in a long term care home. In a section called How it Works the handbook states,We will ask you to be very honest with each other, and give feedback as to how you are affected by each others behaviour. This is because we believe that residents who become aware of these factors are able to make significant changes in their lives and strengthen their sobrieties. The home agrees a range of limitations with residents that form part of the initial agreement for people receiving a service at the home. These include: no alcohol or illegal drugs on or off the premises and agreed testing to verify this; residents must participate in agreed groups and keyworker sessions and must show respect in their dealings with other residents regardless of their race, gender, sexuality or disability.The files inspected showed documentary evidence the individual had agreed to these restrictions including a room search agreement, urine testing and breathalyser agreement and a confidentiality agreement. Residents spoken to stated that they accepted the restrictions as part of their rehabilitation programme, felt that staff implemented these restrictions fairly and that they respected this. Detailed and personalised risk assessments and risk management plans were seen on the files inspected. These were informed by the persons care plan and the two documents were kept under review by the home and the resident as part of the process of reviewing the persons progress throughout their placement. Care Homes for Adults (18-65 years) Page 13 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are encouraged and supported to participate in a range of therapeutic activities including within the wider community. They also enjoy contact with relatives and friends within agreed boundaries of their therapeutic programme. People are supported to be as independent as possible and are supported to enjoy healthy and nutritious meals of their choice. Evidence: The home currently provides a group work programme of thirteen different groups that offers residents a structured, therapeutic week. The homes annual quality assurance assessment (AQAA) states, Our group work programme consists of sessions that include: relapse prevention, anger and stress management, communication skills, diet and nutrition and healthy lifestyle choices. Residents spoken to confirmed that they attended a range of open and closed groups and indicated that they felt engaged in Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: the therapeutic process. We saw evidence that the home promotes equality and diversity throughout the service. Residents cultural, religious and sexual needs and wishes, including how they wished to be supported with these, were recorded on their care plans. This was discussed with residents who felt the home was supportive to their particular needs and addressed issues raised seriously. It was noted that the home has an Exclusive Relationship Policy. This acknowledges that exclusive relationships between residents, including sexual relationships, may occur within residential treatment and rehabilitation. The policy states that it is the staff teams responsibility is to ensure that exclusive relationships are not damaging to healthy community relationships. The policy goes on to say that any perceived exclusive relationship will be discussed at the team meeting and may lead to a termination of the placement. Residents spoken to indicated that they accepted the restrictions placed on them while receiving rehabilitation from the home. We also spoke to the homes After Care worker. This worker is funded for 14 hours per week to help support residents who are referred by L.B. of Waltham Forest, when they move on from the home. Evidence was seen that this work includes one to one sessions and group work after a resident moves on from the home. In their first week residents are restricted from leaving the home unless accompanied by a member of staff and during the second week they can also go out with longer standing residents, who are designated as escorts. After that people accept responsibility to travel independently in the community. However, although they can travel independently in the community they are still are expected to return by 10pm unless otherwise agreed with staff. Documentation sampled, residents spoken to and staff spoken to all evidenced that this system was clearly agreed by all concerned. At the last inspection a requirement was made that the home must liaise with residents care managers to apply for public transport Freedom Passes to facilitate travel in the community. This requirement was being complied with, one resident asked confirmed they had a freedom pass. Although a significant part of each residents week is committed to therapeutic groups the home does arrange some social and recreational activities for people. Evidence was seen of recent outings to the Tate Modern and that the home provides an opportunity for residents to participate in playing football in a local league if they wish. Residents are encouraged to maintain relationships with relatives and friends although within clear house rules. This includes no visitors for the first two weeks of the placement and visitors then having to agree to the homes house rules. Again, residents spoken to accepted this as part of their overall rehabilitation programme. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: As part of their rehabilitation programme residents are supported to cook their own meals and a financial allowance is provided to facilitate this. There are two kitchens in the home that residents have access to and storage facilities for the food that they purchase. Residents are supported and monitored with preparation of meals, including in purchasing and cooking food that meets their cultural preferences. The homes annual quality assurance assessment (AQAA) states, Food storage is sensitive to residents culture and religion. One resident stated that different people could often being eating a range of different meals including Caribbean and Italian and the resident went on to say that they felt well supported in this process. The kitchens, food storage arrangements and health and safety checks relating to the kitchens were all checked and found to be satisfactory. Care Homes for Adults (18-65 years) Page 16 of 29 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. People living in the home receive appropriate personal support in accordance with their needs. They are also supported in meeting their physical, mental and emotional healthcare needs, including by accessing relevant health care professionals during their stay. The medication administration procedures within the home assist in protecting the people living there. Evidence: All the current residents were independent regarding their personal care, although we were informed that on some occasions individuals may benefit from verbal prompts in this area. Residents were appropriately dressed and presented during the inspection and confirmed that the only restrictions in areas such as getting up/ going to bed, meals and bathing routines were those laid down in the house rules, which they accepted. Residents health needs are assessed as part of the admission assessment. Individual agreements are made as to whether the person wishes to keep their own GP or whether to temporarily register with a GP practice nearby to the home. Documentary Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: evidence of this was seen on the files inspected and one resident was observed leaving and returning to the home for a GP appointment. Residents are also encouraged and supported to visit a dentist whilst at the home, the registered manager and staff being clear on the importance of dental care and oral hygiene. Evidence was seen that the home continues to work closely with specialist professionals such as the Waltham Forest Drug and Alcohol Team. The home has an appropriate medication policy and procedures that were seen and that support the rehabilitative ethos of the home. An assessment is undertaken on the ability of each resident to manage their own medication with a view to most people being independent in this area by the end of their placement. The homes medication storage facilities were seen to be satisfactory, none of the residents were prescribed controlled medication, medicines and medication administration records were sampled and those seen were also satisfactory. It was noted that all staff that supported residents with their medication had received training to do so. However, the majority of training in this area had been in-house and a good practice recommendation is made that refresher training in safe administration is provided by a specialist in this area. Following this inspection the registered manager informed us that he had arranged for a registered nurse to provide refresher training in the safe administration of medication for staff in February 2009. Care Homes for Adults (18-65 years) Page 18 of 29 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. People living at the home are able to express their views and concerns and have these acted on appropriately. The homes safeguarding adults policy and procedures assist in protecting people from abuse. Evidence: The home has a clear complaints policy that was seen in the residents handbook and a copy displayed in the entrance to the home. The registered manager stated that no complaints had been recorded in the past twelve months and the homes complaints log confirmed this. Residents spoken to stated that they knew how to complain if they needed to. One resident told us that if they had any worries or concerns they would discuss this with their key worker and could also raise issues in the weekly meeting or in the groups they attended. No complaints about the home have been made to the Commission since the last inspection. The home has a satisfactory in-house safeguarding adults (adult protection) policy and procedure and the registered manager also showed us a copy of the London Borough of Waltham Forests safeguarding adults procedure. This is the local authority in whose area the home is located. Evidence was seen that staff had undertaken training in safeguarding adults and staff spoken to understood the principles of keeping people safe and the actions they should take if an allegation or disclosure of abuse was made to them. However, not all staff were familiar with the L.B. of Waltham Forests Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: procedure that includes the relevant contact points for reporting any instance of abuse. A good practice recommendation is made that staff familiarise themselves with the L.B. of Waltham Forest procedure so that they are aware of the local reporting points and systems. Following this inspection the registered manager informed us that he had spoken to all staff team members and impressed upon them the requirement to read and familiarise themselves with Waltham Forests Safeguarding policy and procedure. There have been no allegations or disclosures of abuse made to the home or to the Commission since the last inspection. Care Homes for Adults (18-65 years) Page 20 of 29 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. People live in a home that is comfortable, well decorated, well maintained and that meets their current needs. People who live in the home, staff and visitors benefit from the building being kept clean and tidy. Evidence: The home consists of two neighbouring purpose built houses with an enclosed central garden and patio between them. Each house contains four residents bedrooms with en-suite shower, toilet and wash hand basin. The communal facilities include a kitchen in each house, one of which allows wheelchair access, a sitting room and an additional toilet in each house, one of which also contains a bath. Residents spoken to stated that they liked the communal accommodation and their bedrooms which are well equipped, bright and airy. Evidence gathered from a tour of the premises, the homes records and discussion with residents and staff showed that Circle Anglia, the housing association that supplies the property, provides a generally satisfactory service including decorations and maintenance. The home was clean, tidy and free from unpleasant smells during the inspection and the registered manager stated that people living in the home were encouraged and supported by staff to look after the accommodation, including keeping the home clean. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The home has suitable laundry facilities that meet the needs of the current residents. Care Homes for Adults (18-65 years) Page 22 of 29 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. A staff team with a range of qualifications and competencies, in sufficient numbers, support people living in the home. The homes recruitment policy assists in protecting people living in the home. People are supported by staff who have access to a range of appropriate training. Staff also receive formal supervision to assist in further meeting the needs of people living in the home and in their own personal development. Evidence: At the time of this inspection the staff team comprises: a registered manager; four substance misuse practitioners, one of whom is a senior practitioner and deputises for the registered manager; a part time after care worker and identified bank staff that have been recruited by the home. All of the practitioner staff are qualified and skilled to undertake their respective roles. The senior practitioner is a registered nurse and has a diploma in analytical group work skills and the two other practitioners have achieved the national vocational qualification (NVQ) level 3 in care and a range of relevant counselling qualifications. Two staff work in the morning and afternoon, one staff works in the evening and one member of staff sleeps in at night; the registered manager is in addition to this. A copy of the staff rota was seen and confirmed the deployment of staff in the home. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Staffing ratios were judged to be satisfactory to meet the needs of the current residents. Staff turnover at the home is very low. Staff files of long standing members of staff were sampled and showed evidence of proper recruitment checks undertaken by the home including two references, identification with a photograph and evidence of an enhanced criminal records bureau (CRB) clearance and a protection of vulnerable adults (POVA) check. The file of one new member of bank staff who had been recruited since the last inspection was also inspected and showed evidence that all the required recruitment checks had been satisfactorily carried out. Evidence was seen from training records that the home provides regular training for staff. This includes refresher training in core areas such as first aid, food hygiene, fire precautions and health and safety. In addition to this evidence was seen that a range of other training is provided for staff. Staff members spoken to independently stated that they had attended training in the last year including: working with people who are lesbian, gay, bisexual or transgender; working with difference; first aid, fire warden training; and specific training in undertaking urine tests and use of the breathalyser as part of the agreed residents rehabilitation regime. However, as noted elsewhere in this report, good practice recommendations are made at this inspection regarding refresher training in the safe administration of medication and familiarity with the L.B. of Waltham Forests safeguarding adults policy and procedure. Evidence was seen from records in the home that staff receive regular and meaningful supervision. This includes all staff receiving individual line management supervision every two weeks. In addition group supervision is also held every other week by an independent facilitator. Staff spoken to independently stated that they found the supervision offered by the home to be very helpful in assisting residents and in their own professional development. Care Homes for Adults (18-65 years) Page 24 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the effective and robust management systems used in the home. This includes their views being regularly sought in a variety of ways regarding the quality of life they experience and the results of this are acted upon. Health and safety procedures assist in protecting people living at the home, staff and visitors although further attention is needed to the electrical installation to evidence that people are being properly protected in the home. Evidence: The registered manager has a range of qualifications and skills to enable him to undertake his role effectively. He is an experienced counsellor holding an accredited diploma, a trained group worker and supervisor with over twelve years experience of working with people with problematic drug and alcohol use. He has also achieved the Registered Managers Award, national vocational qualification (NVQ) level 4 in management and care and is also qualified as an NVQ assessor. Feedback from residents and staff was very positive, including that he is skilled, competent, friendly and approachable. We were generally impressed throughout this inspection of the Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: management overview and monitoring of the processes relating to individuals rehabilitation programmes. The home has a variety of robust ways of monitoring the quality of the service and implementing improvements. The homes annual quality assurance assessment (AQAA) states that the home remains compliant with a national framework for measuring quality assurance for drug and alcohol services (QUADS), and documentary evidence to support this was seen during this inspection. Feedback is also sought from residents including through regular feedback forms during their placement and feedback from weekly community meetings. Documentary evidence was seen regarding this and residents confirmed that they were regularly asked for feedback, including through regular contact with their key workers. The registered manager also compiles a quarterly report on the progress of the unit. A copy of the latest finalised report was seen and we found it to be very thorough. These reports include information about Referrals, Admissions and Completions that includes detailed equality monitoring and sets targets for the next quarter. The report seen also confirmed that the home works positively with the local Community Drug and Alcohol Team (CDAT). In addition to this, evidence was seen on documents such as care plans that the registered manager spot checks these on a regular basis. Feedback from two care managers spoken to included that they were very satisfied with the rehabilitation programmed their clients were undertaking and the way the staff at the home communicated with them. At this inspection a range of satisfactory health and safety documentation was seen including a gas safety certificate and portable appliance test. It was noted however that the homes electrical installation certificate stated that some remedial work was necessary before the installation could be judged satisfactory. The registered manager stated that this work was in hand although a requirement is made regarding this to evidence that the identified risk to people using the home had been eliminated. The homes fire log was inspected and showed that the fire fighting equipment was serviced on a regular basis, weekly safety checks on fire equipment were being carried, that regular fire drills were being undertaken, and the home had a current fire plan and fire risk assessment. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 13 The registered persons must 27/02/2009 ensure that unnecessary risks to the health and safety of residents are identified and so far as possible eliminated. This is to include that the home has a current and satisfactory electrical installation certificate. This is to ensure that protection to all that use the home is maximised. 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 20 The home should provide staff further refresher training in the safe administration of medication by a specialist in this area to assist staff in maximising protection to staff in this area. Staff should familiarise themselves with the L.B. of Waltham Forests safeguarding adults policy and procedure so that they are aware of the local reporting points and systems should they need to use these. 2 23 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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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