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Inspection on 02/04/05 for Community Resettlement Project

Also see our care home review for Community Resettlement Project for more information

This inspection was carried out on 2nd April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The admission process is designed to support the new resident and not overwhelm them. Admission into the home is a planned process. Staff are available to offer support. Staff are provided with sufficient information through a very broad assessment and care planning system. Residents are able to say how they wish to be supported and include their any future goals in their individual care plans. Staff regularly check out with residents if the care plans are working and what progress is being made. There are opportunities for residents to make changes to their care plans. Links with the community are good and enable residents to benefit from social, health related and educational opportunities. Residents said that the staff are supportive and available for guidance.

What has improved since the last inspection?

The service has developed and included a "family contact questionnaire" which is part of the admission process. This allows the service user to take the lead in saying how much information is shared with relatives.

What the care home could do better:

The service needs to look at the deployment of staff in the evening and overnight to ensure that sufficient staff are on duty to ensure the health to meet the complex needs of some of the residents.

CARE HOME ADULTS 18-65 Community Resettlement Project 24-28 Argyle Street Kings Cross London WC1H 8EN Lead Inspector Pippa Treadwell-Smith Unannounced 02 April 2005 09.30 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 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 Stationary 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. Community Resettlement Project Version 1.10 Page 3 SERVICE INFORMATION Name of service Community Resettlement Project Address 24-28 Argyle Street, Kings Cross, London WC1H 8EN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7278 3629 0207 813 9776 Community Housing Association Care Home 18 Category(ies) of Mental Disorder excluding Learning Disability or registration, with number Dementia (18) of places Community Resettlement Project Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 01.11.2004 Brief Description of the Service: The Community Resettlement Project (CRP) is managed by Community Housing Association. This organisation has considerable experience in the housing sector and provide a wide range of care and support services.The home itself provides care and support to adults with mental health needs. It is situated in a residential/commercial street very close to Kings Cross Station. The property is three adjoining houses. House number 24 is registered to accommodate five women; house number 26 is the office-cum-staff area and house number 28 is registered to accommodate thirteen male service users. The houses are interconnected.Accommodation for service users is provided in single rooms, each is furnished with a fridge and a wash hand basin. Communal facilities include toilets, bathrooms, kitchens and lounges. There are two gardens to the rear of the premises. The houses are not suitable for service users with mobility problems and as they are listed buildings therefore alterations and adaptations are unlikely. The focus of the CRP is on rehabilitation and resettlement. Residents are to be motivated to be able to cook and undertake cleaning and laundry or imprve these skills. An average stay is twenty-two months although residents can be there for longer. Prospective service users must have the ability or at least be motivated with regard to social skills, shopping and budgeting, self-catering, domestic cleaning, laundry, personal care and self-medication. Community Resettlement Project Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first announced inspection within the new inspection schedule from 1st April 2005 to 31st March 2006. The inspection took up to 4 hours during a Saturday morning. Most of the inspection was spent talking to the 4 service users and 2 members of staff. The remainder of the time was used to examine care records. Ten of the key standards were assessed. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Community Resettlement Project Version 1.10 Page 6 The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Community Resettlement Project Version 1.10 Page 7 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 Standards Statutory Requirements Identified During the Inspection Community Resettlement Project Version 1.10 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 only. The service has a comprehensive admission procedure to ensure that there is a proper assessment prior to people moving into the service. EVIDENCE: Residents are given a two month structured induction into the home. Check lists are available. Residents confirmed that the admission process had been designed to support them. Individual records are kept for each service user and an inspection of the records for the three most recent admissions show that there is a full assessment. One resident spoken to, provided significant information about his care needs. This information was recorded and known to staff. There are contracts available on the care files. Community Resettlement Project Version 1.10 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The service has an effective care planning system in place, which addresses the needs and aspirations of the service user. EVIDENCE: Each resident is allocated a key worker, usually during the admission process. Individual plans of care are available and residents confirmed their input into the development of their personal support plans. Each service user completes and a “support plan self assessment plan” which is also translated into the plan of care. Reviews are regular and documented as part of the key working meetings. There are signatures on the care plans and reviews of key workers and residents. Residents spoken to say, that they are able to make their own decisions. Support and guidance is available from key workers so that they can make an informed choice. Discussions with staff showed that they recognise the right of service users to take risks and aware of their responsibility to minimise danger. Where restrictions may apply, these are as the result of a risk assessment. Risks are identified as part of the assessment process and key working Community Resettlement Project Version 1.10 Page 10 meetings. Dependent on the severity of the risk, there may be a need to involve a multi-disciplinary approach. There are copies of risk assessments on file. The service has a missing person policy and it operates as a clearly defined procedure. Community Resettlement Project Version 1.10 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 16 Links with the community are good and support and enhance service users’ social and educational opportunities. EVIDENCE: The residents described the various activities that they attend. This can be from part-time college courses to full time education. Support plans confirm the number and level of activities for residents according to their motivation. The support plan records activities both inside and outside the home. The residents have keys to their bedrooms as well their respective front doors. They were seen to come and go according to choice and need. The focus of the project is for residents to develop personal, social and life skills. The residents said that they are supported to develop a structured weekly programme of activities both in and out side of the home. They confirmed that they knew there is an expectation that they will be selfmotivated. The care contract is clear that residents who join the project will have the responsibility for their own personal self-care. Community Resettlement Project Version 1.10 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 There are satisfactory arrangements in place to meet the health care needs of the residents. EVIDENCE: Information about the home clearly states that the service does not provide nursing care. Service users are expected to take responsibility for their own personal care although staff were observed offering guidance. Support plans and care records show the input of other health care professionals. A resident confirmed that he has been assessed by an occupational therapist in relation to his physical needs. All residents are registered with a General Practitioner and residents said that they have access to other healthcare professionals. A resident confirmed that he has been assessed by an occupational therapist in relation to finding suitable accommodation following discharge. He confirmed that the GP was also supporting his housing application. Mental health assessments are carried out and residents said that they had contact with care manager and community psychiatric nurses. Community Resettlement Project Version 1.10 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 only The home has a satisfactory complaints system and there is evidence that residents feel that their views are listened to and acted upon. EVIDENCE: The complaint’s procedure forms part of the service user induction into the service. A copy is also available in the statement of purpose and service user guide. A look at the complaints monitoring system showed that service users are able to bring complaints and representations to the notice of the manager about a variety of subjects. These include the attitude of staff and the behaviour of other residents. Residents spoken to say that they are able to raise issues both formally and informally. Community Resettlement Project Version 1.10 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These key standards were not assessed during this visit. EVIDENCE: Not Applicable Community Resettlement Project Version 1.10 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 only The deployment and number of staff during the nighttime hours seems to be an area of concern for some staff. It is an area, which needs further consideration. EVIDENCE: On arrival the inspector found one member of staff on duty. The second person was unavoidably late because of problems with public transport. An examination of the rota and discussions with the staff showed that there is one member of staff on duty from 20.00 hours to 09.00 hours. This staff member sleeps in and there is no wakeful night staff. The organisation has an emergency out of hour’s on-call system, which is set up to, allow sleep-in staff to have immediate contact with a manager. The on-call manager may either arrange additional staffing or travel to the home to attend on-site if required to do so. Discussions with the staff highlighted that there is an on call system although the criteria for the on-call manager to attend an incident was not clear to them. It was highlighted that the reduction in the number of staff was as a result of concerns by a previous registration authority about staff security issues. This was some years ago. The home is in a high-risk area and staff were vulnerable leaving the home late at night. The area is now heavily policed and supported by CCTV. Staff leaving the project walk to the tube station that is Community Resettlement Project Version 1.10 Page 16 approximately five minutes walk away. An examination of the notifications and admission information shows that service users have complex needs and in some instances a history of threatening behaviour and assaults. The support plans and risk assessments address the personal safety elements and the visitor’s policy is designed to protect both service users and staff. Nevertheless staff working alone for 11 hours needs to be reviewed in light of the needs of the residents and the nature of the service. There were two female staff members on duty. At the time of the inspection there were 13 men and 5 women in residence. The organisation does not provide male only staff or a gender balance on shift. The approach of the organisation is that experienced staff are recruited to work with all needs regardless of gender. The gender balance is addressed as part of key working. Community Resettlement Project Version 1.10 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The key standards were not assessed during this visit. EVIDENCE: Not Applicable Community Resettlement Project Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 x x 3 x Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 Score 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x Page 19 Community Resettlement Project Version 1.10 21 x Community Resettlement Project Version 1.10 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 33 Regulation 18(1)(a) Requirement The registered person is required to review the staffing levels and the gender balance to ensure that sufficient staff are working in the home for the health and welfare of service users. Timescale for action 31.05.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Community Resettlement Project Version 1.10 Page 21 Commission for Social Care Inspection Centro 4 20-23 Mandela Street Camden Town London NW1 0DW National Enquiry Line: 0845 015 0120 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 Community Resettlement Project Version 1.10 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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