Inspection on 20/02/07 for Crouch House and Crouch Cottage

This inspection was carried out on 20th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Crouch House and Crouch Cottage 24/02/09

Crouch House and Crouch Cottage 08/02/06

Crouch House and Crouch Cottage 06/11/05

Crouch House and Crouch Cottage 09/11/04

Similar services:

Flint House

The Ley Community

Yeldall Manor

Cherwood House Care Centre

The Manor Clinic

Francis House

1 Butler`s Drive

Stoneleigh

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Crouch House and Crouch Cottage Forest Mere Health Farm Liphook Hampshire GU30 7QJ Lead Inspector Ms J Hartley Unannounced Inspection 20 February 2007 11:00 Crouch House and Crouch Cottage DS0000051857.V323876.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 Crouch House and Crouch Cottage DS0000051857.V323876.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. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crouch House and Crouch Cottage Address Forest Mere Health Farm Liphook Hampshire GU30 7QJ 01256 766711 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) The Sporting Chance Clinic Mr James Albert West Care Home 4 Category(ies) of Past or present alcohol dependence (4), Past or registration, with number present drug dependence (4) of places Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of two service users may be accommodated in the large bedroom of Crouch House, based on the assessed needs of each service user. 8th February 2006 Date of last inspection Brief Description of the Service: Crouch House and Crouch Cottage are registered to provide personal care (PC) for up to four service users in the Categories A Past or Present Alcohol Dependency and D Past or Present Drug Dependency. Dependent on need, the duration of the stay can be between seven and twenty eight days. Programmes are adapted for service users on an individual basis. The service is run for mainly professionals or ex-professional sportsmen and women who experience addictions. The establishment is located on the grounds of Forest Mere Health Farm. Accommodation is provided over two floors. There is one shared room, one small single and a double with en-suite facilities. The service is a charitable organisation. The Registered Manager is Mr James West. The Responsible Person on behalf of the company is Mr Peter Kay. Fee levels were unavailable at the time of this report. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit for this key inspection took place over three and a half hours. The registered manager Mr James West was present throughout the inspection and provided the information required. The inspector examined information held on the service file since the last inspection in February 2006, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose. Evidence was also gathered from the pre-inspection questionnaire completed by Mr West. During the inspection the inspector spoke to all of the service users, and a members of staff. The inspector undertook a tour of the premises and looked at three care plans and three staff files. Various record books, policies and procedures were also examined. What the service does well: What has improved since the last inspection? What they could do better: Assessments seen on service users’ files did not include details about religious or cultural needs. These should be included to ensure the service is able to meet these needs. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 6 There is an in-house induction in place but there is no recorded evidence that staff have completed this. The registered person needs to ensure that there is a structured induction programme and that a record is kept of staff who have undertaken this. Staff recruitment procedures are thorough, however to provide more protection for service users it is recommended that a full employment history is requested from prospective employees and any gaps in employment are explored. As part of the quality monitoring system the home needs to undertake and record monthly monitoring visits and ensure they are made available to the Commission on request. This is a requirement that has been outstanding since 31st December 2005. 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. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service provides the information needed by service users to make an informed choice about using the service. Service users are involved in the assessment process prior to admission. Pre-admission assessments need to include details about individuals’ religious and cultural needs. EVIDENCE: An up to date Service User Guide and Statement of Purpose were received prior to the site visit. Both documents contain the required information to enable prospective service users to make an informed choice on whether to use the service. Prospective service users are also given a brochure that describes the philosophy of the programme, the services provided, the facilities available and introduces the staff team. The registered manager or one of the therapists undertakes pre-admission assessments. These take place at the service or at a venue closer to the service user’s home. Assessments seen on service users’ files did not include details about religious or cultural needs. These should be included to ensure the service is able to meet these needs. The manager said that the programme and the pre-admission assessment could be adapted to take into account the diverse needs of individual service users. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 9 All the service users spoken with during the visit said they had been fully involved in the assessment process, and had received comprehensive information about the recovery programme. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 10 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan that reflects their needs and goals. Service users are supported to make decisions about their lives and take risks as part of an independent lifestyle. EVIDENCE: All the service users’ files were inspected. They were all found to contain comprehensive care plans that had been drawn up using the information gathered in the pre-admission assessment. Care plans were detailed and easy to follow with clear goals in place. Records include weekly reviews by the therapeutic team. Through this process, objectives and progress are identified and discussed with individual service users. All the service users confirmed that they are involved with their reviews and are encouraged to give feedback about their progress. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 11 The therapeutic nature of the programme encourages service users to make decisions about their lives and lifestyles in a supportive environment. Risk assessments are carried out as part of the assessment process and are documented as part of the plan of care. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are required to participate in a structured programme, which includes group and individual activities both in the home and wider community. These are appropriate to their personal development and encourage individuals to take responsibility in their daily lives. Personal relationships are maintained during the programme mainly through telephone contact. The service provides a healthy, well balanced and nutritious diet for service users. EVIDENCE: The service users at Crouch House are all, or have been, professional and amateur sports men and women. Activities that are provided enable service users to maintain fitness whilst taking part in the programme. Each service user has an individually designed fitness programme that is kept under review Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 13 throughout their stay. Other activities available include massage, swimming, yoga, acupressure, shiatsu and equine assisted psychotherapy. Service users felt that their timetables were well balanced with fitness activities, therapy and free time. As part of the programme service users attend local support groups which enables them to mix with people in the community. They also have unrestricted access to the extensive grounds of Forest Mere. Due to the nature of the programme provided at Crouch House communication with family members is mainly restricted to telephone contact. This is clearly stated in the terms and conditions. However, on the twenty-eight day programme a family day is organised to enable close family members to visit and to gain an understanding of the programme. Service users do their own laundry and light housekeeping duties. Service users make their own breakfast in the home. All other meals are taken at the Champneys restaurant at Forest Mere Health Resort where a range of healthy nutritious food is provided. Service users described the food as “very healthy”, “fantastic” and “beautiful”. Provisions and facilities for making hot and cold drinks and snacks are provided in the house. Each service user also receives nutritional guidance as part of their individualised programme. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 14 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive specialist support and advice as part of the programme provided at the service. Physical, emotional and healthcare needs are met by in-house professionals and community health services. Due to the nature of the service, medication is not retained by service users during their stay. EVIDENCE: Service users at Crouch House do not require assistance with personal care. All residents are required to complete a full detox, (if required), prior to entering the programme. A Consultant Psychiatrist is available to advise and monitor residents as required. A Yoga and Shiatsu therapist, Horse therapist and Sports Psychologist provide group sessions as part of the 28-day programme. Each resident is assigned a counsellor who provides a therapeutic one to one session each day. These sessions provide residents with the opportunity to Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 15 talk through all aspects of their care needs and make supported changes where needed. The programme provides a rigid daily structure for the service users which is relevant and personalised to their on going treatment and complex needs. However individuals have the opportunity to make choices and demonstrate some independence within this. The service users attend daily group counselling sessions in addition to community meetings that provide on-going peer support. All service users are registered with a local GP. Any specialist health needs arising from the pre-admission assessment will be catered for by the home. The service also provides an after care programme which includes counselling sessions and refresher stays of one week. There is a policy in place regarding the storage and administration of medication. The policy states that all medication must be handed to the manager and is kept in the office in locked storage. Service users come to the office for their medication. A new form for recording the administration of medication has recently been put into place. This enables clear, accurate records to be kept. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel that their views are listed to and acted upon. The home has policies and procedures in place that protect services users, as far as possible, from abuse. EVIDENCE: The home has a complaints policy and procedure, which is included in the Service Users Guide. There have been no formal complaints recorded since the last visit. Service users said that they were aware of the complaints procedure but had no complaints to make. They said they would discuss any problems with the manager of staff, and felt that they would be listed to and dealt with appropriately. An Adult Protection policy and procedure is in place. West Sussex County Council Adult Protection procedures and guidelines are available in the staff office. In house training has been undertaken so staff were clear about their responsibilities should an incident occur. Assessments for individual service users highlight areas of vulnerability. This information helps staff to make informed choices about protecting residents and staff from potential risks. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Crouch House provides a homely and comfortable environment for service users that is clean and hygienic. EVIDENCE: The environment at Crouch House is of a high standard, homely comfortable and well maintained throughout. There is a large communal lounge and dining room, spacious modern kitchen, counselling room, three bedrooms (one ensuite) and shared bathroom facilities. Decoration and furnishing are of good quality. On the day of the visit the home was seen to be clean and hygienic. Staff accommodation and offices are located in a separate building located next to service users’ accommodation. Service users said they were happy with their accommodation and enjoy the feeling of seclusion that the service provides. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 18 There are adequate bathrooms and toilets to meet the number of residents and staff. The home is cleaned weekly by domestic staff, and service users are responsible for the day-to-day cleaning. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 19 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 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are individual and joint needs are met by competent, appropriately trained and qualified staff that receive regular supervision. There is an inhouse induction in place but there is no recorded evidence that staff have completed this. Residents are supported and protected as far as possible by the home’s recruitment policy and practices. However, it is recommended that a full employment history is requested and any gaps in employment are explored as part of the recruitment process. EVIDENCE: All of the therapeutic staff at the service are fully qualified in Psychotherapy, Physiotherapy or Sports Therapy and are involved in ongoing outside supervision in their respective fields of expertise. They all have recognised qualifications relevant to their professions. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 20 Service users said that all the staff are very supportive, good listeners and have an encouraging and positive attitude with service users. The home’s recruitment policies and procedures were inspected and found to be thorough. Three staff files were examined and found to include all the required documentation including two written references, Criminal Records Bureau and POVA checks. It is recommended that a full employment history is requested and any gaps in employment are explored as part of the recruitment process. There is an in-house induction in place but there is no recorded evidence that staff have completed this. Evidence was seen that a First Aid training course has been booked for March 2007. A requirement was made at previous inspections that evidence must be provided that staff receive regular supervision. Written evidence was seen at this visit so this requirement has now been met. Evidence was also seen that support staff are now undertaking the NVQ level 2 qualification. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 21 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 and 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 run by a competent and qualified manager. The home has policies, records and procedures in place to safeguard as far as possible the health, safety and welfare of residents and staff. Monthly monitoring reports are not being undertaken. A requirement has been made regarding this. EVIDENCE: The manager of the home is a qualified Psychotherapist and has also completed the NVQ4 in Management and Social Care. Service users said that he was approachable and supportive of their needs. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 22 The home has a quality assurance system in place that includes gathering the opinions of service users to measure success and find out where improvements can be made. Reports of monthly monitoring visits by the Responsible Individual are still not being made available to the Commission. This was discussed with the Registered Manager during the visit. This is an outstanding requirement from the last two inspections. The inspector saw documents concerning health and safety and maintenance records. The manager said that all maintenance in the service is carried out by the landlords, Forest Mere. Copies of the last electrical inspection report and occupational safety inspection are now being kept at Crouch House. The fire officer visited on the 27th January 2007 and requirements from that visit are currently being addressed by the service. Records of fire safety training and weekly fire tests were seen during the visit. This was a requirement at the last inspection and has now been met. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 23 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 3 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 3 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 2 X 3 X X Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA2 Regulation 12 (4) (b) Requirement Pre-admission assessments need to include details on the cultural and religious needs of service users to enable the service to meet these needs. As part of the quality monitoring system the home will undertake and record monthly monitoring visits and ensure they are made available to the Commission on request. This has been outstanding since 31/12/05. Timescale for action 20/04/07 2. YA39 26 20/03/07 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 YA34 Good Practice Recommendations It is recommended that a full employment history is requested from prospective employees and any gaps in employment are explored to further protect service users from risk. Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Crouch House and Crouch Cottage DS0000051857.V323876.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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