Inspection on 24/02/09 for Crouch House and Crouch Cottage

This inspection was carried out on 24th February 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Crouch House and Crouch Cottage 20/02/07

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Crouch House and Crouch Cottage Forest Mere Health Farm Liphook Hampshire GU30 7QJ     The quality rating for this care home is:   one star adequate 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: Liz Palmer     Date: 2 4 0 2 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. that people have said are important to them: They reflect the things 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 26 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Crouch House and Crouch Cottage Forest Mere Health Farm Liphook Hampshire GU30 7QJ 08702200714 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Sporting Chance Clinic Name of registered manager (if applicable) Mr James Albert West Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence Additional conditions: The maximum number of service users to be accommodated is 4 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category: Past or present dependence on alcohol (A) Past or present dependence on drugs (D) Date of last inspection Brief description of the care home 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. They provide a structured 26 day programme for amateur and professional sportsmen and women who experience addictions. The accomodation is located in the grounds of Forest Mere Health Farm. There is one shared bedroom and two singles. The service is a charitable organisation. The Care Homes for Adults (18-65 years) Page 4 of 26 care home 4 Over 65 0 0 4 4 Brief description of the care home Registered Manager is Mr James West. The Responsible Individual on behalf of the company is Mr Peter Kay. Fee levels were unavailable at the time of this report. Care Homes for Adults (18-65 years) Page 5 of 26 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: one star adequate 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 unannounced key inspection was completed by one inspector and took over six hours. During this time the Responsible Individual (RI) and the registered manager (manager) were present and assisted with the inspection. All four current residents were met and spoken to as were a visiting nutritionist and a visiting General Practitioner (GP). Records were sampled, including; assessments, care plans, daily records, policies, medication records and feedback forms. We also looked at the homes Annual Quality Assurance Assessment (AQAA) and used all this information to form our judgements. The home offers a 26 day programme for up to four residents who all start the Care Homes for Adults (18-65 years) Page 6 of 26 programme together on day one. After each 26 day programme the home is not occupied by any residents for one week. This time is used to prepare the premises for the next residents and for assessments to take place. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 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 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can expect to get detailed information about the programme as well as a thorough assessment to ensure their needs can be met here. Evidence: On the day of the inspection there were four new residents who had arrived at Crouch House the day before. They were therefore, all on day two of the twenty six day programme. They met with the inspector in the lounge and were asked about their experience of finding out about the service provided, the assessment process and their experience so far. They all said making contact had been smooth and easy. Some had been recommended the clinic and others had found it on the internet. One said I had a fantastic response to my email on the same day, they were very supportive. Another said they had made telephone contact with the RI, visited for a look round and a week later met a therapist for an assessment, all my questions were answered. One person told us that on their visit they had met the previous residents who all gave glowing reports. All of the current clients said they had received enough information about the service Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: in order to make a decision about it. They said they had received a Statement of Purpose and Service Users Guide which clearing explained the programme so they would know what to expect when they arrived. people told us that a detailed contract was given to them at the assessment meeting. They all agreed there were no surprises. In their AQAA the home tells us that they complete detailed assessments for potential residents to establish their suitability for the programme. The assessments are undertaken by the registered manager or another therapist employed by the home. If the assessor deems it needed, a clinical psychiatrist is brought in to do their own assessment. Assessments for the four current residents and two previous residents were looked at. These were seen to contain the detail referred to in the AQAA. Evidence of specialist psychiatric involvement was seen, this was based on individual needs and tailored to the person concerned. The AQAA also tells us that religious and cultural needs are now a mandatory part of the assessment form. These was seen to be the case on the assessmnts looked at. A clear policy on equality is read out to residents as part of their induction. Care Homes for Adults (18-65 years) Page 11 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are fully involved and have agreed the daily routine of the home, although this occurs within the tight boundaries of the homes daily structure. Individual goals and aspirations are strived for within the therapeutic framework of the service. Evidence: The homes AQAA tells us that care plans are written up weekly and they try to be as flexible and responsive as possible. As it was only day two of the programme care plans had not been drawn up for the current residents. Care plans were looked at for two previous residents. These were detailed and reviewed at the three stages of the planned programme. Records of therapy sessions and details of peoples emotional well-being are recorded and handed over to staff members. They are individual and person centred in their approach. Current residents said they felt well looked after so far and that staff genuinely cared about them. They told us that they had agreed on any rules and restrictions placed upon them at the assessment stage of the process. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Risk assessments are undertaken and people are supported to take risks within the secure and therapeutic framework. Care Homes for Adults (18-65 years) Page 13 of 26 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 who use the service are supported, within the structured therapeutic framework, with the provision of recreational and occupational activities to aid them in their recovery. A nutritious and well balanced diet is part of this process. Evidence: The residents spoken to said they were able to use the facilities at the health farm. This is particularly important as all residents are amateur or professional sports people and regaining their fitness is part of the recovery process for them. They are also expected to take part in a structured programme of activities and therapies including equine therapy, shiatsu, football, swimming, using the gym and one to one therapy sessions. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: Due to the nature of the therapeutic programme communication with family members is restricted and risk assessed on an individual basis. This is clearly stated in the terms and conditions and current residents said they were fully aware of these restrictions prior to coming to Crouch House. All meals are taken at the restaurant at Forest Mere health farm where a range of healthy nutritious food is provided. Residents described the food as fantastic so far. Provisions and facilities for making hot and cold drinks and snacks are provided in the house. Each person also receives a nutritional assessment and guidance from a qualified nutritionist at the start of their programme. Care Homes for Adults (18-65 years) Page 15 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to services that support their health and personal support needs. The policies and procedures for the administration of medication suitably protect people who use the service. Evidence: Care plans and daily records show that people get the emotional and therapeutic support they need and that staff respond to any indication that the persons health or well being is effected. The home has good links with other professionals who can offer advice and support. People spoken to said there privacy is respected within the boundaries of the therapeutic framework. Each person is supported to maintain their health and well being by being registered as a temporary patient with a local General Practitioner (GP). This GP will usually visit on day one of the programme and give each person a general health check as well as looking at any specific health issues relating to their past behaviour. The GP who had visited for many years has retired and a new GP was visiting during the inspection. We heard a handover to the new GP from the RI and registered manager about the usual procedure and also about individuals currently on the programme. From this and written evidence in care plans and daily records Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: which pick up peoples moods and well being, it is clear that each person gets individual treatment, as needed. People were spoken about in a respectful manner and the care given to them is person centred. People are supported and encouraged to improve their general fitness as part of the programme here. The facilities at the health farm are available to them for this. Medication is safely stored and administered. Only one current resident is taking one medication. Procedures and records for this were sampled and found to be secure and accurate. Care Homes for Adults (18-65 years) Page 17 of 26 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. Residents are able to complain and expect to have their views listened to and addressed. The home has satisfactory systems in place to protect the residents from abuse, neglect and self-harm. Evidence: The home has a complaints policy and procedure, which is included in the Service Users Guide and given to people at the assessment stage. Two of the people spoken to could not remember seeing the proceedure, however all said they would complain to the manager or RI and felt that they would be listened to. One said I could talk to any of the staff, I trust them. The manager agreed to put the complaints proceedure on a notice board for residents to be able to see and refer to if needed. It was also noted that the proceedure needed updating with the Commissions new contact details. The manager agreed to action this. The manager and RI were fully aware of their responsibilities with regard to safeguarding adults and stated that their staff were too. Guidance for staff on reporting risk of or disclosure of abuse was seen on individual staff files. The home did not have an up to date copy of the West Sussex County Council Policy on safeguarding. The manager agreed to get one as soon as possible. We have been informed since the inspection that this has been done and an up to date policy is now available in the home. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: There has been no complaints or allegations received by the home or us since the last visit. Care Homes for Adults (18-65 years) Page 19 of 26 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. Residents benefit from an environment that is clean, well maintained and furnished to a high standard on the inside. Outside the grounds are peaceful and secluded. Evidence: Crouch House is maintained through a contract with the Forest Mere health farm. The RI said this works very well and repairs are done promptly as needed. Outside, the house is surrounded by beautiful countryside. Current residents said they were really happy with the accommodation. The two people sharing a room said this had been agreed before they arrived. It formed part of one persons care plan that they should share and both parties said they were happy with the arrangement. Care Homes for Adults (18-65 years) Page 20 of 26 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. People who use the service benefit from having their needs met by staff that are trained, supportive and sufficient in numbers. The recruitment process protects people who use the service. Evidence: Three staff work in the home alongside the manager and the RI, including a qualified addictions counsellor and two weekend staff who are both trained to NVQ level two and have certificates in Emergency First Aid. All have worked here for at least six years. A psychiatrist is available to the home to be called upon as needed following assessment. Handover notes were seen to show that staff are sharing information to ensure consistent and smooth running of the home. Evidence of regular supervision was seen and the manager gave an example of how one persons practice had improved as a result of supportive supervision. The home has a robust recruitment procedure. No new staff have been employed since the last inspection. Care Homes for Adults (18-65 years) Page 21 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements need to made to the quality assurance systems, this will ensure all policies and procedures are kept up to date and available to staff and residents. Evidence: The RI and the manager are qualified psychotherapists and the manager has also completed the NVQ level four in Management and Social Care. Residents say the home is well run and they have confidence in the management. Residents are encouraged to influence the running of the home through group meetings, one to one sessions and anonymous feedback sheets completed at the end of each twenty six day programme. The RI completes detailed reports which he presents to the board of trustees on a quarterly basis. These reports include details of the clinical side of running the home, any funding issues, staff issues and maintenance issues which may require funding. At the last inspection we asked the home to complete monthly Regulation 26 monitoring forms. This has been an outstanding requirement since December 2005. The RI said he was confused about this and whether or not he should be doing it. The RI and the manager have been informed Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: that these must be completed, as part of their quality assurance and that the commission takes a serious view on continued breach of regulation. This matter will be followed up separately from this report. Regular monitoring visits would help to ensure that there are always up to date policies available in the home. If the RI feels there is a conflict of interest for him then the board could nominate another trustee to carry out the monthly visits. The feedback forms completed by residents were sampled. Out of thirty looked at only one negative comment was made and this related to the lunches. Typical comments made by residents included the levels of counselling and therapy are excellent, felt extremely cared for. saved my life, and changed my life. The home has worked hard in the past to comply with our regulations and continues to strive for improvement in the service. Maintenance and general repairs for the home are carried out by the health farm. The RI said this works very well. This includes the electrical testing and testing of fire safety equipment. Any maintenance outside of the contract would need to be agreed and funded by the trustees. West Sussex Fire and Rescue service inspected the home in February 2008. No requirements or recommendations were made by them. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 39 26 As part of the quality 20/03/2007 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. Care Homes for Adults (18-65 years) Page 24 of 26 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 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 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!