Inspection on 06/11/05 for Crouch House and Crouch Cottage

This inspection was carried out on 6th November 2005.

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 4 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 20/02/07

Crouch House and Crouch Cottage 08/02/06

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 Beth Tye Announced Inspection 6th November 2005 10:00 Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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.V252600.R01.S.doc Version 5.0 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.V252600.R01.S.doc Version 5.0 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.V252600.R01.S.doc Version 5.0 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. 9th November 2004 Date of last inspection Brief Description of the Service: Crouch House and Crouch Cottage is a care home, registered to provide personal care (PC) for up to four service users in the Catogories 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. Accomodation 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 orgnisation. The Registered Manager is Mr James West. The responsible person on behalf of the company is Mr Peter Kay. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Announced Inspection of Crouch House took place over 4 hours. Prior to the inspection information held on file was examined, including the last inspection report and all official documentation relating to the home. The manager had completed a pre-inspection questionnaire, which detailed any changes to the service since the last inspection. During the inspection a tour of the home was undertaken and records relating to the residents care and health needs was examined. The inspector spoke to the manager at length about the service and he was able to provide relevant documentation on request. Staff files and Health and Safety records were reviewed. The inspector did not have the opportunity to talk with residents or staff as there were no placements at the time of the inspection. This will be undertaken at the next inspection. What the service does well: What has improved since the last inspection? Since the last inspection the registered manager Mr James West has completed the National Vocational Qualification award in Management and Care (Level 4). Policies and procedures relating to Adult Protection have been implemented in line with current legislation. The manager has provided in house training to staff in the area of Adult Protection, so staff are aware and able to act appropriately should an incident occur. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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.V252600.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3, 4 & 5 Pre-admission assessments are completed prior to admission to the home. Prospective residents are provided with relevant information and have the opportunity to visit the home and speak with other service users and staff during their visit. All residents are provided with a contract of Terms and Conditions. EVIDENCE: The inspector viewed an up to date Statement of Purpose and Service Users Guide, which are given to all prospective residents prior to admission. This provides detailed information about the services available to them and helps them to decide whether the home can appropriately meet their needs. All residents meet with the manager prior to admission to undertake a comprehensive assessment. These were examined by the inspector and found to be in good order. Individual care files contained pre-admission information, which was relevant and detailed. Records showed prospective residents had contributed to the assessment process. Providing the opportunity for them to identify their perceived needs and aspirations prior to admission. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 9 Terms and Conditions are provided and signed by each resident on arrival, copies of which was seen on file. This ensures residents are fully aware of their rights and exactly what the home has to offer them. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8, 9 & 10 Residents have the opportunity to contribute to and review the care planning process through one to one and group therapy. Documentation that was examined confirmed that the home meets their changing needs and personal goals appropriately. The service promotes independent living as part of a structured programme and in line with assessed risk and agreed limitations. All information is stored securely and staff are required to sign documentation to maintain confidentiality. EVIDENCE: The inspector examined care records. These are generated from the initial assessment information. Each plan relates to all aspects of the residents assessed care needs including health, personal and social care. The plans are easy to follow which means staff can transfer the information into daily practice. Records include weekly reviews by the therapeutic team. Through this process, objectives and progress are identified and discussed with individual residents. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 11 This was evidenced by the residents completion of written assignments and signed documentation held on file. Each review provides an opportunity for the resident to be consulted and participate in the care planning process. Individual assessments are in place, providing staff with clear guidelines about residents agreed limitations and promoting independence where possible, within the structured programme. Risk assessments are undertaken as part of the pre-admission assessment. This includes detailed information relating to personal history, mental health and behaviours. Assessment of risk ensures the manager and staff can provide care within safe boundaries. Residents meet on a daily basis for group-work. This forum enables residents to discuss and resolve issues relating to their recovery. Through these meetings and detailed feedback forms, the residents have the opportunity to discuss and contribute to the way the programme is run. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 & 17 The residents of Crouch House 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. EVIDENCE: Records showed that leisure activities and personal family contacts were being provided and maintained according to individual need and circumstance. Part of the programme at Crouch House includes work with family members to help resolve on going issues and provide support where needed. Residents feedback in relation to their lifestyle and care needs matched the written records and the work being undertaken by the therapeutic team. It is clear each resident has the opportunity to develop their personal goals and is encouraged to do so through group work and individual sessions. Care needs have been set out in individual care records to support this and there is evidence these are reviewed regularly according to the individuals changing needs. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 13 Residents are required to attend support groups in the local community where positive relationships with their peers group can be established. Residents also have the opportunity to go for coffees locally after evening meetings. In addition to the therapeutic aspects of the programme residents have the opportunity to develop and maintain their social and leisure interests. Forest Mere Health spa provides high quality sports facilities including a gym and swimming pool. Use of which is incorporated into the daily programme according to individual assessed need. The programme also offers weekly attendance to the home by a yoga and shiatsu therapist. Domestic staff cleans the facilities weekly and meals (excluding breakfast) are provided by the Forest Mere restaurant. The inspector examined sample menus and all the food offered was well balanced and nutritious. Specialist dietary requirements are catered for. Feed back forms from some of the residents stated the food was ‘sometimes repetitive’. To counter this, the programme provides the opportunity to go to restaurants, including a weekly trip to London to attend a meeting, followed by a meal out. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 21 None of the residents require personal care however all have complex emotional and health needs. Care records were examined and showed evidence that needs of residents are assessed and reviewed on a regular basis. The home has an up to date policy and procedure for Death and Dying. EVIDENCE: Care plan information is formed from the initial assessment and weekly reviews. Following the initial assessment each resident undertakes a full physical by a physiotherapist or sports therapist. An appropriate fitness regime is then designed to cater for the needs of the individual. 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. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 15 Each resident is assigned a counsellor who provides a therapeutic one to one session each day. These sessions give residents with the opportunity to talk through all aspects of their care needs and make supported changes where needed. The programme provides a rigid daily structure to the residents which is relevant to their on going treatment and complex needs. However individuals have the opportunity to make choices and demonstrate some independence within this. The residents attend daily group counselling sessions in addition to community meetings five nights a week, which provide on-going peer support. All residents are registered with a local GP and Dentist. Any specialist health needs arising from the pre-admission assessment will be catered for by the home. An up to date policy and procedure for Death and Dying is available at the home. This ensures staff are clear about their practice should a relevant incident occur. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The inspector concluded that 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. Feedback forms examined by the inspector showed residents are given the opportunity to complain. The complaints log was examined and the inspector found no recorded complaints since the last inspection. The manager monitors this on a regular basis. The inspector viewed assessments for individuals on each file, which highlighted areas of vulnerability for each resident. This information helps staff to make informed choices about protecting residents and staff from potential risks. Harassment, Grievance and Residents Rights policies and procedure provide clear guidelines for the protection of residents and staff. An Adult Protection policy and procedure is in place. County 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. Daily group meetings provide individuals with peer support and the opportunity to discuss any issues of concern. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 17 The inspector recommended the complaint address in the homes literature be changed from Hampshire to West Sussex. Despite the location of the home it currently falls under West Sussex Social Care and Inspection offices. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 18 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 the following standard(s): 24, 25, 26, 27 & 30 The communal areas and residents bedrooms were of a high standard and therefore the outcome for residents was good. EVIDENCE: The environment at Crouch house is of a very high standard. There is a large, tastefully decorated communal lounge and dining room, spacious modern kitchen, counselling room, three bedrooms (one en-suite) and shared bathroom facilities. Staff accommodation and offices are located in a separate building located next to residents accommodation, this also offers excellent facilities. There are adequate bathrooms and toilets to meet the number of residents and staff. The home is cleaned weekly by domestic staff from Forest Health spa, which ensures the premises is kept clean and hygienic. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34 & 36 Recruitment procedures are in place and records reflected these are adhered to. The manager confirmed staff are supervised and attend regular team meetings but there was no written evidence of this. A requirement has been made to ensure all meetings and supervisions are recorded in the future. All therapeutic staff are fully qualified. The manager is setting up an NVQ 2 equivalent with an external training company which, the night staff to start in early 2006. EVIDENCE: During induction the residents meet each staff member and their role in the programme is explained. Consequently residents benefit from clarity of staff roles and responsibilities within the home. All therapeutic staff who work at Crouch house are fully qualified in Psychotherapy, Physiotherapy or Sports Therapy. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 20 Relief/Night staff have job descriptions on file. The manager is in the process setting up an NVQ 2 equivalent with an external training company, for the night staff to start in early 2006. This is due to the current NVQ not having modules relevant to carers who work in the field of Drugs and Alcohol. The inspector examined staff files and concluded they held the correct information. All contained references, CRBs and staff contracts. Crouch House has up to date policy and procedures for Recruitment and Equal Opportunities. Therapeutic staff are supervised outside the home, with the exception of one therapist who is supervised in house by the Clinical Director. Records of these meetings were on seen on file. The inspector found there were no supervision records available at the home for night care workers. The manager confirmed that although he met with them regularly, these meetings were not recorded. This was also the case for staff meetings, which are held in the home every three months. The inspector made a requirement that all future supervisions and meetings should be recorded in order to provide evidence the standards were being met. This will be monitored at the next inspection. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 41 & 42 Good practice in the home was evident and supported by detailed feedback from ex-residents. The home would benefit from more efficient administrative systems. Recording of regular health and safety checks would ensure residents and staff live and work in a safe environment. A requirement has been made in respect of this. Residents rights and best interests are safeguarded through policies, procedures and record keeping. EVIDENCE: The home has up to date policies and procedures in line with current legislation. This gives staff consistent guidance in working effectively with residents at the home. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 22 The inspector examined all safety records and concluded weekly fire tests and hot water checks need to be recorded more frequently. As these systems safeguard the residents and staff from potential risk and harm. A requirement has been made in respect of this. A designated person in the organisation needs to complete monthly Regulation 26 reports and forward them to the Commission. To date this has not been done. A requirement has been made in respect of this. The inspector recommended that management complete a full risk assessment in relation to the gender mix of night staff (women) to residents (majority male). The management has discussed this issue with staff and intends to formalise strategies in a Risk Assessment at the earliest opportunity. Since the last inspection the manager/clinical director has completed the NVQ4 in Management and Social Care. Through this qualification he has worked hard to implement systems within the home, which meet the required standards. Discussions confirmed staff receive support and direction in their roles from management. Good working practices are promoted through regular staff monitoring and handovers. There is a Confidentiality policy in place and all care records are kept in a locked cabinet in the staff office. These measures ensure residents personal information is protected at all times. The inspector viewed feedback forms from residents whose views underpin on going development of the home. Following examination of all safety records and relevant documentation, the inspector concluded that overall the conduct and management of the home served the best interests of the residents by actively promoting their welfare and providing a good standard of care. Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 x 3 x 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crouch House and Crouch Cottage Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 2 2 x DS0000051857.V252600.R01.S.doc Version 5.0 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 2 3 4 Standard YA36 YA42 YA38 YA41 Regulation 18 13(4) 26 25e Requirement To provide evidence of supervision to staff which should occur no less than 6x annually To ensure all safety checks and records in the home are kept up to date The home will complete monthly Reg 26 reports and provide a copy to the commission To display up to date insurance policy in the home Timescale for action 01/02/06 01/02/06 31/12/05 06/11/05 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 2 Refer to Standard YA22 YA42 Good Practice Recommendations To change current complaints address in homes literature from Hampshire to Worthing Commission For the manager to complete risk assessments in relation to female night staff Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Crouch House and Crouch Cottage DS0000051857.V252600.R01.S.doc Version 5.0 Page 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. 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