CARE HOME ADULTS 18-65
Flint House Police Rehabilitation Centre Reading Road Goring Oxfordshire RG8 0LL Lead Inspector
Marie Carvell Unannounced Inspection 20th April 2007 10:30 Flint House DS0000027184.V330945.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 Flint House DS0000027184.V330945.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. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Flint House Address Police Rehabilitation Centre Reading Road Goring Oxfordshire RG8 0LL 01491 874499 01491 875002 enquiries@flinthouse.co.uk 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 Board of Trustees, The Police Rehabilitation Centre Mrs Sarah Allen Care Home 5 Category(ies) of Past or present alcohol dependence (2), Past or registration, with number present drug dependence (2), Physical disability of places (3) Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 18 years of age and over. To allow no more than 2 residents in the categories A or D at any one time 1st November 2005 Date of last inspection Brief Description of the Service: The Police Rehabilitation Centre at Flint House is managed by a charity and is set in 19 acres of Oxfordshire countryside near Goring. Flint House has very comfortable accommodation and communal facilities and offers convalescence facilities for eligible sick and injured police officers from 28 police forces in England and Wales, serving or retired. The Board of Trustees manages Flint House and the Chief Executive has responsibility for the day to day running of the centre. Departmental managers have responsibility for staff and services within their area, and the registered manager is responsible for the management of the nursing department. Service users are admitted for 12 day therapeutic stays and return home after that time. Facilities include a physiotherapy department, hydrotherapy and gymnasium. Other therapeutic services include massage, acupuncture and workshops designed to meet individual psychological needs. Registered nurses care for the service users admitted to the nursing department. There are no charges payable as many of the guests donate 85 pence per week to the charity. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Commission has, since 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘key Inspection’. The inspector arrived at the service at 10.30am and was in the service until 4 pm. It was a thorough look at how well the service was doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection. One General Practitioner responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standards of the service. Time was spent with two service users, the manager and staff on duty, a tour of the premises was carried out and a sample of records required to be kept in the home were examined, including the case tracking of two service user files. At the last inspection carried out in November 2005, one requirement was made that the manager must ensure that all the details regarding persons working at Flint House are available. This has been complied with. Feedback was given to the manager at the end of the inspection. What the service does well:
The assessment process includes a written application form from the individual, and supported by a police welfare officer and the individual’s General Practitioner. A care plan is developed, following a nursing assessment and agreed with the service user. Care plans are detailed and flexible to meet the changing needs of the service user, and supported by appropriate risk assessments. Comments made by service users included “ An exceptional facility where nothing is too much trouble, when my recuperation was paramount and staff seemed happy to be at work”, “ Nothing is too much trouble”, “ Sarah (manager) and the nurses could not be more caring and helpful”, “ I would have no hesitation in recommending the rehab. centre, everything was first class”,” A therapeutic experience in itself, excellent food, a nice setting and staffed with wonderful people”. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 6 From the evidence seen and discussion with the manager, the inspector considers that the home is able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. All meals are prepared and served by a team of professional chefs. The nutritional needs of service users are assessed and special dietary needs can be catered for. The food was described as “First class”, “Excellent” and “ The quality and quantity of food provided could not be found in any restaurant”. Service users have a choice of several hot or cold dishes at all meals, served in a relaxed and comfortable environment. Service users physical and personal care needs are detailed in their agreed care plan. Registered nurses, following a nursing assessment, provide all personal care. There is a wide range of treatments, therapies and workshops provided by the nursing team, including health checks, counselling, relaxation, stress awareness/ management, aromatherapy and healthy eating workshops. Several nurses have completed counselling training courses. All service users have access to the well-equipped “ state of the art” gymnasium, exercise facilities and exercise pool, spa bath, sauna and numerous other facilities. The premises are maintained to a high standard, are welcoming and comfortable. The communal areas include several lounges, games rooms, quiet areas for reading and a licensed bar. The home is set in nineteen acres of parkland. Facilities are available for outdoor sports. All bedrooms have en-suite facilities and the five bedrooms used for service users requiring nursing care are equipped with appropriate aids and adaptations to assist service users with reduced mobility, to be as independent as possible. Comments made by service users include “ I have never had a room which was so comfortable, clean and checked by such friendly and helpful staff”. The registered manager is a well qualified nurse who works closely with the Chief Executive and Heads of Departments in the day to day running of the centre. The Chief Executive manages the overall running of the centre and the manager is responsible for nursing care. It is very clear that the manager is well respected by the service users and staff team. Service users and staff expressed their satisfaction of the management of the centre. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. 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. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 8 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 Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 9 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): Standard 2 and 5. Quality in this outcome area is excellent. The needs of the service user are assessed before a service is offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The assessment process includes a written applicable from the individual, and supported by a police welfare officer and the individual’s General Practitioner. A care plan is developed, following a nursing assessment and agreed with the service user. One service user described the process of his initial application, the nursing assessment and agreed care plan, which was well organised and he felt that his views were taken into consideration and was involved throughout the whole process. Service users do not receive a written contract, but must agree to abide by the centres rules during their twelve day stay, which is described in the written information provided before their arrival at the home. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 10 Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 11 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): Standards 6,7 and 9. Quality in this outcome area is excellent. Service users are encouraged to be independent within a risk assessed environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are detailed and flexible to meet the changing needs of the service user, and supported by appropriate risk assessments. In addition the premises are risk assessed, and are regularly reviewed and updated. All service users must agree to the premises risk assessments as a condition of their stay, for example fire precautions and the use of the swimming pools, outside stated hours. Comments made by service users included “ An exceptional facility where nothing is too much trouble, when my recuperation was paramount and staff
Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 12 seemed happy to be at work”, “ Nothing is too much trouble”, “ Sarah (manager) and the nurses could not be more caring and helpful”, “ I would have no hesitation in recommending the rehab. centre, everything was first class”,” A therapeutic experience in itself, excellent food, a nice setting and staffed with wonderful people”. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 13 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): Standards 15 16 and 17. Standards 12 and 13 do not apply to Flint House. Quality in this outcome area is excellent. Service users have full control over their personal relationships and take responsibility for their stay. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home expects service users to be responsible for their personal relationships during their stay. Accommodation can be provided for family members or service users with children or babies. The policies of the centre promote service users’ rights and responsibilities in their daily lives. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 14 From the evidence seen and discussion with the manager, the inspector considers that the centre is able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. All meals are prepared and served by a team of professional chefs. The nutritional needs of service users are assessed and special dietary needs can be catered for. The food was described as “First class”, “Excellent” and “ The quality and quantity of food provided could not be found in any restaurant”. Service users have a choice of several hot or cold dishes at all meals, served in a relaxed and comfortable environment. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 15 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): Standards 18,19 and 20. Quality in this outcome area is excellent. Service users support and healthcare needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users physical and personal care needs are detailed in their agreed care plan. Registered nurses, following a nursing assessment, provide all personal care. There is a wide range of treatments, therapies and workshops provided by the nursing team, including health checks, counselling, relaxation, stress awareness/ management, aromatherapy and healthy eating workshops. Several nurses have completed counselling training courses. All service users have access to the well equipped “ state of the art” gymnasium, exercise facilities and exercise pool, spa bath, sauna and numerous other facilities. The Rehabilitation Department is staffed by Physiotherapists. This department is responsible for service users admitted for rehabilitation treatment and individual exercise programmes. Each service user using this facility has a
Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 16 named physiotherapist allocated at the start of their treatment programme. Comments made by service users included “ The physiotherapy was first class, I encountered a wealth of knowledge. First time that I’ve had acupuncture, it worked well and gave me relief from pain and stiffness. A great bunch of friendly people”. There is a Doctor’s surgery held in the centre twice a week and service users are able to access this service by appointment. Comments received from the General practitioner who provides medical cover at the home stated “I have great confidence in the superb nursing care provided”. Policies and procedures are in place regarding the safe storage of medication. A health authority pharmacist carries out regular medication checks. At the time of this inspection, all service users were taking control of their own medication. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 17 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): Standards 22 and 23. Quality in this outcome area is good. There is a clear complaints procedure in place. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a clear complaints procedure in place and a copy is provided in all bedrooms. The centre has received no complaints since the last inspection. The Commission has received no information concerning complaints about this service since the last inspection. All staff have undertaken training in safeguarding adults from abuse. From discussion with staff it was evident that they were familiar with the centre’s policies and procedures regarding protecting vulnerable adults from abuse and the home’s whistle blowing policy. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 27, 29 and 30. Quality in this outcome area is excellent. The premises and facilities at the home are maintained to a high standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises are maintained to a high standard, are welcoming and comfortable. The communal areas include several lounges, games rooms, quiet areas for reading and a licensed bar. The centre is set in nineteen acres of parkland. Facilities are available for outdoor sports. All bedrooms have en-suite facilities and the five bedrooms used for service users requiring nursing care are equipped with appropriate aids and adaptations to assist service users with reduced mobility, to be as independent as possible. Comments made by service users include “ I have never had a
Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 19 room which was so comfortable, clean and checked by such friendly and helpful staff”. The housekeeping staff work hard to maintain a high standard of cleanliness. The premises were seen to be clean, well maintained and fresh smelling. The laundry service is contracted out to an outside contractor. There are several laundries available for service users use. Several service users commented that they appreciated the welcoming atmosphere of the centre and the lack of formality. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 20 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): Standards 32,34, 35 and 36. Quality in this outcome area is good. Service users benefit from an experienced staff team in sufficient numbers to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All care staff are registered nurses. Staff on duty were clear about their roles and responsibilities. Since the last inspection one registered nurse has been recruited to the centre. Nurses on duty said that the staff team work well together. In discussion with staff and from observation it was evident that within the nursing team is a good balance of skills, knowledge and experience to meet the needs of the service users. Staff were able to demonstrate a thorough understanding of the needs of individual service users. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 21 There are robust recruitment procedures in place. The recruitment process was discussed with the manager, who agreed to provide written evidence of the formal interview. At the last inspection in November 2005, a requirement was made that the manager must ensure that all the details regarding persons working in the centre are made available. This has been addressed. The manager agree to provide an up to date photograph of each member of staff on their personnel file as currently only a photocopy of a passport photo is kept. The centre currently has no vacancies for registered nurses. There is a detailed staff training and development programme in place, all staff complete mandatory as well as specialist training. All newly appointed staff complete an induction training programme and mentoring by an experienced member of staff. Staffing levels reflect the needs of the service users and rosters are flexible to fit around the needs of the service users. The centre very rarely uses agency staff, during periods of leave or sickness staff are prepared to work additional shifts. The manager provides 1-1 formal supervision to all nurses on a monthly basis. At present this is not recorded, the manager has agreed to provide a written record of all future supervision. The nurse/ counsellors, receive additional specialist supervision on a regular basis. Staff spoken to said that they enjoyed working at Flint House, felt well supported by the manager. Communication between the manager and staff team was described as very good and staff feel valued. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 22 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): Standards 37,39 and 42. Quality in this outcome area is excellent. Service users benefit from a well managed home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a well-qualified nurse who works closely with the centre’s Chief Executive and Heads of Departments in the day-to-day running of the home. The Chief executive manages the overall running of the centre and the manager is responsible for nursing care. It is very clear that the manager is well respected by the service users and staff team. Service users and staff expressed their satisfaction of the management of the centre. Staff when asked said that the manager was calm, thoughtful and approachable.
Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 23 Staff also felt that the manager was able to be firm and would not tolerate poor practices in the centre. Reports on the conduct of the centre are completed by the Chief Executive on a monthly basis on behalf of the Board of Trustees; the format used is currently being developed. Policies and procedures are in place and reviewed on a regular basis. Records seen during the inspection were well maintained and up to date. Regular meetings take place to monitor, review and develop the centre; these include management meetings, Trustee meetings and seeking the views of the service users. There are well-maintained records of checks in relation to health, safety and fire. Appropriate risk assessments are in place and reviewed and updated on a regular basis. Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 24 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 X 2 4 3 X 4 X 5 4 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 4 25 X 26 X 27 4 28 X 29 4 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 4 X X 4 X Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Flint House DS0000027184.V330945.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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
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