Inspection on 28/02/06 for Francis House

This inspection was carried out on 28th February 2006.

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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Francis House 30/05/08

Francis House 17/01/07

Francis House 05/12/05

Francis House 03/02/05

Francis House 01/11/04

Francis House 03/02/04

Francis House 11/12/03

Similar services:

Flint House

The Ley Community

Yeldall Manor

Cherwood House Care Centre

The Manor Clinic

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

CARE HOME ADULTS 18-65 Francis House 2 Hulse Road Southampton Hampshire SO15 2JX Lead Inspector Chris Johnson Unannounced Inspection 28th February 2006 09:15 Francis House DS0000011915.V252098.R01.S.doc Version 5.1 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 Francis House DS0000011915.V252098.R01.S.doc Version 5.1 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. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Francis House Address 2 Hulse Road Southampton Hampshire SO15 2JX 023 8022 4481 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) Streetscene Care Home 18 Category(ies) of Past or present alcohol dependence (18), Past or registration, with number present drug dependence (18) of places Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 Brief Description of the Service: Francis House is situated in a residential area of Southampton near to the city centre and Southampton common. The home is registered with the Commission for Social Care Inspection as a treatment centre to accommodate eighteen service users, with drug and alcohol related problems. Francis House is part of the Street Scene organisation with two other treatment centres in Bournemouth. The treatment programmes consist of cognitive behavioural therapy, motivational enhancement and twelve-step therapy. The home offers both primary and secondary treatment courses. All adults over 18 years of age can be accommodated at the home. An application is currently being processed by the Commission for Social Care Inspection to register a new manager. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection carried out for the year April 2005/06. This inspection was unannounced and took place on the 28th February 2006. The purpose of this visit was to carry out an inspection of the home and follow up on requirements made at the last inspection. Both reports should be read for an overview of how the home is meeting the standards. Evidence for this report was gained from a number of sources. These included: Discussions with residents, staff and the acting manager, a tour of the premises that included looking at service user’s bedrooms and all communal areas of the home and inspection of records. The acting manager assisted the inspector throughout the inspection. Written and verbal feedback was given to the acting manager at the end of the inspection. Some requirements from the previous inspection have been carried over into this report, as at the time of this visit they were still within the timescale for action. What the service does well: What has improved since the last inspection? The acting manager has made efforts to address the requirements made at the last inspection within the agreed timescales. Privacy screens have been fitted in all shared bedrooms. Improvements to the physical environment remain ongoing. Recently greater attention has been paid to detail with the addition of mirrors, ornaments and new furniture placed in the hallways and other communal areas creating a more homely, comfortable and welcoming environment. Staff recruitment procedures have also improved, providing better safeguards to residents. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 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. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 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 Francis House DS0000011915.V252098.R01.S.doc Version 5.1 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): 2 The current standard of assessments needs to be improved to ensure that prospective residents can be assured that their needs will be met. EVIDENCE: The files of four residents who had been admitted to the home since the last inspection were inspected. All had been assessed prior to moving into the home. Residents are admitted from all parts of the country and some times from prisons and so it is not often possible for them to visit before moving in. Pre admission assessments are therefore often completed over the phone. The standard and level of assessment documentation varied between the files looked at. More recently this task has been delegated to project staff it would appear however that more comprehensive training is needed to ensure that adequate assessment information is obtained. The home most also obtain care management assessments and ensure that they have all necessary information regarding the service users’ background and needs such as psychological history, including any diagnosis and any associated risks. This is particularly important due to the fact that prospective residents are less likely to impart with all the facts over the phone and that there is a strong likelihood that there will be other associated needs as well as drug and alcohol related problems. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 The current care plan system does not address all the needs of residents. EVIDENCE: The files of four residents were inspected and all found to contain written care plans. Care plans are evaluated and reviewed on a regular basis and all residents spoken with were aware of and confirmed involvement in the care planning process. Care plans were detailed in respect of a persons treatment programme, rehabilitation and daily tasks and were goal focused. Residents meet with their key work counsellor regularly to review their goals and to provide them with support to achieve their personal aims. Residents did comment that they often found these sessions frustrating as a large proportion of the time was spent in completing paperwork and this did not always leave enough time to discuss issues and problems that they may be experiencing. The current model of counselling used is heavily weighted towards care plans and is termed ‘care plan counselling’. Counsellors commented that they found it difficult to focus on an individuals support needs as well as completing forms and that this could at times inhibit them from being able to provide the level of support that a person required. It was suggested that this system be streamlined. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 10 Care plans did not however provide sufficient detail regarding residents’ mental health needs or how these were to be met. Despite evidence to suggest that some people had specific needs in this area. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 While the home provides sufficient quantities of food, residents are less than satisfied with the quality and choice of the food on offer, and have little influence over this. EVIDENCE: Many residents spoken with said that they were unhappy with the quality of the food available. Whilst food stocks were adequate and there was plenty of fresh fruit available the home relies heavily on pre-prepared processed foods. People said that they would much prefer fresh joints of meat. The majority of residents spoken with said that particularly disliked the processed meats and that they would also prefer fresh vegetables. Residents said that as they began their recovery, food became increasingly important to them, as many had neglected their dietary needs in the past as a result of their substance misuse. The inspector saw a large bag of processed / reformed chicken pieces intended for the following days meal. Residents said that the preferred alternative to this would be chicken breasts. Another example given was the previous days meal, which had been lasagne. Again this had consisted of pre prepared portions, whereas residents said that they would prefer to make their own. These issues have been raised at previous inspections. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 12 Residents said that they were free to help themselves to snacks and drinks as and when they required and this was observed to be the case. The inspector saw from menus that a vegetarian option is available daily and that special diets are also catered for. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 13 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): 19 Residents are fully supported with their physical healthcare needs. EVIDENCE: On admission to the home project staff take responsibility for ensuring that all residents are registered with a local GP. All residents spoken to confirmed that they had access to a GP and that they were supported to attend healthcare appointments as necessary. Records were available to support this. All residents spoken with felt that they were well supported with their healthcare needs. The acting manager said that it was becoming increasingly difficult to register residents with a dentist, as many were not accepting NHS patients. This is increasingly difficult due to the fact that residents spend a relatively short time at Francis House (anywhere between 3-6 months). Arrangements were in place for residents to receive emergency treatment and service users were able to confirm this to be the case. The acting manager had been actively seeking dentists willing to accept NHS patients. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 14 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): 23 Residents feel safe and are protected by the homes’ policies and procedures. EVIDENCE: All residents said that they felt safe, protected and that the staff treated them well and with respect. The home has all relevant policies and procedures in place for the protection of residents and the acting manager was in the process of organising refresher training for all staff. The acting manager demonstrated a thorough awareness of reporting procedures and a good understanding of all issues relevant to protecting residents from abuse and neglect. Risk assessments and risk management strategies were in place for a resident at risk of self-harm and this was being closely monitored. Robust recruitment procedures also serve to protect residents. The home looks after several resident’s money. Records were in place to show that this was being managed appropriately. It was noted that other items of value such as bankcards and passports, were also being looked after. There were some occasional discrepancies with the records and the manager was advised to carry out a regular audit of the records to ensure errors were more safely managed. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 15 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 and 26 Improvements to the physical environment have made the home a more homely place to live in. Further improvements are needed to provide more privacy and comfort. EVIDENCE: Improvements to the physical environment remain ongoing. Recently greater attention has been paid to detail with the addition of mirrors, ornaments and new furniture placed in the hallways and other communal areas creating a more homely, comfortable and welcoming environment. Plans are in place to revamp the dining area and bedrooms continue to be improved. There remains however further room for improvement. The inspector was satisfied however that action was being taken to address these. Screening has now been provided in all shared bedrooms to provide more privacy. The layout of one shared bedroom identified at the last inspection as being inadequate had been improved as much as is possible, however there still remains insufficient storage for residents clothing leaving residents no choice but to hang their clothing around the room. An acceptable solution will need to be reached and further negotiation with the Commission for Social Care Inspection will need to be held. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 16 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): 32,33,34 and 36 The staff are well supported and supervised and are committed to providing a good level of support to residents. Insufficient staff cover at times hampers this. EVIDENCE: The home employs counsellors and project staff and also offers placements to social work students as well as voluntary workers. Staff have the opportunity to undertake NVQ training. All residents spoken with spoke highly of the attitude and support of the staff team. The inspector viewed the files of newly appointed staff and was satisfied that all appropriate checks and documentation was in place. Protection of Vulnerable Adults and Criminal Records Bureau checks had been completed. One member of staff was working at the home for which a Criminal Records Bureau check had not been confirmed. There were however sufficient levels of supervision in place to ensure the safety of those living in the home and all other documentation had been received. The staff member demonstrated that they had been made fully aware of the limits to their role while awaiting the return of their Criminal Records Bureau disclosure. The requirement from the previous inspection to ensure that two satisfactory references are obtained prior to employing staff had been met and all outstanding references had been obtained retrospectively. Staff stated that they received regular supervision and sufficient support and looking at records substantiated this. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 17 On the day of the inspection the home was short staffed by one counsellor and one project worker. This meant that staff were struggling to deliver the normal programme of activities and one to one sessions with residents. Whilst it was accepted that this was due to unforeseen sickness there was a lack of replacement staff that were available to cover. The home only has one bank worker. It was clear that the home did not have sufficient resources to cover sickness and this will need to be addressed. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 18 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): 42 Health and safety within the home is being promoted. EVIDENCE: The home appeared to be safe and well maintained. Risk assessments and risk management strategies were in place as necessary and there were not any concerns as to the safety of the environment. The requirement from the last inspection to demonstrate the safety of the gas system had been met and the home had current Landlord’s gas safety certificate. Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 19 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 2 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 X 23 3 ENVIRONMENT Standard No Score 24 X 25 2 26 2 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X X X X X X 3 X Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA2 YA2 Regulation 14 (1) 14 (1) Requirement Assessments must be more thorough and be carried out by a suitably qualified person. That care management assessments are obtained prior to admission for any resident who is fully or partially funded. Care plans must address mental health and all other care needs. Suitable, wholesome and nutritious food must be provided. All residents must be given access to lockable storage. This requirement was outstanding from the previous inspection. At the time of this inspection it was however still within the timescale for action. You must ensure that all service users have adequate storage facilities for their clothing and other belongings in line with the standards. This requirement was outstanding from the previous inspection. At the time of this inspection it was however still within the timescale for action. The home must ensure that there are sufficient numbers of DS0000011915.V252098.R01.S.doc Timescale for action 30/04/04 30/04/04 3 4 5 YA6 YA17 YA26 12 (1) 16 (2) (i) 23(2)(m) 30/04/04 30/04/04 01/03/06 6 YA26 16 (2) (c) 01/03/06 7 YA33 18 (1) (a) 30/04/04 Francis House Version 5.1 Page 21 staff on duty at all times. 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 Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Francis House DS0000011915.V252098.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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