Inspection on 05/12/05 for Francis House

This inspection was carried out on 5th December 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 no outstanding requirements from the previous inspection report, but 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 28/02/06

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 5th December 2005 11:00 Francis House DS0000011915.V276455.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.V276455.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.V276455.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.V276455.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 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.V276455.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, carried out over one day on the 5th December 2005. The purpose of this visit was to carry out an inspection of the home and follow up on any requirements made at the last inspection. Evidence for this report was gained from a number of sources. These included: A pre inspection questionnaire completed by the acting manager, a tour of the premises that included looking at service user’s bedrooms and all communal areas of the home. Talking with service users, observation of practice, feedback from comment cards, discussion with staff, and the examination of records. The inspector was also able to attend a community meeting and observe residents involvement in the running and decision making process within the home 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. What the service does well: What has improved since the last inspection? What they could do better: There remains plenty of scope for improvement to the physical environment. At present the layout and décor of some bedrooms do not promote privacy. Although there has been an increase in the level of activities available, residents are less than satisfied with the opportunity to engage in activities of their own choosing. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 6 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.V276455.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.V276455.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): 1,3 and 4 The home provides prospective residents with sufficient information to enable them to decide whether the home is right for their needs. EVIDENCE: Written information regarding facilities and what is on offer at the home is made available to prospective residents prior to moving into the home. Prospective residents can visit the home on an introductory basis, however the majority of referrals come from residents whose home base is in other parts of the country, or are ex- offenders. It is therefore often impractical or not possible for them to visit the home prior to moving in. All prospective residents are given a copy of the home’s Service Users Guide. This details the terms and conditions, facilities, their rights’ and responsibilities including any restrictions that may be placed upon them during their treatment and what is on offer at the home Written information is reviewed and updated regularly to ensure that any changes in the services offered are correct. New residents are issued with a welcome pack are allocated a buddy to assist them with the settling in process. All service users enter the home for treatment and rehabilitation for either drug or alcohol dependency. All residents spoken with were in agreement that the home and staff team were meeting their individual needs. Information gathered throughout the inspection would support this view. It was evident that the home was providing the assistance and support as stated in the Statement of Purpose and Service User Guide and that, residents’ expectations Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 9 of the home and the level of support in relation to their needs and aspirations were being realised. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 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): 7,8,9 and 10 The opportunity for residents to be involved in and influence the day to day running of the home is good. EVIDENCE: Due to the philosophy of the home and treatment plans of the individual residents, residents are not enabled to take many risks at the onset of their treatment. Residents are enabled to take greater risks as their treatment progresses. Residents have several restrictions and limitations placed upon them as part of the treatment process. These are especially prominent during the early stages of treatment. These include restrictions on visitors, managing their own finances and compulsory attendance at all group therapy sessions and meetings. Residents spoken with were in agreement that any such limitations were a necessary part of the treatment process giving people the opportunity to change their lifestyle safely and away from external pressures and possible triggers. All residents are made aware of and agree to these limitations prior to moving into the home. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 11 Residents have an opportunity to take part in the day-to-day running of the home and attend weekly meetings with the staff and the manager to discuss house issues, make decisions share information and contribute to the setting of menus. The inspector was able to sit in on one of these meetings and observe first hand the level of participation and decision making afforded to residents. Residents’ information and personal details are handled confidentially. Since the last inspection the board in the main office had been covered to protect residents confidentiality and files and records are stored safely. Residents are made aware of the homes’ confidentiality policy when they move into the home and sign a declaration to say which organisations, agencies or individuals information can be shared with. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 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): 11,12,13,14,15 and 16 The home offers residents a good opportunity for personal development and to develop skills. Residents are however less than satisfied with the opportunity to engage in activities of their own choosing. EVIDENCE: All residents take part in the day-to-day running of the home including cooking and other domestic duties. Also during their stay at Francis House residents are given the opportunity to take the role of “House Group Leader” and “Assistant Group Leader” who’s responsibility it is to oversee and support other residents in their therapeutic duties and to facilitate community meetings. This enables residents to develop and gain a variety of daily living, social and communication skills. At the last inspection residents did not feel that there were sufficient activities. Despite some increase in the level of activities the current residents said that generally they were not content with the opportunities to engage in outside activities. Feedback from comment cards completed by residents living at the home in May 2005 showed that they were also less than satisfied with the level of suitable activities. Therefore this amounts to three different groups of residents expressing the same opinion. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 13 Several residents spoken with felt that it would be beneficial to have more opportunity engage in sporting activities. Currently those in the primary stage of treatment only have the opportunity to do sports once a week. Residents said that they did have the opportunity to visit the common regularly, however this became monotonous after a while. Residents also felt that there needed to be more opportunity to do things at the weekend. Residents confirmed that they are able to keep in contact with their families by phone and could receive visitors. However there are limitations and restrictions on visits by family and friends. All residents had signed a contract agreeing to this prior to moving into the home. Visiting arrangements have to be discussed with the individuals counsellor and agreed prior to receiving a visitor as there is a potential risk of service users re-establishing networks that were previously unhelpful to them. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 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 and 20 Robust medication procedures ensure that residents’ medication is safely managed. EVIDENCE: At the time of this inspection there were not any residents whom needed assistance with personal care needs. Medication was found to be well managed. The administration records are checked and monitored daily and systems are in place to monitor and record any errors or omissions. This information is closely monitored by the project worker and passed to the manager. The manager is then able to address any issues with staff/ implement training as appropriate. Stock records were checked against administration records for several residents and all were found to be correct. The home’s medication procedures were found to be thorough. All medication was stored safely and securely. The administration and records pertaining to the administration, safe handling, receipt and disposal of medicines are managed and maintained in line with the homes policy and procedures. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 15 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 Satisfactory systems are in place for service users to address any concerns or complaints that they may have. EVIDENCE: The Commission for Social Care Inspection had not received any complaints about the home since the last inspection. The home has a complaints procedure and this is explained and issued to residents on the first day that they move into the home. The procedure is also set out and explained in the Service Users Guide and welcome pack. During the weekly house meeting residents are able to raise any concerns regarding the running of the home they can also take up concerns or complaints privately and through formal channels if they so wish. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 16 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): 24,25,26,28 and 30 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. Several improvements had been made since the last inspection including, the refurbishment of the entrance hall and a communal seating area. Couches have been purchased as has a large fish tank and lighting of a more modern and domestic type has been installed. Both of these improvements have created a more homely and welcoming and feel to the home. The provision of new hot water and heating system has meant that previous problems with hot water supplies during peak periods of the day have been rectified. Further improvement is still needed to bring the environment up to standard. The current dining room is bland and has an institutional feel. This is however due to be addressed and the inspector was informed that funds are now available to revamp this area. Several bedrooms were seen and many fall below the minimum standard especially with regard to the décor. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 17 The layout of one shared room did not afford privacy to either resident and meant that they had to share wardrobe space. There was also insufficient screening available for the number of shared rooms. Some toilets had been removed from bedrooms since the last inspection and not replaced. This will need to be addressed and is not reflected in the home’s Statement of Purpose which details more toilets than are actually in place. All rooms now contain individual lockable storage facilities for residents to keep any personal items safe as required at a previous inspection. However currently residents are required to pay a five pounds deposit if they require a key. This would seem to detract from and limit residents from their right to access this resource as the majority of residents have very limited incomes and would not be in a position to pay this deposit. On the day of the inspection the home was clean and tidy and there were not any unpleasant odours. Residents keep the home clean and tidy as part of their daily routine and each has their delegated area of responsibility. This is made clear to them prior to moving into the home. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 18 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): 31,34, and 36 Residents benefit from clarity of staff roles and receive care and support from a caring staff team. Generally the homes’ recruitment procedures offer protection to residents. EVIDENCE: The home has a well-structured and organised staff team. Responsibilities are delegated amongst the team and residents are clear of each staff member’s role. The home employs counsellors and project staff and also offers placements to social work students as well as voluntary workers. The role of project staff has recently been reviewed. They have been delegated more responsibility and appropriate training has been provided. Counsellors reported that this has enabled them to concentrate on providing more one to one support to residents. Residents said that staff were supportive and caring. Comments received included, “ They are very good for getting things done” and “ They work with you, they don’t like giving up on you”. From observation residents were relaxed and at ease with staff and were able to discuss, debate and raise issues freely with them. The recruitment records of several staff were inspected. Checks against the Criminal Records Bureau and Protection of Vulnerable Adults lists had been made for all staff prior to commencing work at the home. The acting manager demonstrated that he was aware of and followed correct procedures in respect of this. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 19 There was found to be a lack of sufficient references in respect of one recently employed staff member. All others were found to be sufficient. This was discussed at the inspection. Staff receive regular one to one supervision and all staff spoken with confirmed this was sufficient to enable them to fulfil their roles. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 20 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): 37,38,39,41 and 42 The home is well managed and run in the residents’ best interests. EVIDENCE: The management arrangements were satisfactory. An application to register the acting manager has been submitted to the Commission for Social Care Inspection. The acting manager is at the home for a sufficient time each week to oversee the day-to-day running of the home and reports directly to a senior manager within the Streetscene organisation. The acting manager has demonstrated during this and previous inspections that he is well organised is able to prioritise his work and run the home safely and efficiently. Requirements from the previous inspection had been met within agreed timescales. Staff reported that they considered the manager to be supportive and approachable. The value base and ethos of the management and staff team appear to be in the best interests of residents. Communication between management, staff and residents is good and residents clearly benefit from the weekly community meetings. Systems are in place to ascertain residents’ views, in addition to the weekly meetings service users moving on from the home are asked to complete a Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 21 feedback questionnaire. This questionnaire is used to assess all parts of the treatment process from admission through to discharge and the results are made known to residents. The home is regularly visited and monitored by the trustees and reports are submitted to the Commission for Social Care Inspection as required. The home appeared to be safe and residents are encouraged to report any defects or maintenance issues that may pose a risk and are made aware of all health and safety precautions. The only concern being that the acting manager was not able produce a current Landlord’s gas safety certificate. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 X 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 2 25 2 26 2 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 2 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 3 3 X 3 3 X Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 23 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. 1 Standard YA25 Regulation 23 (2) (a) Requirement A review of the current shared bedrooms must be completed and action must be taken to provide adequate space and privacy. Screening must be provided in all shared rooms. All residents must be given access to lockable storage. You must ensure that all service users have adequate storage facilities for their clothing and other belongings in line with the standards. An action plan must be submitted detailing the plans to decorate all bedrooms to an acceptable standard. References must be obtained before staff commence work at the home. A copy of the gas safety certificate must be submitted. Timescale for action 01/03/06 2 3 4 YA26 YA26 YA26 12 (4) (a) 23(2)(m) 16 (2) (c) 01/03/06 01/03/06 01/03/06 5 YA26 23 01/03/06 6 7 YA34 YA42 19 (1) (b) 13 (4) 06/12/05 12/02/06 Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA14 Good Practice Recommendations That a review of the current activities available is carried out. This should be done in consultation with service users. Francis House DS0000011915.V276455.R01.S.doc Version 5.1 Page 25 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. 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