Inspection on 20/01/09 for Frenchay Mews

This inspection was carried out on 20th January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Frenchay Mews 06/02/07

Frenchay Mews 26/01/06

Frenchay Mews 30/09/05

Frenchay Mews 01/02/05

Frenchay Mews 17/08/04

Frenchay Mews 24/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Frenchay Mews 35-37 Lower Church Road Weston Super Mare North Somerset BS23 2AQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vanessa Carter     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Frenchay Mews 35-37 Lower Church Road Weston Super Mare North Somerset BS23 2AQ 01934624330 01934624330 frenchaymews@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Anne Edwards Name of registered manager (if applicable) Mrs Anne Matthews Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence Additional conditions: The Registered Manager should commence NVQ4 Care Management training in 2003 and complete this before 2007. Date of last inspection Brief description of the care home Frenchay Mews is one of two homes owned by the Frenchay Group FRESH, and offers a person-centered programme for individuals working towards recovery from addiction. It is sited in the seaside town of Weston Super Mare, close to local amenities. It is registered with the Commission for Social Care Inspection (CSCI) to provide a service for up to 19 younger adults aged between 18 and 65. The provider is Anne Edwards and the registered manager is Anne Matthews. The service provides single and shared accommodation. Communal space is adequate. Toilet and bathing facilities are adequate. The cost of placement is currently set at 495 pounds per week. This amount will be paid by the funding authority with a service user contribution being made by each person. Care Homes for Adults (18-65 years) Page 4 of 28 care home 19 Over 65 0 0 19 19 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Prior to this inspection we asked the service to provide us with their Annual Quality Assurance Assessment (AQAA). This is a self-assessment that focusses on how well outcomes are being metfor people who are staying at Frenchay Mews. It also gave us information about the service and told us how they intend to maintain of improve the service. We sent out surveys and received completed forms from four people. This gave us some useful information about what is was like to experience living at the home, and how expectations were met. We visited the service, met with a number of the people who were currently in Care Homes for Adults (18-65 years) Page 6 of 28 residence, the staff team and looked at documents maintained for the day-to-day running of the service. These included care planning documentation, staff files and records relevant to health and safety checks and the administration of medications. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 8 of 28 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information made available about this service, and the pre-admission assessment processes ensure that placement is only offered to those people who can accept the terms and conditions of the placement. Evidence: The statement of purpose for Frenchay Mews sets out the terms and conditions of taking up placement on the treatment programme and details what the service has to offer. It refers to the pre-admission assessment process, staffing arrangements and the residents agreement that must be signed on the day of admission. Without agreeing to fully comply to the boundaries that are set out, placement at Frenchay Mews would not be arranged. Assessment for placement is usually undertaken at the home, will involve being shown around the house, being able to chat with other people who are already undertaking the treatment programme, and a discussion about the residents contract. The assessment will be undertaken by a qualified counsellor and the tool used is Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: comprehensive and covers full medical information including eating disorders and psychiatric history. It also covers childhood history, trauma experiences, relationships, sexual orientation and drugs used or alcohol levels taken. These measures will ensure that sufficient information is gathered to make a judgement about whether the placement is appropriate, and can be effective. Frenchay Mews offers specialised services for people who have been dependent upon drug and, or alcohol, and who wish to achieve quality and lasting sobriety. The service is available for males and female, aged between 18 and 65 years. The treatment programme is for 20 weeks although an extension to this can be made in certain circumstances. All admissions are planned and there is no provision for emergency admissions. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning processes are person centred so people will be treated as individuals. It is an essential part of the treatment programme that strict adherence to house rules is followed. Any limitations that are placed will have been agreed upon as part of the treatment programme. Evidence: There were only eight people in residence at Frenchay Mews on the day of the inspection and each person was at a different stage in the treatement programme. Each person has an individual care file prepared and two of these were examined to see what actions the staff take to meet individuals needs. The plans were very much about empowering people to make decisions for themselves, and are reviewed on a regualr basis throughout the treatment programme. Reviews will be signed and dated by both the counsellor and the person receiving the support. The outcome of each counselling session is recorded along with any other other visits Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: to healthcare professionals. There are strict boundaries set about what people can and can not do whilst they are staying at Frenchay Mews. These are all set out in the terms of the residents contract and must be agreed to before admission is arranged. They are an essential part of the treatment programme and one person spoken with said they are there for a reason and are made in the best interests of us. Involvement in household tasks such as laundry, meal preparation and cleaning, enable people to develop a responsibility for their own actions. People have to be present at all group sessions, mealtimes and 1:1 sessions. Individual choices and decision making is limited by the strict programme of activities, however as people progress through the programme, there is greater freedom to do what they want, but within the boundaries set. People who stay here will set their own personal goals and will be supported by their counsellor and the other group members to achieve their goals. The plans and the achievements will be reviewed on a four weekly basis and a record kept of decisions made. This enables a persons progress during the treatment programme to be tracked and evaluated. Discharge planning is an essential part of the treatement programme. Potential risks and triggers, which may cause a relapse will have been identified at the point of admission. Support is arranged for a period of time after discharge with a number of counselling sessions and reunions. There are set procedures to follow if an early discharge from the programme becomes necessary. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Frenchay Mews enables and supports people to identify their goals and achieve lasting sobriety, by means of a strict treatment programme of formal counselling and peer group support. Evidence: People who come to stay at Frenchay Mews will embark upon a 20 week programme that will empower them to develop personal skills, learn about themselves and take responsibility for their own actions. They will participate in a programme of group therapy, individual 1:1 sessions and have a strict programme of house actvities that they must engage with fully. They will share information about themselves and with support from their counsellor, will complete their life story and present it to the group at midpoint in the programme. The group would then feedback their views and discuss the issues raised. This peer group support is an essential part of the Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: programme. One person said when I did my life story everyone was so supportive and suggested ways of dealing with things that I hadnt thought about before, whilst another said I hope I will be feeling stronger when it is my turn to present my life story. In respects of being able to engage in actvities outside of the home, there are stringent guidelines about what people can and cant do. Initially people are not allowed out, then they can go out with a peer who has been in treatment for a set period and then they are allowed out on their own. There are boundaries about entering licensed premises. People will be supported to maintain contact with friends and family where this does not have a negative impact upon their recovery. They will also be supported to reestablish contacts that may have become damaged by their addiction to drugs or alcohol, and to explore ways of repairing relationships. There is a collective responsibility for the day to day running of the household and each person will have allocated tasks to complete. Nutrition is an essential part of the treatment programme as more often than not, people will have neglected their diet before coming on to the programme. One person said that they had been very underweight before coming to Frenchay Mews and had been taught the benefits of healthy eating. Each person must attend for every meal and these are served in the dining room. There is a rota for meal preparation, and peoples dislikes and dietary requirments will be accommodated into the weekly menu plan. Any cultural needs identified during the admission process will be catered for. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service will be encouraged to remain independent in meeting their own personal care needs and managing their own healthcare needs. This will ensure that they are then able to live independently at the end of their placement. Evidence: Each person will be expected to meet their own personal care needs whilst they live at Frenchay Mews, and house rules dictate that they must be well groomed and fully dressed in clean clothes throughout the day. An agreement to this will have been made by each person prior to the placement being taken up. Those people spoken with during the course of the inspection said that they were well supported by the staff team and that they improved both in physical and emotional health since taking up treatment. Each person will be temporarily registered with a local GP practice and will be supported to attend any appointments as needed. They will retain responsibility for their own medications but the staff team can prompt people to take them regularly if Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: this is needed. Any mind altering medication would be held by the staff team but it would still be the responsibility of the person to request this at the prescribed times. An assessment of each persons support needs would be made and the level of support required would be detailed in their plan of care. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can be assured that any concerns they may have will be listened to and acted upon, and that they will be protected from harm. Evidence: Frenchay Mews will provide each person who stays in the home with a copy of the complaints procedure. The home has received one complaint since the last inspection and are still in the process of responding to this. The Commission has not received any complaints or concerns regarding this service. One person spoken with during the inspection said that if they had any concerns at all, they could speak to their counsellor or discuss the matter during a group therapy session. Those other people spoken with during the inspection also confirmed that they feel staff listen to them, they feel safe, and that they are well supported. One person said my stay here has been a lifesaver. Staff spoken with confirmed that they had attended safeguarding adults training and that they knew what their responsibilities were in protecting those in their care, from coming to any harm. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Frenchay Mews provides a non-institutional and homelyenvironment, that is comfortably furnished, and is kept clean and tidy. Evidence: Frenchay Mews is a large victorian property and the accommodation is spread over four floors. The kitchen, laundry, dining room and lounge are located in the basement area, along with the smoking room, the only area in the house where smoking is permitted. There is shaft lift between all floors making the home fully accessible for any person who has impaired mobility. All areas of the home are in a good state of repair and the communal rooms are comfortably furnished. On the ground floor there are the offices and the various communal rooms that are used for group therapy sessions or for 1:1 work. The bedrooms are located on the first and second floors. Most are single bedrooms but there are four shared rooms. Each bedroom is furnished appropriately. There are a sufficient number of bathrooms and toilets located throughout the home. All parts of the house were clean and tidy. The housekeeping duties for the home are Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: considered part of the therapeutic duties for each person who lives here and there is a rota for cleaning, laundry and cooking duties. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People will be support by skilled counsellors who will enable them to achieve their goals and aspirations. Recruitment procedures ensure that only suitable staff are employed and supervision arrangments ensure that the staff team are well supported. Evidence: The home is staffed on a 24 hour basis. In the evenings, weekends and bank holidays support workers are on duty, with back up arrangments for contacting on-call counsellors. During ofice hours, the manager, the administrator and a team of counsellors are on duty. There are specific roles for each staff member. There are a team of nine support workers- they do not undertake any of the therapeutic work but are involved in the running of the house. These support workers either hold or are training for a counselling qualification. There are five full time and four part time qualified counsellors, who undertake the assessments of prospective people who come for treatment, run group therapy sessions, do 1:1 counselling, and handover information to and from support workers. Each counsellor will be a key worker for a number of people. The administrator completes all the day to day administrative work, both financial and general, but also monitors food hygiene issues and nutrition. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: There is a daily process of staff meetings, handover reports between shifts and debriefing sessions after group thereapy sessions. Staff spoke about being well supported in their role. The recruitment files of two counsellors were examined to check on the processes followed by the organised. This evidenced that written application is made, an interview attended, two written references obtained and CRB disclosure and POVAfirst clearance obtained. These measures will ensure that only suitable staff are employed at the home. Examples of training received by staff include fire safety, first aid, protection of vulnerable adults, group dynamics and harm reduction. Training is organised by Frenchay House, a sister home within the same organisation. All staff, support workers and qualified counsellors will receive regular supervision. The responsibility for this is shared between the manager and the deputy. Written notes are kept of all supervision sessions and although these were not seen during the inspection, it was confirmed by three staff members spoken with. In addition to formal supervision, group de-briefing sessions are arranged on a frequent basis. These measures will ensure that the staff team are fully supported to meet the expectations of their role. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Frenchay Mews is a well managed treatment centre that is fully geared up to meet the needs of the people using the service. Evidence: The manager, Mrs Anne Matthews has 19 years work experience in the Drugs and Alcohol treatement field, of which 17 of these she has been qualified as a counsellor. She holds an NVQ Level 3 qualification in promoting independence and is therefore well qualified to run the home and meet its stated purpose, aims and objectives. Following each placement a Treatment Completion Questionnaire is completed to ensure that expectations have been met and to determine how well needs have been met. They also ask if any improvements could be made and for a summary of the the time spent at Frenchay Mews. These measures will ensure the continued effectiveness of the treatment progamme. Staff are not generally involved in any manual handling tasks. Fire safety checks were Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: all up to date. Fire awareness, food hygiene and first aid training is arranged for the staff team. There were no health and safety issues noticed during a tour of the home we were told that any maintenance or repairs are dealt with as and when necessary. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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