Inspection on 19/03/08 for Gilead Foundations Charity

This inspection was carried out on 19th March 2008.

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

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

Other inspections for this house

Gilead Foundations Charity 25/03/09

Gilead Foundations Charity 11/04/07

Gilead Foundations Charity 23/06/06

Gilead Foundations Charity 11/10/05

Gilead Foundations Charity 05/04/05

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Gilead Foundations Charity Risdon Farm Jacobstowe Okehampton Devon EX20 3AJ Lead Inspector Anita Sutcliffe Unannounced Inspection 19th March 2008 14:45 Gilead Foundations Charity DS0000061096.V359679.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 Gilead Foundations Charity DS0000061096.V359679.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. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gilead Foundations Charity Address Risdon Farm Jacobstowe Okehampton Devon EX20 3AJ 01837 851240 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) Gilead Foundation Charity Miss Beth Rosanna Samuel Care Home 10 Category(ies) of Past or present alcohol dependence (10), Past or registration, with number present drug dependence (10) of places Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The first of the three new bungalows must be completed and available for occupation by Service Users by 31st October 2006 The Farmhouse modernisation and extension programme must be completed by the 30th April 2007 The mobile homes/caravans must be removed from the site once the 3 new bungalows are occupied. (as per planning application) Upon completion of the first bungalow, no more than 2 service users may be accommodated in the Farmhouse. No more than 10 service users undergoing a detoxification programme for substance abuse may be accommodated at any one time. Upon completion of the first new bungalow, service users must only be accommodated in this bungalow and the Farmhouse. 11th April 2007 Date of last inspection Brief Description of the Service: The Gilead Foundation, previously registered as Risdon Farm, is a Registered Charity. The home provides care services and supported living in an extended family community, which follows the principles of Christianity. It is registered to provide care and accommodation for people who wish to recover from drug and alcohol dependency. The current registration allows for the admission of up to 10 service users, referred to as students, of both sexes between the ages of 18 and 65. Care is divided into phases, phase one known as detoxification and stability and lasting ten weeks. This is the part for which the home is registered. The home is part of a working dairy and livestock farm, which provides opportunities for work and an income to support the charity. It is set in a rural area near the town of Okehampton in Mid Devon. Female students are accommodated in the farmhouse and male students in temporary static caravans, which are to be replaced with three large bungalows with modern amenities and single rooms. Communal areas are provided in the caravans, farmhouse and the community centre. Currently the fee for phase one is £590 per week. This covers care, support, accommodation, food, basic toiletries, personal protective clothing (for use in the dairy), study materials and skills training. The most recent report is displayed in the office and the report summary is included in the pre admission material sent to prospective students. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 5 Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The quality outcome for people would be good if it were not for the poor standard of accommodation. This key inspection was to check the home’s compliance with the National Minimum Standards for Younger Adults, using the Commission’s guidance on how those standards relate to drug and alcohol addiction. Prior to the inspection the home provided current information on the service and we (the Commission) anonymously sought opinion from the people (known as students) living at the home, and some staff. A GP and drug and alcohol worker with experience of the home gave their opinion of it. We did two unannounced visits to the service. Only two people were in Phase one of the programme (detoxification) at the time of this inspection. We spoke at length with one; care records for two were examined. We spoke with the Responsible Individual of the organisation, the Registered Manager and the programme manager for Gilead. We looked at two of the static caravans currently in use. We were given the current pre admission information (Service User’s Guide). People who use the service may be described within this report as students or clients. What the service does well: The manager and staff, who live on the premises, provide 24 hour care and support to people who use the service in a sensitive and respectful, but structured way while they withdraw from drug and alcohol dependency. One student said: “Nice system. Comforting”. Another said: “I’m happy here”. A member of staff said: The ‘family’ atmosphere allows clients to relax and trust the environment they are in”. The pre admission information ensures that people who may wish to use the service are fully aware of what to expect at Gilead. The assessment of their needs is detailed and fully inclusive. Additional information (example, from specialist drug and alcohol worker or psychiatrist) is always sought so medical history and any risk will be fully researched. This is then translated into the plan of care, which is equally detailed and regularly reviewed with the person themselves and all staff who are supporting them. Where a person might leave the programme early, and whilst still vulnerable, Gilead has steps in place to protect them. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 7 There is a structured routine at Gilead and opportunities to learn new skills from which qualifications can be taken if people wish. People like the food, much of which is locally produced. Students are treated with respect and their diverse needs are understood. They appreciated the amount of freedom the farm environment offers. The atmosphere at the home is warm and welcoming. All the staff and managers are helpful and showed a sincere willingness towards continuing improvement and better outcomes for people they care for. What has improved since the last inspection? Pre assessment, assessment of need and care planning is under continual review and improvement. Assessment of risk is now more thorough. There has been a cut back on practical work hours providing more time for study and group therapy. Leisure and social activities available have been improved a little and the recently introduced Duke of Edinburgh Award Scheme is an incentive for people as they progress through the programme towards better health. Health care professionals involved with the home feel the standard of health care provided at Gilead has improved, adding: “They’ve done some really useful work”. Policies and procedures now contain contact details for agencies outside the home, such as social services. This better protects people should there be concerns for any person’s welfare. It also means complaints can be made outside the home if people prefer, again better protecting people. When a complaint was made it was investigated fully by the manager. She is also now fully aware of what steps must be taken should an allegation of abuse be made. The standard of recruitment is now more robust and new staff/volunteers are not starting at Gilead until all safety checks are in place. Staff are now more satisfied with the standard of training and the support they receive is more structured. Comments include: “Ongoing training provides greater understanding of what client needs are and how to meet them. I also have good support from co-workers”. A staff worker said: GF is on a good path of change and helping others”. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 8 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. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 9 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 Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 10 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): 1, 2 & 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to make a fully informed choice as to whether Gilead Foundation is suitable for them. Their needs and aspirations are fully assessed prior to admission. EVIDENCE: Prospective students, and drug and alcohol agencies, are provided with detailed information from which they can start to make a judgement as to whether the service is suitable for them. For example, the Christian ethos and structure of the students’ week is clearly defined. The pack also includes policies and procedures, which must be followed by people at the home. These leave people in no doubt as to what we will expected of them, including any restrictions they can expect whilst there, such as restricted contact with people outside the home. Of the five people asked if they wanted to move into the home four said yes and one said the question was not applicable to them. One added: “It was my choice. Recommended by family”. Asked if they receive enough information before moving in all said yes one adding: “I visited first”. We were told that potential students are: “Highly encouraged to visit”. We spoke with one Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 11 student who chose to undertake the programme for a second time. They said it was a place where they felt most safe. A rating system, used to determine if a person is a suitable candidate for the programme at Gilead, was started January 2008. We were told: “The more pre-screening the more likelihood of success”. Also taken into account are staff numbers, training and experience so the needs of people who are admitted can be properly met. The assessment records of two people were examined. There was sufficient detail in them for staff to be able to plan care very well. They also showed that people had been involved in the assessment. Appropriate contacts and other enquiries were made with outside agencies (health and social professionals also working with the person). This helped to ensure the student’s specific needs could be understand on admission. It also helps to reduce any risk associated with the admission. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 12 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): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a detailed and clear programme, which helps them towards achieving their goals in a safe and measured way. Where they might fail they are protected. EVIDENCE: Plans are required to be clear so that staff can look after people in the correct way, once their needs have been assessed. A person who uses the service said she was clear what expectations and restrictions were placed on her through the care planning, which would help her to meet her goals. She said she has fortnightly assessment with her counsellor to look at different parts of her care plan, where she is ‘struggling’, ‘moving forward’ and if she is ‘on target’. Response from people surveyed, when asked if they receive the care and support you need, varied from always to sometimes, but no additional Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 13 information was provided about this. Amongst many positive comments from staff about the programme of therapy provided was: “Gilead offers an holistic approach to recovery and support on many levels. We offer a treatment that empowers clients to understand themselves and gain skills to resolve problems”. We saw that care records clearly showed all aspects of people’s needs are addressed as part of breaking addiction and behaviours which the person themselves has identified as being a problem to them. Progress is regularly reviewed. There is also a grading system in place to give further details of how a person is progressing. Risk associated with people cared for in Phase 1 of the programme at Gilead is high and quiet specific to this circumstance, for example, stopping alcohol. This risk is managed through the care planning, ‘family’ support system, the student review meetings, group leadership and shadowing/ mentoring of staff. As the risk reduces people are able to become more independent. This continues to be planned with risks properly considered. A re-settlement plan for people is in place and communication with their social workers/agencies is well organised. The possibility of relapse is understood and managed in people’s best interest. People are expected to work on the farm, in the kitchen and in the office dependent upon their abilities, health and preferences. This is seen as part of the therapeutic approach for recovery. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The structured routine and opportunities to learn new skills helps to promote a positive lifestyle and the leisure and social activities available have been improved. People receive a nutritious and varied diet. EVIDENCE: Spending time employed constructively around the farm, the home and the office is an important part of the care regime and timetabled into the day. One person who uses the service and has been at Gilead for some weeks said: “I would go mad from boredom if not doing some work”. Where basic literacy, numeracy or computer skills are lacking people have the opportunity to develop these through training at a local college when well enough to do so. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 15 They are now also able to take nationally recognised qualifications in the farm work they do. People using the service are initially restricted from using a mobile phone, leaving the premises unsupervised or having visitors unless part of planned car. Intimate relationships are also discouraged for the same reason and also because of the Christian ethos of the Gilead Foundation. These restrictions are understood and agreed when people are admitted. People who use the service and staff/volunteers religions participate in Christian worship. Pre admission information makes this expectation clear. Staff remain a little negative about the leisure choices available at Gilead but people using the service did not mention it. However, people are restricted by the rural position of the home, lack of transport and lack of finance. When new to the home and programme of therapy people’s need for ‘activities’ is less, but as the programme progresses this is more important. To this end Gilead have recently introduced the Duke of Edinburgh Award Scheme, purchased sports equipment and are looking to extend community contact, for example, with churches local to the home. People are provided with a nutritious and varied diet whilst at Gilead. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 16 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): 18,19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a ‘whole person’ approach to their mental and physical health care. Medication management needs to be more robust so that mistakes or mishandling are not possible. EVIDENCE: People who use the service consent on admission to having their health care and medication needs dealt with by staff as this is when they are most vulnerable. Their care records show that all aspects of their care is fully planned, delivered and reviewed in a structured way. There is liaison between the home and health and social care practitioners from people’s home area; they prescribe any detoxification schedule. A local General Practitioner ensures other medical care needs are met. There had been frequent change of G.P., outside the home’s control, but this appears to Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 17 be resolved. A GP with current knowledge of the home said that secondary mental health needs are now better managed, adding: “They’ve done some really useful work”. The way medicines at the home are handled was part of a complaint made to us since the previous key inspection. The manager investigated and now the procedure used to administer medicines has been ‘tightened up’. We found that it is possible to fully audit medicines at the home, which reduces the likelihood of mistakes or mishandling. Currently no person is prescribed medicines classed as ‘dangerous’, but should this occur the storage arrangements would not meet the Misuse of Drugs (Safe Custody) Regulations 1973. We also found the key to other medicines storage kept in the key-pad safe which would currently be used for ‘dangerous’ drugs. The person in charge of medicines at any one time must keep the keys; this is also part of the audit arrangements so that the use of medicines can be properly monitored. Otherwise medicines are stored securely. Medicine records were mostly, but not fully complete as there was a gap in the record of what has been given. We also found that, where a medicine is to be given ‘as necessary’ or ‘as required’ their use is not part of planned care, which it must to ensure the use is properly monitored. However, no staff member handles medication without having completed a training course and there is a method in place to check staff competency. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 18 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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students are protected from abuse and self harm and complaints are appropriately responded to. EVIDENCE: Each of the five people who use the service, asked if they know who to speak to if not happy and how to make a complaint, said yes. The complaints procedure is within the pack of information provided prior to admission. People live in a family setting at Gilead that creates a secure and safe environment that encourages people to share any concerns with support staff. One person said: “I trust them. It feels like a safe environment”. The complaints and prevention of abuse (including whistle blowing) policies have been reviewed and they now contain contact details that people can use to take complaints or concerns outside the home environment should they need. We received one complaint against the home, which we referred to them to investigate under their own procedures. This was done to a satisfactory standard. They then changed one of the medicine procedures to improve safety. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 19 Staff are fully aware of the vulnerability of people using the service and this knowledge informs some restrictions imposed, such as separate living quarters for men and women. History of any self-harm is part of pre admission assessment of risk and its management part of planned care. The registered manager is aware of what actions must be taken should there be an allegation of abuse. She reports that there have been none. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 20 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): 24 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People’s wellbeing is adversely affected by the standard of accommodation provided. Cleanliness and hygiene are adequate maintained. EVIDENCE: People live in either static caravans or in the farmhouse pending the building of three large bungalows in the grounds, the completion of the first (which will accommodate those currently living in the caravans) is far over due and continues to affect people’s wellbeing. We have reviewed the timescale for completion in line with new information provided. Although the accommodation is old, worn and in need of regular maintenance to keep them watertight, the two caravans in use were warm and clean. No Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 21 surveys indicated that people using the caravans were unhappy with their accommodation, although this was raised as a concern by staff. Each person in the caravans has a small single bedroom and some quite small bedrooms are shared in the farmhouse. One person currently living in the farm house confirmed that they are each involved in the cleaning of accommodation, the standard of which she considered perfectly satisfactory. People are able to benefit from the freedom the farm and farmlands provide. The shared community areas are somewhat worn but homely. No specific environmental health and safety concerns were identified during the visit. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 22 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): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a staff properly recruited, trained and supported. EVIDENCE: Most staff surveys report that there were sufficient staff numbers available. However, shortage of staff was given as the reason for some lack of leisure activities and we are told staffing numbers did impacted on the quality of care provided earlier in the year. We are told that the problem has now passed. A person using the service, asked about staff numbers said: “No problem”. There has been a review of staff training in parallel with the review of the programme for people who use the service. Staff were less positive about their training at the time of the last key inspection but, asked what the home does best one staff this time said: “Provide consistent training for staff”. Asked if their induction training covered everything they needed to know to do the job well when they started one said very well and four said mostly, one Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 23 adding: “I had to learn a widespread of instruction, and the general initial induction was fine, I just had to be prepared to learn more further down the road”. Asked if they are being given training, which is relevant to their role, four of the five said yes. We saw training records that further confirmed staff are receiving training. Some staff are trained in addictions counselling and Gilead is working toward all staff being certified as drug and alcohol counsellors. They are also considering ‘buying in’ a package for some training, such as health and safety and the protection of vulnerable adults Recruitment records of two staff/volunteers show that all checks, to ensure they are suitable to work with vulnerable people, were complete, including Criminal Record Bureau (CRB) and references. Of the five staff asked if the employer carried out checks prior to them starting at Gilead all said yes one adding: ”They were helpful dealing with queries”. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 24 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): 37, 38, 39, 41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from the commitment of management and staff and the caring culture at the home, which is generally well run. The quality of service is continually improving except for that of accommodation. Health and safety are understood and managed so that all people are protected. EVIDENCE: Information provided toward the inspection and discussion with the registered manager shows she has a good understanding of her responsibilities and a Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 25 commitment to the people who use the service, the staff and organisation. She is keen to continue reviewing the quality of the service and raise standards. To this end Gilead now has a programmes manager who reviews and improves the programmes of therapy and staff training and support. The manager says: “We have a strong management team and structure in place where individuals show commitment to their job roles and needs of service users. The managers communicate well and efficiently as a team and the welfare of the service users is promoted and protected at all times”. The homes’ policies and procedures instruct staff and inform people who use the service what is expected. They are regularly reviewed and updated. We discussed how the home manages the diverse needs of people there. The registered manager says: “Although Gilead is Christian based we are open to accept anybody that needs help with addictions no matter what their belief, race, gender, etc. We discussed how, for example, the Civil Partnership Act 2004, might affect Gilead Foundation and recommend they consider how they will meet such new legislation. We also discussed the need for staff to have an understanding of the Mental Capacity Act 2005 and its implications at Gilead. The registered manager says: “To incorporate the views of individuals we have regular group meetings where views can be discussed, we use quality assurance surveys, staff review meetings take place weekly and the code of practice, service user guide etc. are reviewed and updated on a regular basis. As a result of listening to people who use our services we have made many positive changes to the recovery programme. These include cut back on practical work hours and increasing time for study and group therapy, also bringing more stability to the general work/community rota and daily schedule for service users”. Talking to people who use the service, staff and through records we found this to be the case. Asked through survey if staff listen and act on what people say to them two said always and three said usually. Staff felt that communication between staff, including management, worked well. One added: “The networked data base is an efficient communication tool. We also have weekly meetings to discuss clients”. Health and safety are properly managed and take into account risk associated with work at the farm and the circumstance for which people are admitted. Although far from ideal, the accommodation is maintained as safe. Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 26 Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 27 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 4 3 X 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 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X 3 3 X Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 28 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. Standard YA24 Regulation 23(2) Requirement Student accommodation must be of solid construction, meeting building regulations and national minimum standards so that they are safe and comfortable during their time at the home. Not met by the due date of 30/09/07 Where a medicine is prescribed to be given ‘as necessary’ it must be clearly described within a person’s plan of care under what circumstance it may be given. This will reduce the likelihood of mishandling or mistake. A full audit of medicines, including how they are handled, must be possible at all times. To this end all records must be up to date and the person who is responsible for medicines at the time must be the only person able to access them. Timescale for action 31/03/09 2. YA20 13(2) 14/04/08 3. YA20 13(2) 14/04/08 Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 29 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 Gilead Foundations Charity DS0000061096.V359679.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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