Inspection on 07/11/05 for Greig House

This inspection was carried out on 7th November 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greig House 20/11/06

Greig House 18/04/05

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

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

CARE HOME ADULTS 18-65 Greig House Greig House 20 Garford Street London E14 8JG Lead Inspector Anne Chamberlain Unannounced Inspection 7th November 2005 09:30 Greig House DS0000061559.V261337.R01.S.doc Version 5.0 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 Greig House DS0000061559.V261337.R01.S.doc Version 5.0 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. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greig House Address Greig House 20 Garford Street London E14 8JG 020 7987 5658 020 7987 8942 greighouse@salvationarmy.org.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Salvation Army Ms Rita Ann Carol Wooldridge Care Home 18 Category(ies) of Past or present alcohol dependence (18), Past or registration, with number present drug dependence (18) of places Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th April 2005 Brief Description of the Service: Grieg House is an 18 bed residential detoxification project, operating a two or three week voluntary admission detoxification from drugs and alcohol, for men and women aged 18 - 65. In addition to the registered care manager, project manager, and deputy project manager, the home employs a mixture of nursing and care staff as well as administrative and maintenance staff. They retain the services of a masseuse and an art therapist. A psychiatrist visits daily and general practitioner twice a week. A keyworking system is in place The treatment programme is holistic and in addition to medicated withdrawal complementary therapies are available, including acupuncture, massage, aromatherapy, and art therapy. Grieg House comprises an older property and a new build. In addition to the bedroom accommodation and bathroom facilities there are spacious communal areas, and a number of office and meeting rooms. Greig house has one disability adapted bedroom and access to all ground floor areas is adapted. Grieg House is situated just off East India Dock Road close to transport links and with a number of community resources close by. The home is run by the Salvation Army and has been open for four years. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between the hours of 9.30a.m. and 3.15p.m. on one day. The standards which were the subject of requirements at the previous inspection were revisited also a number of non-key standards which have not been inspected this year. The inspector met with the project manager and deputy project manager and spent most of the time with the care manager. The inspector toured parts of the project and had lunch in the dining room. She examined records including three service user files. Given that Greig House offers detoxification programmes and these last usually for no more than three weeks, the inspector did not feel it appropriate to interview any service user. The inspector would like to thank the service users, managers and staff for their co-operation with the inspection. What the service does well: What has improved since the last inspection? Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 6 There has been some redecoration since the last inspection and this has freshened up areas of the buildings. Some curtains and chairs have been replaced and desks have been provided in bedrooms. A good practice recommendation has been followed further improving the soundness of the arrangements for the administration of medication. 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. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 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 Greig House DS0000061559.V261337.R01.S.doc Version 5.0 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): 1,3,4 and 5. Prospective service users have the information they need about the service. The home is able to meet the needs of persons they admit. The opportunity to visit the service before being admitted is offered to service users. Service users have individual contracts. EVIDENCE: The project has produced a statement of purpose which gives comprehensive useful information about the service. In the complaints section the address and telephone number given for the Commission for Social Care Inspection (CSCI) are incorrect. The manager must ensure that the statement of purpose gives the correct address and telephone number for the commission. This is a requirement. The project has produced a service user guide which gives much helpful information to service users. However it fails to meet the requirements of regulations and the manager must amend the document to take into account the following elements under Standard 1.2 of the National Minimum Standards, iii,iv,v,,vi,vii. The manager must ensure that the service user guide incorporates the stated elements of information. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 9 This is a requirement. The service user guide whilst carrying information about the complaints procedure gives no telephone number for the CSCI and does not advise that the commission can be contacted directly at any time. The manager must ensure that the service user guide is amended to take account of the omissions identified. This is a requirement. The purpose of the service at Greig House is to support withdrawal from alcohol and other substances. To this end medical and emotional support is offered. The service operates an admissions criteria. They are able to give only limited physical assistance and take only individuals who have a level of independence in personal care, feeding, etc. There is no nursing care provided other than that related to the detoxification process. As the treatment plan rests on positive and authentic interactions the project is not able to take persons who are psychotic and untreated.. Notwithstanding the above the project had one adapted bedroom and the whole ground floor is wheelchair accessible. Within the above criteria the project can accept people who have compromised mobility and sensory losses, but they do not have sign language skills within the staff group. The project has worked with individuals who have autistic spectrum disorders. The service can provide one to one support for individuals who cannot function in therapy groups. The service offers introductory visits but these are rarely made by referees. In order to avoid uneccessary delays in admission and duplication of assessment the service uses the assessment information gathered by keyworkers in the community. Keyworkers are encouraged to visit the home and frequently do. The manager stated that when service users have visited the project they have been pleasantly surprised by the nurturing and supportive atmosphere. The brochure does include photographs of the project. Service users sign a contract on the second day after being admitted to the home. Most service users are funded by health and social services. Some individuals fund their own service. Terms relating to funding costs are not included in contracts signed by service users. This is a conscious decision on behalf of the service. Their view is that on the whole it is psychologically better for service users to keep treatment and funding issues separate. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 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): 6,8 and 10. Service users are consulted appropriately on aspects of living in the home. Information about service users is handled in a confidential and respectful way. EVIDENCE: The inspector viewed three files including care plans. The manager advised that the design of care plans is under consideration as the service wants to involve service users more in the planning of their care and the writing of their care plans The inspector felt that care plans could be more user friendly. She suggested that the care plan could have more pre-printing, as handwriting can be difficult to read. It may be more practical to have single pages comprising the care plan but the plan could be in more of a book style. The inspector suggested that the care plan have more pre-printing and be in a book style to make it more user friendly. This is a recommendation. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 11 The manager stated that service users have little say in how the service is run. The inspector felt that this is quite understandable given the nature of the service and the short duration of stay. The manager stated that comments regarding temperature of the buildings, food etc. would be listened to and where appropriate acted upon. In response to user feedback some additional heaters have been provided for the old part of the building where the bedrooms are hard to heat The service seeks quality assurance information and gives service users evaluation feedback forms. Residents meetings are also held. The inspector viewed the well developed confidentiality policy of the organisation. Staff are expected to read the policy and they also have training in confidentiality. Information within the service is guarded to the extent that the presence of an individual in the project will not be confirmed without their permission, unless in exceptional circumstances. Callers requesting information are always called back after the service user has been consulted. Care planning with the service user includes ascertaining their wishes with regard to the sharing of information. Service users sign a disclaimer agreeing to the sharing of information with their general practitioner and referer/social worker and both agencies are sent a discharge summary. Electronic information is password protected and paper files are kept in locked cabinets. The service is required to keep service user information for seven years and they have made secure arrangements for this. After seven years the information is shredded. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 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 and 14. The service offers valuable opportunities for personal development. Service users are supported to engage in recreational activities within the project. EVIDENCE: There are real opportunities for personal development for individuals using the service. Therapeutic interventions, including one to one work with keyworkers, group work and counselling are important elements of the treatment plan. Spiritual support is also available and the deputy manager of the project is an ordained minister in the Salvation Army. The service offers a range of recreational opportunites, including pool, table tennis, football and tennis in the garden, DVDs videos, and music. The project has an exercise bicycle, a piano and guitars. Service users can bring in with them reasonable recreational equipment for example a CD player. The inspector observed service users playing pool together and interacting in a sociable way generally in the shared spaces. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 13 Greig House DS0000061559.V261337.R01.S.doc Version 5.0 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): 20 and 21. The arrangements for the administration of medication are sound although there is scope for further elimination of errors. Ageing, illness and death are handled with respect at the project. Individuals are offered opportunities to discuss their feelings around these issues which they find helpful. EVIDENCE: This standard was the subject of a requirement at the previous inspection. The requirement had been met. However the inspector noted some other shortfalls in the administration of medication charts. A herbal preparation had been listed twice, once on the sheet for herbal medications under its generic name and once on the sheet for prescription drugs under its trade name. Confusion had arisen and a dosage had been entered under the wrong column. The service keeps separate MAR sheets for prn medications. Entries are dated. A drug which is prescribed prn had been entered on the sheet for prescribed dosages under the wrong date. The manager agreed that unless workers comply with putting the prn medications on the prn sheets there is a potential for error. The manager agreed that having a horizontal line of numbers, representing days, across the top of the prn sheets is confusing and uneccessary as prn dosages are always dated. She has agreed to redesign the form. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 15 The manager must ensure that paperwork relating to the administration of medication is designed and completed to eliminate errors as far as possible. This is a requirement. Notwithstanding the above the inspector noted that complex regimes of medication are administered to service users by the nurses in the service, and the arrangement for administration are of a high standard. The service uses only registered nurses at grade F who specialise in drug and alcohol work. The inspector was pleased to note that the recommendation regarding medication, made at the last inspection, had been implemented. The manager stated that they are holding more controlled drugs now due to an increase in service users being admitted to detox from drugs. They have therefore bought an additional controlled drugs cupboard which the inspector viewed. The cupboard is not within another cupboard but is, the manager stated, home office approved, with special hinges and special bolts into the wall. The manager stated that counselling offers an opportunity for service users to discuss issues including ageing, illness and death. She said that some people who have chronic bad health related to their dependency are very anxious about dying. Others are dealing with terminal illness and deaths in their families and have issues related to this including feelings of guilt. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 16 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 and 23. Service users have opportunities to express their views and have them considered and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: This standard was the subject of a requirement at the previous inspection. The complaints information is helpful but still does not meet the requirements of regulation fully. The shortcomings are as follows:The complaints procedure has no telephone number for the CSCI. The statement of purpose includes an address and telephone number for the commission which are incorrect. The service user guide complaints procedure gives no telephone number for the CSCI and does not advise that the commission can be contacted directly at any time. The manager must ensure that the correct contact details for the CSCI are included in the complaints information. This is a restated requirement. The whistleblowing policy has been included in the main policy file as required by the previous inspection. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 17 Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25,26,27,28, 29. The environment at the project is homely and safe, and support service users comfortably. Bedrooms are suitable for the purpose of short term stays. They provide a private space and are well furnished. The bathroom facilities meet the needs of service users. Shared spaces are pleasant and promote recreational activity and sociability. Specialist equipment is not provided as the support of significant disability is not within the remit of the project. EVIDENCE: This standard was the subject of two requirements at the previous inspection, both of which have been met. There has been some necessary touch up redecoration, but also major redecoration of bedrooms, hallways etc., and retiling of bathrooms. There are other areas which will be repainted as the decorating programme rolls on. The bedrooms at Greig House are comfortable and adequate for the purpose of the service. They are all single rooms. There are new curtains and armchairs in a number of the bedrooms and they have been furnished with desks. The inspector felt the desks were a positive development and service users would find them useful. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 19 The manager stated that service users are encouraged not to bring too many possessions with them, as they are not staying for long, and everything has to be taken home again afterwards. Service users bring photographs and other small items. There are 14 bathrooms and toilets in the centre with a mixture of showers and baths and two additional toilets. The four female bedrooms, which are in the new wing, have en-suites bathrooms, male bedrooms in the old wing, have shared bathroom facilities. However these are domestic in size and there are an adequate number of them. The manager remarked that there have been no negative comments about shared bathrooms. There are no shared bedrooms. The shared spaces which the inspector saw were cheerful and pleasant. The garden looked well kept. There are two lounges in the project. One has a pool table, computer, TV and music. This lounge is very pleasant having large windows and doors on to the garden. The other lounge is referred to as the quiet lounge. This has TV only and is used for the group work. The quiet lounge has just been refurnished with new armchairs. A machine in the main lounge dispenses free coffee and tea. There is also a machine where carbonated drinks can be purchased. Staff are provided with lockers. There is a staff room where breaks can be taken. It is furnished with fridge and microwave. Staff handovers take place in this room. The contracted staff responsible for cleaning and catering, have a room to use for changing their clothes. Service users see visitors in their rooms and there is also a small quiet room which they can use. They see medical professionals in the treatment room. As previously mentioned there is one adapted room in the project and the whole ground floor is wheelchair accessible. The project can offer placement to people with some impairments and would for example be open to someone with moderate hearing loss, or someone who uses a zimmer frame. They cannot offer placement to people who are not independently weight bearing and they do not provide any specialist equipment. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 35 and 36. Service users are clear about the roles and responsibilities of the staff who are supporting them. The staff are qualified, experienced and skilled and support service users effectively. Staff undertaking direct work are well supported by a structured organisation. Staff in the service receive induction training but refreshers of core training have fallen behind and a requirement has been made. Staff supervision is not as frequent as necessary and a previous requirement has been restated. EVIDENCE: The team at Greig House comprises 6 clinical registered nurses and 6 project workers. Service users are allocated one nurse and one project worker to be their keyworkers. A team leader co-ordinates the 12, overseeing rostering and clinical standards, checking administration of medication, monitoring care plans and supporting service users. The team leader is responsible for practice development. He reports to the care manager. The care manager is responsible for clinical standards and also provides counselling for service users. She reports to district officer who is the responsible individual for the service. All staff at the project are issued with job descriptions, which are linked to Drug and Alcohol National Occupational Standards (DANOS). There are separate job descriptions for nurses and day and night project workers There Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 21 is no mixing of day and night shifts. The inspector viewed the job descriptions and felt that they were satisfactory .All new staff sign a contract of employment and have induction. In addition to the above staff, there is a centre manager who is responsible for the building, including cleaning and catering. She is supported by a deputy. He is also the minister for the project and available to clients for spiritual support. In addition to the above the project employs two receptionists and a handyman. The inspector felt that the project is well structured and that workers would be clear about their roles and responsibilities and able to communicate these to service users. The statement of purpose produced by the service gives the qualifications of the staff and the level of attainment is high. Staff training profiles were also viewed. Personal skills are assessed at interview using likely scenarios. There is an emphasis of diffusing situations and dealing with anger. The manager stated that the level of violence in the project is low. The project uses bank staff, inducted and employed by the organisation in preference to agency staff. The manager felt that the use of bank staff provided flexibility in rostering. Each shift is staffed by one nurse and two project workers. There are a number of languages spoken within the project, three asian dialects, Italian, French and an Arabic language. The project also uses interpretation services. The manager stated that workers are matched as well as possible to service users and can almost always establish adequate communication with them. Many individuals can comprehend more English than they can actually speak. The organisation aims to refresh core training for staff annually, infection control being an exception as it is included in induction but not repeated. The manager stated that fire training is done every year. She further stated that CPR training was refreshed for most staff in July 2004. It is a requirement of the Nursing and Midwifery Council (NMC) that nurses refresh their CPR training every year and it is good practice for project workers to refresh their CPR training once every year, including training on any associated equipment held. The manager stated that most staff have undertaken basic first aid training 1 and 2, in April 2004, this is therefore also due and is also needed for any staff who have joined the service since that date. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 22 The manager stated that all staff in the service at the time, completed moving and handling training in February 2004, so this is also due. The manager must ensure that core training is refreshed annually for all staff, including CPR, with any associated equipment held, first aid, moving and handling and fire training. This is a requirement. This standard was the subject of a requirement at the last inspection and a concern that without regular one to one supervision the staff do not have opportunities to discuss training needs. The manager stated that she has not been able to reach the required level of staff supervision, i.e. not less than six times per year. The inspector viewed the records which bore this out. She also discussed with the manager the agenda for supervision which indicated good quality sessions. The manager has decided to delegate some staff supervision to the team leader and believes this will enable them to meet the requirement. The delegation will be put into effect shortly. The inspector also suggested to the manager that group supervison could be acceptable if appropriately integrated into the supervision programme. The manager must ensure that staff have regular recorded supervision not less than six times per year. This is a restated requirement. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 23 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): 37,38,40,41,42 and 43. The home is well run supporting service users to utilise the treatment offered. The ethos of the home supports a high success rate for the programme and for service users. The policies and procedures, of the home including those governing record keeping, are well thought out and safeguard service users. Health and safety is promoted but there is a minor shortfall which has resulted in a restated requirement. The management of the service is competent and accountable and securely underpins the programmes of treatment offered to service users. EVIDENCE: The registered manager has a nursing and counselling qualification. She has 26 years experience which includes management of acute health settings and commissioning of hospitals. The manager has developed a strong interest in the area of detoxification and uses her counselling skills on a daily basis in her role. She said that the organisation is supportive of further personal development and she is released for relevant training. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 24 The inspector felt that the managers qualifications and experience fitted her well for her role. Also that she had a strong grasp of the aims and objectives of the home and the ability ensure that the policies and procedures are properly implemented. The ethos of Greig House is holistic, nurturing and empowering. The inspector felt that this was evidenced by the therapeutic input which includes massage and herbal relaxants, like herbal teas. The atmosphere feels relaxed and this was experienced by the inspector when she ate in the dining room and passed through other parts of the building. The manager said that initially some agencies were concerned that the programme which as a Salvation Army project is underpinned by Christian principles, would include preaching to service users. They are now reassured that this does not happen. The manager stated that many service users have experienced a lifestyle with weak boundaries. They benefit from firm boundaries within the project which promotes a safe and secure environment. The inspector viewed the policies and procedures manaual which is comprehensive. The manager stated that apart from regulation by the commission the project conforms to other good practice requirements for drug and alcohol services, principally QUADS standards. The project has a policy for recording which provides guidance for staff and which the inspector viewed. She also viewed three service users files. The running notes were well written, informative and up to date. The manager stated that service user files are inspected and should recording fall below the standard set it would be regarded as a performance issue. The inspector viewed the incident report book which demonstrated incidents were not too frequent and were well recorded on a report form. The incident reports are signed off by a manager in the project and then go to divisional headquarters where they are considered and recommendations may be made for future practice. Following a requirement at the last inspection the manager stated that all the refrigerators in the centre have now been fitted with thermometers and temperatures are recorded daily. The inspector viewed the recording of refrigerator temperatures. The manager agreed that the recording had at times faltered had gaps, and stopped altogether at a date in the previous month. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 25 The manager must ensure that temperature recordings are made for all the refrigerators on the premises. This is a restated requirement. The manager explained that she and the centre manager have different lines of management. This is to ensure that any differences arising which could affect clinical practice are independently arbitrated. The manager felt such an occurrence would be highly unlikely. Both managers feedback to their respective managers on their supervision of the centre staff. The care manager also has a counselling supervisor. The managers would make budget requests jointly. The care manager said that the organisation is very committed to the project and the budget is not unduly constrained. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 26 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 3 3 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 3 x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 x 13 x 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 3 x 2 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greig House Score x x 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 2 3 DS0000061559.V261337.R01.S.doc Version 5.0 Page 27 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 YA1 Regulation 4 Requirement The manager must ensure that the statement of purpose gives the correct address and telephone number for the commission. The manager must ensure that the service user guide incorporates the stated elements of information. The manager must ensure that the service user guide is amended to take account of the omissions identified. The manager must ensure that paperwork relating to the administration of medication is designed and completed to eliminate errors as far as possible. Timescale for action 01/01/06 2. YA1 5 01/01/06 3. YA1 5 01/01/06 4. YA20 17 01/01/06 5. YA22 22 The manager must ensure that 01/01/06 the correct contact details for the CSCI are included in the complaints information (previous timescale of 01/07/05 not met). Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 28 6. YA35 18 The manager must ensure that 01/02/06 core training is refreshed annually for all staff, including CPR, with any associated equipment held, first aid, moving and handling and fire training. The manager must ensure that staff have regular recorded supervision not less than six times per year (previous timescale of 01/06/05 not met). The manager must ensure that temperature recordings are made for all the refrigerators on the premises (previous timescale of 01/06/05 not met). 01/03/06 7. YA36 12 8. YA42 12 01/01/06 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 YA6 Good Practice Recommendations The inspector suggested that the care plan have more preprinting and be in a book style to make it more user friendly. Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greig House DS0000061559.V261337.R01.S.doc Version 5.0 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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