Inspection on 15/06/06 for Haven Residential Rehabilitation Alcohol Dependency Unit The

This inspection was carried out on 15th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haven Residential Rehabilitation... 01/06/09

Haven Residential Rehabilitation... 30/04/09

Haven Residential Rehabilitation... 02/05/08

Haven Residential Rehabilitation... 10/05/07

Haven Residential Rehabilitation... 08/12/05

Haven Residential Rehabilitation... 22/06/05

Haven Residential Rehabilitation... 02/12/04

Haven Residential Rehabilitation... 19/05/04

Similar services:

Oakmount Hostel

Ark House

St Anne`s Alcohol Services - Leeds

Lynwode Park

Parkfield Rest Home

Priory Road

Elmhurst

Linwood Court

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Haven Residential Rehabilitation Alcohol Dependency Unit The The Haven 5-7 Marshall Avenue Bridlington East Yorkshire YO15 2DT Lead Inspector Mr M. A. Tomlinson 15 Haven Residential Rehabilitation Alcohol Dependency Unit The th and Key Inspection 16 June 2006 09:30 th Version 5.1 Page 1 DS0000019743.V293522.R01.S.doc 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 Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Haven Residential Rehabilitation Alcohol Dependency Unit The The Haven 5-7 Marshall Avenue Bridlington East Yorkshire YO15 2DT 01262 400329 Address 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) Mr Cyril Herbert Dennis Marsburg *** Post Vacant *** Care Home 10 Category(ies) of Past or present alcohol dependence (10) registration, with number of places Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8th December 2005 Brief Description of the Service: The Haven is a residential facility for up to ten service users who have alcohol dependency problems. It is situated in the centre of Bridlington close to all main community facilities and the public transport network. It was previously awarded the ‘Investors in People Award’. The staff team consists of the registered person, the manager (not currently registered), a full time support worker and a qualified counsellor employed on a ‘sessional’ basis. When possible the manager also employs experienced volunteers. The double fronted property has two floors. There are ten single bedrooms. None have en suite facilities. The property does not have a passenger lift and is consequently not suitable for service users who have mobility problems. Nursing care or medical detoxification is not provided. The home provides a programme of recovery for service users who have made a positive decision to stop drinking alcohol. The service users are required to be alcohol free prior to their admission into the home and must remain so whilst resident in the home. They are encouraged to maintain contact with family and friends within agreed limitations. Specific ‘house rules’ deemed to be necessary and of benefit to the service users are explained during the admission/assessment process and incorporated in the Service Users’ Guide. The rehabilitation and recovery programme is based on the recognised ‘twelve step’ approach as advocated by Alcoholics Anonymous. This process involves manageable stages so that the service users can obtain sobriety and are prepared for living within the community. The programme of recovery takes a minimum of three months to complete but the time scale is flexible to take into account each service user’s needs, abilities and circumstances. It is primarily based on group and individual therapy/counselling and places considerable emphasis on peer group support. Through the use of a planned daily routine the service users are provided with an opportunity to learn, or re-learn, life skills in order to develop their confidence so that eventually they are able to live independently within the community. The fee for accommodation and rehabilitation at The Haven is £450 a week. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit to the home was the first undertaken by the Commission for Social Care Inspection during this inspectoral year. The site visit formed part of The Haven’s Key Inspection. The site visit was made over two days, the second day being required to talk to those staff and service users (clients) not available on the first day. Discussions were held with service users in a group setting without staff being present as well as on an individual basis. Discussions were also held with the Manager and Senior Support Worker. Survey forms were provided for the service users’ as well as their care managers and social workers. Previous discussions held with health and social care professionals since the last inspection were taken into account. The inspector joined in a discussion group held by a volunteer who was also a recovering alcoholic. An inspection of the premises was carried out. Several policies, procedures and records, including the service users’ and staff records, were examined. A meeting was held with the manager on the completion of the inspection to discuss the findings of the visit. What the service does well: The Haven presented as a friendly and informal environment in which the service users were able to undergo a relatively formal programme of recovery and rehabilitation to achieve continued sobriety. It was apparent that the service users were relaxed in the home and felt respected by the staff. The service users were of the opinion that the manager had achieved a good balance between informality and the very rigid structure used in some rehabilitation units. One care manager stated, “Placing people in rehab. units is based on the ‘horses for courses’ approach – some individuals need a lot of structure and set boundaries whereas others need a more relaxed approach. This is up to people like me to assess. The Haven has been very successful with both of my clients”. It was also apparent that a good relationship existed between the service users and the staff and that the service users were not reticent to offer their views and opinions even in front of staff. Some of the comments provided by service users included: “The staff are incredible – they support you and build you up”; “I’ve got my life back”; “I’ve been to other units – they don’t give you the support I’ve had here”; “The staff treat as an adult here – it’s up to you whether you succeed or not”; “The staff don’t push you (with the recovery programme) – they give you all the help you need”. An important part of the recovery programme was the promotion of the service users’ independence and the support required to enable them to eventually live independently within the community. According to the manager, the unit has a high success rate with approximately 82 of service users retaining sobriety six months after leaving The Haven. Diversity and equality was addressed for the service users as an integral part of the recovery programme so not to disadvantage those service users, for example, with literacy or numeracy skills. By ensuring that all prospective service users visit The Haven before Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 6 their admission for an interview ensures that their assessment is reasonably accurate and that the placement will be within the remit of the home. A Care Manager who had recently attended The Haven for a review meeting commented in the survey: “I was greeted with courtesy and hospitality. The meeting was handled professionally and effectively. Feedback from the resident was god and was given in private”. What has improved since the last inspection? 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. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service”. Prospective service users and Placing Authorities are provided with sufficient information on which to make a considered decision regarding a proposed placement. Some of the information in the Service Users’ Guide is, however, somewhat inaccurate and could be misleading. EVIDENCE: In spite of the requirement made during the previous inspection, the home’s Service Users’ Guide or brochure had not been reviewed or amended. As previously identified it needs to include details of the staffing arrangements and whether there is 24-hour staffing coverage. It refers to the ‘twelve-step’ approach for recovery but again does not provide sufficient detail on how it is to be addressed. Some of the ‘house rules’ also need to be better defined. For example, the written information states that a service user will be excluded from the programme if they relapse and take an alcoholic drink, whereas in practice this may not always be the case. The manager fully acknowledged the need to update the Service Users’ Guide and provided assurance that they fully intended to do so. In mitigation they said that the action had not been taken due to pressure of work (i.e. sudden increase in client numbers due to the closure of another unit) and the fact that they had also been off sick for several weeks. Since the previous inspection the manager and staff had Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 9 developed a ‘user friendly’ web site. This site contained basic but relevant information on the service provided and advice on how to access the service. It was evident from discussions with the service users that they had been provided with adequate information in order that they were able to make a considered decision as to whether to be admitted into The Haven. They were all aware, for example, of the ‘house rules’ and all agreed that they were applied fairly and sensibly. In addition to a written assessment, every prospective service user had been interviewed on a one-to-one basis either by the manager or the support worker. The service users said that during this interview the programme of recovery was fully explained to them. This process also enabled the manager to assess the appropriateness of the proposed placement. The manager provided examples where a prospective service user had been refused admission. The outcome and decisions made during the assessment interview were not, however, recorded. During the assessment the prospective service user was given the opportunity to look around the premises and meet other service users. In addition to the contract provided by a placing authority, each service user had signed an ‘agreement’ with the home. This included their agreement to abide by the conditions of residence and the ‘house rules’. The service users were fully aware of this agreement and understood its implications. Copies of the agreements and contracts were retained with the respective service user’s records. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service”. The service users are provided with sound staff support and are consulted on all aspects of life in the home. They are also provided with a range of opportunities to obtain sobriety and learn life skills to enable them to live and function independently within the community. EVIDENCE: The core care plan for the service users was the ‘twelve steps to recovery’ programme which is a ‘staged approach’ to achieving and maintaining sobriety. All service users were expected to have undergone detoxification treatment prior to their admission into The Haven and consequently not be taking alcohol or un-prescribed medication/drugs. The service users had also been provided with a care plan that was based on their initial assessment and was tailored to the needs of the individual service user. The staff had closely monitored the progress of the service users on a daily basis. This was reflected in the care records. This process of ongoing assessment was achieved through group therapy sessions and individual counselling. In addition to the care plans a Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 11 weekly progress report was available to the service users and the placing authority. One Care Manager stated in the survey record that ‘they had to chase progress reports and was not kept informed automatically’. The Senior Support Worker accepted this comment. It was therefore recommended that arrangements to keep placing authorities informed of service users progress was agreed during the admission process. A major part of the service users recovery programme included personal development particularly the promotion of independence, self-discipline and personal responsibility. This was achieved, according to the service users, by encouraging them to make decisions for themselves although the consequences of such decisions would normally be discussed with the staff in the first instance. An observed example of this included a service user who was in the process of claiming state welfare benefits. It was apparent that the service users had a degree of ownership of their environment and to a reasonable extent could take actions and make decisions without reference to the staff. The promotion of independence was seen as being particularly important by both the staff and the service users in order that the service users may be successfully integrated within society. According to the service users and the staff considerable emphasis was placed on ‘trusting’ individual service users for ultimately the success or failure of service users rested with them. Emphasis was also placed on confidentiality of information. An appropriate balance had been achieved between the service users access to information and the security of personal and sensitive information. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service”. The service users are encouraged to make maximum use of community facilities as an integral part of their independence and social skills training thereby assisting with their reintroduction into the community. EVIDENCE: As previously stated in this report a major element of the recovery programme was the promotion of personal development for the service users. In many cases service users had lost their life and domestic skills due to their addiction. Regaining these skills was achieved in a variety of ways including staff assistance with budgeting, re-learning domestic skills such as cooking and laundry and encouraging contact with the community through involvement, for example, in voluntary work schemes. The service users also had the opportunity to attend educational classes on subjects of their choice. These included developing IT skills and improving literacy and numeracy skills. An ex. service user who was working as a volunteer in the home was undertaking Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 13 a computer-networking course at Hull University. The service users also had the opportunity to participate in range of social activities both within and external of the home. The service users provided examples of these. The service users were encouraged to maintain or renew contact with their families. They confirmed, however, that in some instances this could be difficult and upsetting as relationships had been badly damaged by their addiction. The service users confirmed that once established on the programme of recovery they had the opportunity to visit friends and family particularly at weekends. Where necessary, support was provided by the staff to enable them to do so. The biggest fear expressed by the service users was prospect of eventually leaving the security of The Haven on their completion of the recovery programme. It was evident that this process was, however, carefully planned with the support of the staff. It was also, where possible, undertaken in stages so that the transition to communal living was as stress and risk free as possible. The service users confirmed that they were able to arrange support in the community, such as having a ‘sponsor’, prior to them leaving the home. They also stated that they would still be able to contact The Haven if they felt the need. The service users said that they were treated with respect by the staff – “like adults not children”. They also said that it was not a ‘them and us’ situation but that the staff saw them as equals. It was very evident, for example, that the service users felt able to voice their views and opinions in front of staff and to openly raise any problems or issues. The menus indicated that the meals are fairly ‘traditional’ but are varied and nutritious. Whilst the service users got their own breakfast and tea, the Registered Person generally produced the main meal. The service users comments in relation to the meals included, “They’re ok most of the time” to “They’re fantastic”. One service user commented that, “In some rehabilitation units meals are of a five star standard and you can have them in your room but it doesn’t help you overcome your addiction”. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service”. The service users health care needs are met through good liaison by the home’s staff with the local healthcare services. EVIDENCE: The service users expressed complete satisfaction with the service provided by the home, particularly the support provided by the staff. It was evident from the discussions with the staff and service users that the programme incorporates a holistic approach to rehabilitation by not only addressing the service users’ addiction but also by addressing those personal skills required to live independently within the community whilst maintaining sobriety. It was evident that a close but professional relationship existed between the staff and the service users. This approach had lessened any reluctance of the service users to be open with their concerns or views. Specific comments by service users included: “I’ve been to other (rehab.) Units and they don’t give you the support I’ve had here”, “Some rehab units are too rigid and others too relaxed. This is right and prepares you for living on your own” and “The staff are incredible – they support you and build you up. I’ve got my life back”. Emotional support for the service users was seen as extremely important Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 15 particularly during the early stages of their recovery when they were at their most vulnerable. The service users confirmed that there is always a staff member available to talk to “even at four in the morning”. The records confirmed that the service users had good access to local health care facilities. The manager stated that problems existed in accessing a local NHS dentist and that consequently use had to be made of the on-call emergency dentist. All of the service users were registered with a local medical practice. In keeping with the overall philosophy of the home with regard to the promotion of independence, the service users were encouraged arrange their own medical appointments with, where necessary, the assistance and advice of the staff. Service users’ medication was appropriately secured with the key to the drugs cabinet being carried by the senior member of staff on duty. The Medication Administration Records (MAR) were complete and up to date. It was a stated requirement by the home that service users declare all medication on their admission into the home. Trained members of staff then administered it at the appropriate times. As an integral part of their life skills development training the service users were encouraged, when assessed as being ready, to take partial responsibility for the administration of their medication. They were consequently issued with daily medication dispensing strips. This generally only applied to non-prescribed medication such as vitamin tablets. Prescribed medication continued to be administered by the staff. The administration of the medication was discussed at length with the senior support worker who was responsible for the process. He stated that many of the procedures in the home were, to an extent, based on trust of the service users. The rationale being that the home was endeavouring to make the service users take responsibility for their actions as they would when living independently within the community. Whilst there were no controlled drugs in use at the time of the inspection, the senior support worker, who was a registered nurse, demonstrated a sound understanding of the procedure required for such medication. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 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 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service”. The internal and external network of support provided for the service users should ensure that they are adequately protected and have the opportunity to raise any concerns. EVIDENCE: The home had an appropriate complaints procedure that was accessible to the service users. The service users were aware of the procedure and were confident that they could use it. It was evident that the service users had a high ability level and consequently were able to make complaints independently through whichever source they wished. They all had contact with a representative of their placing authority and past evidence showed that the service users were most likely to make a complaint via their care manager/social worker. It was also evident that they were not reticent to voice their views and opinions and they were generally of the opinion that problems and issues would be resolved before they became a formal complaint. An Adult Protection procedure was available. The manager demonstrated a satisfactory understanding of the process. It was conclude from discussions with the staff and service users that any serious issue would be quickly identified, either internally by staff or service users or externally by health and social care professionals. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 17 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, 27 and 30. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service”. The service users are provided with an environment, which is domestic in character and is suitable for their needs. EVIDENCE: All of the bedrooms used by service users were inspected. They were reasonably furnished and decorated. Two bedrooms were in the process of being redecorated following major refurbishment that consisted of converting a double bedroom into two single rooms. The manager said that this was to further promote the service users’ independence in line with the lifestyle they would experience on leaving The Haven. It was evident that the majority of the service users had brought personal belongings with them. The service users expressed satisfaction with their accommodation and confirmed that they had unrestricted access to their bedrooms. Whilst the bedroom doors had locks fitted these were not used as it was the stated policy of the home that the staff must have unrestricted access to all parts of the premises at all times. It was also a concern of the staff that the use of door locks could undermine the ‘trust’ element of the home and encourage some service users to become Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 18 isolated in their rooms particularly during the early stages of recovery. The bedrooms were clean and reasonably tidy. The cleanliness of the rooms was the responsibility of the occupants as part of their life skills training. The service users confirmed that they had allocated time in the mornings for such domestic tasks and that this did not encroach on the recovery programme. The staff undertook weekly checks of the bedrooms. It was confirmed that there were adequate toilets and bathrooms available to the service users that ensured their privacy and dignity and took into account their gender. The lounge was located on the ground floor and doubled as a group and training room during the day. The lounge had recently been redecorated and refurbished with new carpets, curtains and furniture. It presented as being domestic in character. The lounge was a ‘smoke-free’ zone with service users able to smoke cigarettes either at the front of the building where there is appropriate seating or in the rear lounge. The rear lounge also had equipment, such as weights, for the service users to keep physically fit if they wished. There is also a ‘games room’ with a pool table, television and a selection of board games and books. The dining room was furnished to an appropriate standard with the service users sitting in pairs at small tables. The laundry room and kitchen were clean and of a good standard of hygiene. The home had a close circuit television (CCTV) that monitored the main entrance door, which is always open during the day, for security purposes. The monitor for the CCTV was located in the manager’s office. On the day of the inspection the main road at the front of the property was being re-surfaced and consequently there was no access for cars. This work was apparently going to take approximately three weeks to complete. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 19 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, 34 and 35. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service”. The service users are supported by experienced, qualified and enthusiastic staff that gives unqualified precedence to the service users’ needs. EVIDENCE: As in keeping with similar alcohol rehabilitation units, The Haven had essentially a ‘core staff’ team supplemented by volunteers. The basic staff team consisted of the Registered Provider, the manager and a senior support worker. There was also an external counsellor who was used on a ‘sessional’ basis. The primary aim of the staff was to provide the service users with support, advice and encouragement to enable them to achieve and maintain sobriety. It was also an aim to provide the service users with the skills to enable them to eventually live independently within the community. Both the manager and the support worker were appropriately qualified and were experienced counsellors. The volunteers used by the home were recovering alcoholics and were able to relate to the service users and assisted in group discussions as well as other routine tasks such as shopping and driving. The manager and senior support worker saw this balance of experience as being vital so that the service users could be provided with a service that was objective and professional in its approach. It was evident from discussions with Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 20 the service users that they related well with the staff and spoke of them with considerable praise and respect. The staff provided twenty-four hour coverage and were, according to the service users, always available during the day and night. Two staff records were examined. These confirmed that all staff, including volunteers, had been appropriately vetted although the CRB checks had yet to be finalised. With such a small staff team it was deemed appropriate to have formal staff meetings or supervision sessions as these were undertaken on an ongoing basis. From the discussions with the staff and the service users, it was apparent that the staff had a good understanding of the service users’ needs and of those elements of care such as the promotion of independence and choice that go to ensuring that the service users were able to live a meaningful lifestyle within the community. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 21 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): 34, 38, 39, 41 and 42. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service”. The manager has a clear understanding of the aims of the service and has communicated those aims to the staff and the service users. EVIDENCE: The manager had been working in the home for a considerable number of years and as manager for the last two years. She was in the process of applying to the Commission for Social Care Inspection to be registered as manager but this process had been delayed due to her recent illness. In addition to professional qualifications for counselling she had achieved a National Vocational Qualification at level 4 in management and had recently completed the Registered Manager’s Award. The Senior Support Worker, who was also the deputy manager, was a Registered Mental Health Nurse. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 22 The manager, with the assistance of the Senior Support Worker, had made considerable progress in developing the role of The Haven. During the last two years, for example, the programme of recovery had been ‘formalised’ so that included the complete ‘twelve-step’ programme as opposed to the rather ‘adhoc approach in place prior to her becoming manager. Greater emphasis had also been placed on promoting the service users’ independence, encouraging them to take ownership over their lives and providing them with a greater range of educational, social and work opportunities. The latter had been achieved by forging good links with the community particularly through members of a local church. The service users expressed considerable respect for the manager. It was observed that the manager had established a good balance between informality and a professional approach to the recovery programme. For example, she had introduced an ‘open door’ approach to management and insisted that the service users must have unrestricted access to her regardless as what other things were going on. The manager had recently purchased a Quality Assurance Monitoring Package and the she was in the process of adapting it for use at The Haven. The quality assurance process will be verified through future inspections of the home. The home has previously achieved a quality award issued by the Humberside Training and Enterprise Council. A number of policies, procedures and records were examined including the accident and fire safety records. These had been maintained to an acceptable standard. The records also confirmed that the staff had received training in health and safety matters and that the manager had taken reasonable steps to ensure a safe environment for the staff and the service users. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 23 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 2 2 2 3 3 4 3 5 3 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 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000019743.V293522.R01.S.doc 2 3 3 4 3 LIFESTYLES Standard No Score 11 4 12 3 13 4 14 4 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 3 X 3 3 X Version 5.1 Page 24 Haven Residential Rehabilitation Alcohol Dependency Unit The Are there any outstanding requirements from the last inspection? Yes 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 Regulation 5 Requirement The Service Users’ Guide and Statement of Purpose must accurately reflect the service provided, the staffing arrangements and details of the recovery programme. (Previous requirement – timescale of 01/03/06 not met). 2. YA37 8 The manager must apply for registration to the Commission for Social Care Inspection (Previous requirement – timescale of 01/03/06 not met). 01/11/06 Timescale for action 01/11/06 Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 25 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. 2. 3. Refer to Standard YA2 YA6 YA34 Good Practice Recommendations Information gained during a prospective service user’s preadmission assessment interview should be recorded. The progress of service users should be regularly and automatically communicated to their placing authority. The manager should advise the CSCI when CRB checks have been completed on the staff and volunteers. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V293522.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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