Inspection on 06/02/06 for Hebron House

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hebron House 09/05/07

Hebron House 01/08/05

Hebron House 15/02/05

Hebron House 03/08/04

Similar services:

Nascent House

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

CARE HOME ADULTS 18-65 Hebron House 12 Stanley Avenue Norwich Norfolk NR7 0BE Lead Inspector Mrs Susan Golphin Announced Inspection 6th February 2006 10:00 Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hebron House DS0000027445.V275365.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. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hebron House Address 12 Stanley Avenue Norwich Norfolk NR7 0BE 01603 439905 01603 700799 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) Hebron Trust Ms Michelle Ruth Curtis Care Home 10 Category(ies) of Past or present alcohol dependence (10), Past or registration, with number present drug dependence (10) of places Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to ten (10) female Service Users may be accommodated who have past or present drug dependence, or past or present alcohol dependence. 1st August 2005 Date of last inspection Brief Description of the Service: Hebron House offers accommodation to ten women with a drug and/or alcohol dependency. The home is situated on the outskirts of Norwich within easy reach of local amenities and public services. The large family type house comprises of six single and two double rooms and communal sitting rooms and dining room. In addition there is an art/craft room. The main garden to the rear of the premises is well maintained. There is some off street parking space on either side of the premises. The home is supported by local GP practices, community services and other specialist health professionals. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection carried out between 10am and 3pm with the manager of the home Ms Michelle Curtis. The manager has a good understanding of the inspection process and uses the inspection positively and as part of the homes own development. Two staff and two residents were seen during the visit, and a brief tour of the premises was also undertaken. Five comment cards were received prior to the inspection and all expressed complete satisfaction with the service and support. Feedback on the day was given to the manager at the end of the visit. What the service does well: What has improved since the last inspection? A lot of work has been carried out on the internal layout of the house providing a cosier and more homely setting. The communal and activity rooms are less cluttered and improvements made to the lighting and general layout, which has improved the overall ambience of the rooms. Mandatory training is taking place on a more regular basis including refresher training. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 6 As a direct outcome of the therapeutic review carried out last year there have been changes made to the programme. In the revised programme some of the early restrictions which form part of the first phase of the recovery programme have been relaxed so that residents can receive letters after two weeks instead of eight. Weekend leave is also an option after the first twelve weeks given a successful initial stay. The programme is now significantly more tailored to each resident rather that the client /resident fitting into a formally structured regime. The more personal approach has also been adopted to ensure that the outcome and long term view is always the goal – which includes planning for independent living, employment and re-settlement- and where appropriate working to re establish family contacts with children. This has been a major move for the Hebron Trust who through the review and seeking the views of the users of the service recognised the need to adapt and revise the programme to achieve best practice and outcomes for residents – to focus on person centred care and successfully demonstrate it within the service. 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. Hebron House DS0000027445.V275365.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 Hebron House DS0000027445.V275365.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): 2,3 The home makes good admissions based on detailed assessments of need and formal contracts of care to promote recovery from drug and alcohol dependency. Prospective residents are clear about the service provided. EVIDENCE: Residents are clear about the restrictions and limitations placed on them as part of the recovery programme. A review of the care planning process is taking place to ensure that the complex needs of each person are recognised and acknowledged and can be appropriately met within the home’s own remit. The manager is looking to review the admission process so that the full range of prospective clients needs are known at an early stage and planned for. Equally that the skills and competencies of the staff are also reviewed to broaden their knowledge and understanding of peoples needs that is in addition to the drug and alcohol dependency. (see recommendation) Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 9 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 Residents are provided with a therapeutic and structured programme of recovery, which helps them to achieve and regain their independence and back into the community. EVIDENCE: The review of the programme has ensured that the tailored plan of care is focussed on the successful recovery and discharge rather than concentrating on the problem of dependency. The changes in the programme have moved the thinking away from the ‘nurturing’ approach and promoting residents to regain their independence and self-management. One resident seen on the day said that her stay in the home had been a success and whilst there had been lots of support from staff she had achieved the recovery herself. Another resident said that her expectations of the home had been met and also that the environment is both protective and supportive but allows each person to find their own way to achieve a successful recovery. One resident said that the management and staff listen to the residents and offer the right balance of support and independence. From the discussions and the comment cards received it was said that the staff are skilled and competent as well as having a good knowledge about the Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 10 service. Residents confirmed that their recovery programme was tailored to their specific needs and expectations. One of the staff also confirmed that the service looks at each individual residents needs based on their own risk assessment and in line with the agreed recovery programme. Positive examples of individual support and community activity were provided during the visit. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 11 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): 12,13,16 There are good systems in place for resident consultation and their involvement in the service and their own care. There is range of evidence that indicates that the resident’s views are respected and valued. Residents are involved in the purchasing, planning and preparation of meals. EVIDENCE: From the information and discussions on the day it is evident that whilst residents live and work within the agreed terms of the recovery programme, they remain central to their own care and actions taking responsibility for their own lives and promoting their own recovery from drug or alcohol dependency. Any individual lapses within the terms of the agreed contract are dealt with by the house community and help to promote decision-making and problem solving issues. Some residents are involved in further training and educational projects as well as input to voluntary work. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 12 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 Residents are supported and assisted with their own lives, which promotes their recovery and emotional well being and ensures that their health care needs are met. EVIDENCE: Staff and residents confirmed that the service gives a high priority to the personal health and well being of each resident. Key staff can be accessed to help residents achieve their personal goals and successful recovery. Residents also have the opportunity to improve their physical health and well being with help and guidance on nutrition, medical treatments and exercise such as swimming or aerobics relaxation sessions as well as attendance at the support groups such as the AA and NAA. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 13 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): 22,23 The home operates in such a way as to promote and protect the views of the residents. The homes policies and procedures help to ensure residents are safeguarded against abuse, self harm, or neglect. EVIDENCE: No complaints have been received by the home or the CSCI in the last year. Staff receive appropriate training in the protection of vulnerable adults and adult abuse awareness as part of the induction processes. Regular house meetings and 1:1 counselling ensure that residents are able to express their views freely. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 14 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): 24,28,30 Residents live in a safe homely and comfortable environment. The standard of décor in this home continues to be improved and upgraded. EVIDENCE: Since the last inspection considerable improvements have been made to the premises in that the hall and reception have been redecorated and stair carpets have been replaced to a good standard. Tasteful decoration and subtle lighting has added to the homeliness of the house and is altogether much more domestic in style and welcoming. The sitting room used by smokers has also been redecorated and furnishings replaced. The re-decoration and reorganisation of the art room has also been carried out and now provides a pleasant additional activity area. The plan to replace and refurbish the kitchen area and food storage has been agreed in principle and work on the upgrade is imminent and should be completed within the next six to nine months. A requirement was made at the last inspection in relation to this piece of work and will be reviewed at the next inspection to monitor progress. (see recommendation) Funding for maintenance of the roof has also been secured and work will begin soon. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 15 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): 32,35 The staff team works effectively to meet the needs and well being of the residents EVIDENCE: The home has a stable staff group with a wide range of skills and experience in supporting and counselling people with drug and / or alcohol dependency. The staff role is to support and enable the residents to achieve recovery from their dependency; meet their own needs and regain responsibility for their own lives through the personal plan of care. The ethos of the service is to remain focussed on the outcomes of the service for each resident, and how the service can enable residents to achieve their personal goals. The management continue to promote training in specialist areas of the work including cognitive therapy behaviour, accredited dual diagnosis courses, group work skills, understanding and working within professional boundaries. The Hebron Trust is also working in conjunction with PCT’s and other agencies with toolkits for training and promoting initial guidance skills in the workplace. During the discussions with residents it was said that staff may benefit from having a broader knowledge of how support groups in the community like Alcoholics Anonymous and Narcotic Anonymous function. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 16 Another resident suggested being able to have contact with people who have successfully recovered from their dependency and can share their experiences with others. The suggestions and ideas were passed to the manager for consideration and were well received. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 The home is well managed and there is a clear development plan for the home which is effectively shared with the residents and staff. EVIDENCE: From observations and discussions with residents and staff the home has a comfortable and relaxed atmosphere. The manager is focussed about the aims and objectives of the service and manages the home in such a way which puts residents first and foremost. The home has a Christian ethos but there is respect and understanding for those who hold other beliefs. Staff seen talked of good support and leadership and a commitment to listening to residents and developing the service to achieve best practice and outcomes. A small sample of records relating to CRB details for staff and volunteers were seen on the day as well as maintenance and monitoring processes to promote the safety and protection of the residents. Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 18 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 x 2 3 3 3 4 x 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 3 25 x 26 x 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x x x LIFESTYLES Standard No Score 11 3 12 x 13 3 14 x 15 x 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 x x 3 3 3 x x x x Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA3 Good Practice Recommendations It is recommended that the management continue to review the admission procedure for the home to ensure the criteria for the service and registration criteria are compliant so that the full range of prospective clients needs are known at an early stage and planned for. It is also recommended that staff knowledge and expertise about the standards and regulations for younger adults is reviewed to ensure clear understanding of the homes responsibilities to appropriately meet resident’s needs. It is recommended that the plan to upgrade and refurbish the kitchen areas be implemented as soon as possible. 2 YA3 3 YA24 Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Hebron House DS0000027445.V275365.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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