Inspection on 09/05/07 for Hebron House

This inspection was carried out on 9th May 2007.

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 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 06/02/06

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 Unannounced Inspection 9th May 2007 11:15 Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hebron House Address 12 Stanley Avenue Norwich Norfolk NR7 0BE 01603 439905 01603 700799 mo@hebrontrust.co.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) Hebron Trust Position Vacant 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.V341245.R01.S.doc Version 5.2 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. 6th February 2006 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. The accommodation charges are £635 per week. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers the service to people. The key inspection has been carried out by using information from previous inspections, information from the providers, residents and staff, as well as other health care professionals who visit the home. This report gives a brief overview of the service and the current judgments for each outcome group. What the service does well: What has improved since the last inspection? The Hebron Trust was reorganised in January 2007 with changes to the membership of the Board of Trustees and to the managerial team of the home. The re organisation has prompted a number of other changes in the service and include better focussed individual programmes with additional therapy groups and opportunities for the residents to feedback on their progress and feelings. Some of the domestic and recreational programmes have also been reviewed as part of the overall review of the service and to ensure that they can be tailored to fit each resident’s agreed recovery programme. The agency are also continue to develop better links with outside agencies and maintain good working relationships. The office arrangements have also been improved providing designated work space and IT equipment for the staff and the project manager. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 6 Refurbishment and general maintenance of the property is ongoing and has included redecoration and replacement of furnishings and equipment. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 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.V341245.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,3 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The women using this service are provided with detailed information so that they can make an informed choice, and are confident that the service can meet their assessed needs to achieve their recovery from drug/alcohol dependency. EVIDENCE: As part of the major reorganisation the Statement of Purpose for the service has been revised and re-issued. Other client information has also been updated setting out clear, but stringent guidelines for the service and how it works. Two of the five clients files were seen on the day and contained a full assessment of need with evidence to support clear information being provided to prospective clients prior to admission. There is a signed contract and agreement to the limitations and restrictions set as part of the recovery programme. The aim of the treatment programme is recovery and rehabilitation, and prospective residents are encouraged to set their own goals, length of stay and future outcome. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key inspection Standards 6,7,9 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. A therapeutic and structured programme of recovery is provided to promote and achieve resident’s independence and resettlement in the community. EVIDENCE: There is now a therapeutic and resettlement group in place which residents can access and use as they move through their own step programme. Care plans seen on the day showed that the staff of the home are committed to providing an individually tailored programme that meets the needs of the residents. The plan of care includes a risk assessment which looks at all elements of daily life and external activities. Residents seen on the day commented positively about their own programme and how they are benefiting from the process. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16,17 People who use the service experience excellent quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The service provides a good choice of leisure activities with access to the local community and other support networks, including contact with their families within the limitations of the individual programme. Residents are valued and respected by staff and their personal health and well being promoted. EVIDENCE: Talking to two residents on the day of the inspection they said that their personal programme offered opportunities for social time and reflection as well as taking care of their personal health and diet and improving their wellbeing. The residents can also attend community activities; NA and AA meetings; community support groups or listen to successful recovery speakers. Leisure activities are also available such as swimming and creative arts and crafts and educational services if they are appropriate. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 11 The Hebron Trust is a Christian based service, but residents are not required to make any religious commitment and can choose to attend services if they wish. Residents confirmed that they are not pressured about religion or faith, but have found the ethos of the home comforting and supportive. Depending on each individual programme residents can have contact with their children or specific family members within the terms of the agreement made on admission. Residents said that they felt respected and valued by staff and spoke of excellent support and also enjoyed being involved in the household arrangements. One resident said that her domestic skills and knowledge had been limited on admission but had been encouraged and supported by the staff to cook, use recipes, plan menus and be more aware of food and food values and now feels confident and competent about this newly acquired skill. As a small home there is no dedicated catering staff. Residents are responsible for the menu planning, meal arrangements and shopping. Some of the residents have sound catering and dietary knowledge and are happy to put them to good use. The menus are devised with individual dietary requirements in mind and also to provide well balanced diet. Menus are planned ahead, but there is flexibility in how the meals are served and this will depend on personal choice and activity of the day. One of the comment cards said that when the residents are mainly responsible for the household and catering duties that standards can differ and are not always consistently maintained. In the discussions the manager was able to say that more attention and monitoring is in place and residents are helped to provide wholesome quality meals and maintain good levels of housekeeping. As part of the programme planning one day a month is set aside for major house cleaning and gardening tasks to ensure standards are maintained. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key inspection Standards 18,19,20 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The service provides good systems of care and support that promotes resident’s individuality and well -being. The procedure for the management of medication protects and safeguards residents. As part of the treatment programme for drug and /or alcohol addiction it is not appropriate that residents manage their own medication for the duration of their stay. EVIDENCE: As part of the organisational changes the service no longer offers detoxification as part of the programme. Since that change the service has encountered difficulties in confirming placements for prospective clients to coincide with other support or treatments and who must have completed the detoxification process prior to admission to the home. The service are looking to reintroduce an in-house detoxification service and have put forward a proposal for consideration and are seeking advice and guidance from the CSCI Pharmacist Inspector. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 13 As part of each individual treatment programme residents at this home do not manage their own medication for the duration of their stay. If changes are to be made to the present system then a review of the external support and safe storage of medication will be carried out. Substantial changes have been made to the treatment programmes as part of the reorganisation of the service. The Joshua programme for the service, redesigned as part of the new structure, offers a wider range of therapeutic activities with a greater emphasis on residents managing their own lives and recovery programme. Additional options are available and include computer work, parenting groups, daily reviews, cognitive behaviour therapy and choosing change. Full health care screening is carried out on the day of admission and medication reviewed and checked at the same time. Residents confirmed that the service meets their personal needs and in one comment card received it was said that the service exceeded their expectations and had ‘given them their life back’ They also said that they are well supported by the Care Coordinators and counselling staff who are very approachable. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Inspection Standards 22,23 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. Procedures are in place to protect residents from abuse and self harm and that their concerns and complaints will be listened to and acted on. EVIDENCE: Residents and staff confirmed that the complaints procedure is good and there is an open approach to dealing with issues and concerns and ample opportunities during the group sessions and meetings to raise matters for discussion. There are procedures in place for the protection of vulnerable adults and staff are aware of the signs and symptoms of abuse and self neglect. However, specific training on protecting vulnerable adults needs to be updated for all of the staff. See recommendation. Child protection training has also been completed by a small number of staff as part of the protection process for children who visit the home. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key inspection Standards 24,30 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The home provides a comfortable and safe environment for residents. EVIDENCE: Only a brief tour of the ground floor was undertaken and those areas seen were clean and well maintained to a good standard. Since the last inspection substantial repairs have been carried out to the roof of the premises, replacement boiler and upgraded and refurbished kitchen. carpets have been replaced in the sitting room. The dining room carpet which gets heavy use and is showing signs of wear and tear is due to be replaced this year. Communal rooms and the kitchen and utility room have been redecorated recently which has improved the overall service area used by residents. Residents said that the home is comfortable and homely and that the facilities provided meet all their needs. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Inspection Standards 32,34,35,36 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. Residents are supported by skilled and experienced staff who can confidently and competently carry out their roles and responsibilities. Staff receive appropriate training and supervision but refresher training needs to be brought up to date. EVIDENCE: There is a clear policy on the recruitment and selection of staff including volunteers. Personnel records seen on the day confirm that references and proof of identity and appropriate qualifications are checked as part of the process. A number of staff changes have taken place as part of the reorganisation of the service. Two Care Co-ordinators have been appointed; one with responsibility for the therapeutic input and the second one who is responsible for the life skills and resettlement programme. In addition there are six other staff who act as support workers and counsellors and two who assist the Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 17 Project Manager to administer and run the service. There is also a small team of volunteers. The staff have a wide range of skills and experiences in supporting and counselling people with drug and alcohol dependency. The residents said that the staff are excellent counsellors and appropriately qualified to help them recover from their addictions. They also said that the staff team are open and honest and ‘you know where you are with them’. One resident said that they had been through a number of recovery programmes and had only lasted ‘a couple of weeks’.’ I have stayed here for four months and I know that I am going to succeed this time.’ Staff receive both internal supervision and external counselling support on a regular basis. Appropriate training for staff is in place. In 2006/7 staff attended a range of courses including First Aid; Health and Safety in a Care Home; Management of Medication; Reporting and Recording; Conflict Management; Introduction to Dual Diagnosis; Understanding Eating Disorders and Self Harm; Food Hygiene. Future plans include mandatory training and courses in computer skills and eating disorders and cognitive behavioural therapy. Refresher training in protecting vulnerable adults and protecting children from abuse has yet to be completed. See recommendation Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key inspection Standards 37,39,40,42 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The service is well managed and resident’s rights and interests are protected and promoted by good policies and procedures. The manager should submit an application to register with the CSCI. EVIDENCE: The Hebron Trust has undergone a number of changes in the last year to both the Board of Trustees and the managerial structure in the home. The Board of Trustees are qualified to a senior managerial level in their own field of expertise in business and education. The new project Manager has been in post since March 2007 and has yet to be registered with the CSCI. It is anticipated that an application will be submitted in early June 2007. See Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 19 recommendation One resident said that the staff changes had not really affected them or their care other than they thought the service had improved and is better organised and that the support staff seemed clearer about their own roles and responsibilities. Both Care Coordinators spoke confidently and enthusiastically about the reorganisation and how the programmes have been revised with better and additional sessions available to the residents. Residents now have the opportunity to attend more leisure and interest groups as well as counselling and support groups – some uniquely tailored to deal with possible relapses or target setting and step groups offering a range of topics. Individual risk assessments are in place for each of the residents. Generic risk assessments for the premises and some equipment are in the process of being reviewed, but have yet to be completed. Residents are involved in the domestic, laundry and catering processes in the home on a day to day basis and the review is identifying the obvious risks and safeguards. See recommendation The management carry out internal quality audit each year and are also externally accountable to the National Treatment Agency and European Association for the Treatment of Addiction. The agency are also monitored in relation to their quality assessment framework by Norwich City Council who contract services with the Trust. The outcome of the quality audit is made available to all the network agencies and staff and both past and present clients. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 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 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 3 x 3 x Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 21 None. 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. 2. 3. Refer to Standard YA23 YA35 YA37 YA42 Good Practice Recommendations It is recommended that the management provide training opportunities in protecting vulnerable adults and protecting children from abuse for all staff It is recommended that the project manager for the service submit an application for registration as soon as possible. It is recommended that the management review the policy and procedure for the home and extend the risk assessments on the domestic and household equipment used by residents. Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hebron House DS0000027445.V341245.R01.S.doc Version 5.2 Page 23 - 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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