Inspection on 05/08/05 for Herbert Street

This inspection was carried out on 5th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Herbert Street 12/06/06

Herbert Street 21/02/06

Herbert Street 14/10/04

Herbert Street 17/06/04

Herbert Street 10/03/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Haven (The)

Charis

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

CARE HOME ADULTS 18-65 Herbert Street 2 Herbert Street London NW5 4HD Lead Inspector Franki Solomon Unannounced 5 August 2005 th 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 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 Stationary 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. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Herbert Street Address 2 Herbert Street, London, NW5 4HD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7916 5013 0207 813 5960 randeff@aol.com Rugby House Project Mr Ralph Graham Weller Care Home 9 Category(ies) of An alcohol dependent past/present (9), A(E) registration, with number Alcohol dependent over 65 (3) of places Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service can admit up to 3 service users between the ages of 65 and 75, in keeping with the above service user categories Date of last inspection 14th October 2004 Brief Description of the Service: The Herbert Street Scheme is a registered care home providing a treatment programme for people with long-term alcohol misuse problems. It is part of the Rugby House organisation which is a registered charity with its central offices based at 480A Holloway Road N7 6HT. The Herbert Street Scheme was developed for 9 people between the ages of 18 and 65 and can have up to three people over the age of 65, with long term problematic alcohol use who have abstinence as their treatment goal. The Scheme offers a highly structured addiction treatment programme and aims to enable service users to maintain and suport their long term abstinence. Herbert Street is in North London NW5 in a residential area minutes from Queens Crescent shopping facilities and a bus ride from Kentish Town and Camden Town. Parking is limited. The building is purpose built in two separate units, a house and a bungalow. There are five single bedrooms in the house and four in the bungalow. The house and bungalow are on the same site separated by an attractive courtyard garden. The communal facilities comprise two shared kitchen/dining rooms and sitting rooms, laundry facilities and courtyard gardens. There are three bathrooms and five toilets in the project. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Herbert Street Scheme, was registered as a Care Home by the Commission in 2002. This was the home’s first statutory inspection for the year 1st April 2005 – March 2006. The inspection was unannounced. The inspection took place over one day. The day was spent talking with the manager, examining records and documents, attending a staff handover, meeting with residents and staff. A tour of the house and the bungalow and seeing some of resident’s rooms with their permission. Feedback was given to the manager throughout the inspection. The inspector would like to thank the residents, staff and manager for their assistance and hospitality during the inspection. What the service does well: What has improved since the last inspection? The home’s Statement of Purpose has been revised to include the new manager’s appointment. Since then the manager had applied for registration with the Commission and been proved Fit under the Care Standards Act 2000. The home had contacted the Environmental Health in respect of mice and appropriate action had been undertaken. Window restrictors had been fitted. The monthly visit by an independent person from the home is now undertaken and reports forwarded to the Commission. The home has since the last inspection, had their Portable Appliances Test (PAT) undertaken as well as having had water test in respect of legionella. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 6 The home’s registration certificate was prominently displayed in the reception area. 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. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 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 standard(s) 2 The home undertakes a robust assessment of the service users individual aspirations and needs. The assessment procedures ensure that service users’ needs and development are met and enabled. EVIDENCE: The home offers short stay of a maximum of 6 months rehabilitation for people who misuse alcohol. To undertake the rehabilitation programme the home and service user both have to be confident that the assessment is thorough. The policy and procedure for assessment, records of a sample of service users initial assessment, and discussion with the manager and service users demonstrated that all arrangements were in place and were undertaken to assess prospective service users’ individual aspirations and needs. Service Users said the Scheme gave them a Handbook which also spells out clearly what and how the home operates. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 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 standard(s) 6, 7 & 9 The programme at the Herbert Street Scheme is thorough and ensures service users are fully involved in their on-going assessment and are kept informed of their individual care plan and the recording of their assessed and changing needs. Service users are encouraged and assisted to make appropriate decisions and to be fully involved as appropriate in the running of the home. EVIDENCE: Three Individual Care Plans were examined, discussions with the manager, and with service users demonstrated that Individual plans were the focus of the work with each resident. A keyworker system was in place and their individual programme was recorded. This was drawn up by the resident and their keyworker. During a handover it was evident that day-to-day changes and possible risks were part of the handover. The home’s programme has certain restrictions. The restrictions are discussed with residents. Service User Plans demonstrated that staff discuss service users’ development with them. Care Plans were reviewed on a regular and frequent basis to ensure service users were well informed of their development. Residents confirmed their Care Plan was discussed with them. Risk Assessments are a significant part of the programme. Risk Management Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 10 strategies were clearly spelt out in each case and recorded, reviewed weekly as part of the residents’s care plan and specifically reviewed at 10 weeks, 20 weeks and 3 months. Service Users spoken to were clear about Risk Assessments and reasons for restrictions. One service user compared Herbert Street with another project they had attended and said Herbert Street offered a very supportive programme from all staff. Residents said Risk Assessment and Responsibility for Self were discussed throughout the programme. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 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 standard(s) 12, 13, 15, 16 & 17. The Scheme is successful in it’s aim to enable service users to find paid work and to become independent, in addition to promoting and enabling residents to be part of and contribute to the community. Residents had strong links with the community and benefit from the support in home life skills, including cooking and budgeting for themselves. EVIDENCE: Residents were independent. Policies and procedures, Individual Service User Care Plans seen, discussion with the manager and discussion with the service users indicated the independence of residents, in finding employment and becoming part of the community was encouraged and part of the programme. The inspection was on a Friday and residents had made known to the community and collected and received items for a Yard Sale planned for the Sunday which residents Care Plans indicated service users were encouraged to utilise community activities. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 12 The programme discourages exclusive relationships in the home. Throughout the inspection staff were observed to interact in a friendly, respectful and appropriate way with service users. Appropriate and agreed contact with family and friends is supported. Interagency and statutory protocols were in place. Part of the programme is that service users prepare their own meals and are involved in menu planning as a group or individually. Weekly monitoring of nutrition was through daily observation, food cupboard storage checks and through the Life Skill Assessment undertaken on admission. Service Users development and health through appropriate nutrition was part of the programme. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 13 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 standard(s) 18, 19 & 20 Arrangements are in place to ensure the healthcare needs of service users are met. Service users are well supported in leading a full and active lifestyle. Service Users are independent and able to administer their own medication which is stored by the home. However, medication administration was not recorded appropriately. EVIDENCE: The manager informed that service users are generally independent. On occasion when a resident accommodated has a physical disability, support has been gained from an independent Domiciliary Care Agency. At the time of the inspection all residents were independent and able-bodied. The sample of pre-admission assessments seen included physical health and those records were transferred to the Individual Care Plan. All residents had access to a G.P. and with support of staff were able to access additional health care services as required. Alternative treatments such as acupuncture and relaxation techniques were available to ensure the wellbeing and development of service users. Medication was stored in a secure place in the home. However, of samples seen one set of medication and its administration records did not tally, viz; Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 14 actual medication held by the home did not match up with the number of tablets recorded. This raised concerns for the safe storage and disposal of medication and to the safety of residents. A requirement has been made. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 15 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 standard(s) 22 & 23. The home has a satisfactory complaints procedure and format for the recording of complaints received with evidence that service users feel their views are listened to and would be acted upon. Staff are aware of Protection of Vulnerable Adults policies and procedures and have had necessary training to ensure the protection of residents. EVIDENCE: There was a satisfactory complaints procedure in place at Herbert Street. There were no complaints during this inspection year. The Complaints records had no complaints and residents said they had had no complaints. Residents spoken to said they were satisfied and had no complaints. When asked, they said they felt safe to talk or complain to their key worker and if not satisfied they would talk to the manager, but they were insistent they were well supported, listened to and had no complaints. The Complaints procedure was known by both staff and residents. The home has a policy and procedure for the Protection of Vulnerable Adults (PoVa). The home maintains a record of all staff that have received training in the Protection of Vulnerable Adults (PoVa). Service Users handle their own money. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 16 Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 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 standard(s) 24, 27 & 30 Herbert Street Scheme provides homely and comfortable temporary accommodation but the décor is beginning to look tired. The home needs attention in terms of maintenance and cleaning to give residents a sense of pride in a well-kept environment. More thought could be given to people with disabilities in terms of the shower. EVIDENCE: The home offers short-term rehabilitation stays of up to 6 months. The size of the home and rooms were satisfactory and adequate. Fixtures and fittings were homely. At the time of the inspection items were being collected for the Yard Sale and were stored temporarily in the communal areas. Generally the home has taken into consideration the needs of people with sensory and hearing impairment. A requirement at the last inspection was made in terms of adapting the shower in the bungalow for a person using a wheelchair. However, although the Provider had undertaken the required action, the shower’s door was fitted incorrectly and opens the wrong way. This means a person in a wheelchair is unable to enter the shower. An Occupational Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 18 Therapist’s assessment, and the home’s appropriate action is required. The requirement has been restated. The home is starting to show signs of wear. The first bathroom in the house had a damp, possibly mouldy smell and looked neglected. The stair carpet was starting to fray. On the 1st floor the bathroom tiles needed fixing. One resident’s room was untidy and looked neglected. The floor needed to be vacuumed. The net curtain needed to be washed. In the upstairs the shower room looked neglected and needed a thorough spring clean. Tiles needed grouting. A requirement has been made. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35. Permanent staff are trained and supervised appropriately to ensure service users’ needs are met. EVIDENCE: Staff records and their training schedules seen demonstrated that appropriate staff training and supervision was given to ensure the well being and development of service users. Staff interviewed agreed their training needs were reviewed and met. The training reflected the service offered. Staff spoken to were enthusiastic about the training and support received and one staff spoke of the “excellent” support received from the manager as well as senior management. Service Users had very positive comments to make on the support provided by staff. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41 & 42 Service users have opportunities to comment on the service as appropriate to the structured programme of their rehabilitation and on their individual care and are enabled to make responsible choices. Service user care plans were generally very well kept. EVIDENCE: There is a weekly service users’ meeting. Group counselling and a keyworker system provide forums for discussion on service users’ views to enable service users to get the service most suited to their needs. Issues and views are monitored to review the service offered to residents. Supervision of staff takes place fortnightly. The manager has an open-door policy for service users to be able to approach and inform of their needs. The programme was to enable service users to take responsibility for the choices they made. . Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 21 The policies and procedures could do with an Index to enable easy access to necessary policies. A recommendation has been made. All certificates of appropriate safety inspection were seen and were up to date. The COSHH cupboard was secure. However, a resident’s empty room seen on a day that was sunny, lights and lamps were left on which created a fire hazard. The lamp was situated on a table in front of an open window and could be blown over by a breeze or curtain. A requirement has been made. Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 2 x x 2 Standard No 11 12 13 14 15 16 17 x x 4 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Herbert Street Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 2 x G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 20 Regulation 13(2) Requirement Timescale for action 25/09/05 2. 27 & 42 13(4)(a)( b)(c) 3. 30 23(2)(b)( d) The registered person must ensure that all medication administered to service users are recorded and that balances are accounted for. The registered manager must 10/10/05 ensure the shower in the bungalow is adapted to enable a person with a disability to have acces. This requirement is restated since the shower door was incorrectly fitted. The registered person must ensure lamps & lights in rooms are positioned safely. The registered manager must 15/12/05 ensure the home is clean and hygienic. 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 41 Good Practice Recommendations The registered person should consider having an index to the policies and procedures file to enable easy access to any named policy. G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 24 Herbert Street Herbert Street G58 s10348 herbst v213765 040805 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Centro 4 20-23 Mandela Street London NW1 0DW 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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