Inspection on 23/01/07 for Kintyre

This inspection was carried out on 23rd January 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kintyre 07/01/09

Kintyre 21/02/06

Kintyre 07/10/05

Kintyre 20/12/04

Kintyre 14/06/04

Kintyre 10/03/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Kintyre 1 Newton Road Weston Super Mare North Somerset BS23 1YP Lead Inspector Nicola Hill Unannounced Inspection 23rd January 2007 09:30 Kintyre DS0000008104.V321462.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 Kintyre DS0000008104.V321462.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. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kintyre Address 1 Newton Road Weston Super Mare North Somerset BS23 1YP 01934 620341 01934 620575 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) Western Counselling Services Limited Mr John Alun Davies Care Home 9 Category(ies) of Past or present alcohol dependence (9), Past or registration, with number present drug dependence (9) of places Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 9 persons aged 17 - 64 years Date of last inspection 21st February 2006 Brief Description of the Service: Western Counselling Services is registered with the Commission for Social Care Inspection (CSCI) and provides primary and secondary programmes of rehabilitation for up to 65 people between the ages of 17 and 64 years who have alcohol and/or drug dependencies. The bulk of the primary counselling programme takes place at a day centre and there are two houses (Meijer and St Davids), which provide accommodation for mixed sex groups on primary programmes. Three other houses, Larkhill, Kintyre and Clarence Park Lodge provide accommodation for single sex groups receiving secondary programmes. Kintyre provides up to 9 places. The counselling is based upon the twelve-step Minnesota model. These homes have a private arrangement with a local GP practice to provide medical support and assessments, especially for those who are in the initial part of the primary programme. The fees for the home are negotiable. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Kintyre is an all-female care home providing the secondary stage of treatment for rehabilitation from addiction. The unannounced key inspection of Kintyre took place with the inspector and the managing director, Amanda Lea, and the registered manager Alun Davies. The first part of the inspection process involved reviewing documentation at the administrative headquarters of Western Counselling Services. The inspector then made a site visit to the home with the registered manager. At the time of the visit there were 3 people in residence. Two of the residents and one member of staff were spoken with. The inspector gathered evidence for the report from the residents, staff, and documentation held at the home, and from the responses to the service questionnaire sent to service users by the Commission prior to the inspection. The home has been assessed as providing a good level of service What the service does well: Kintyre is an older, semi-detached property in a residential area it provides a secondary care treatment programme based on the 12 steps Minnesota model for those addicted to drugs or alcohol. The service provision meets criteria identified in research by the National Treatment Agency (NTA) to promote retention of service users in treatment, in that it is a small home with a good staff/service user ratio. The organisation has a good success rate with approximately 60 of service users completing primary treatment and 88 secondary treatment. The organisation is able to be flexible with the length of the secondary care programme, and offer after care on a weekly basis. The residents stated that they were able to appreciate the amount of knowledge they had gained about themselves since coming to Western Counselling Services. There was also recognition that the skills they had acquired by completing the primary-care program had prepares them for the relaxation in the daily structure in the secondary care programme. The small number of residents at the home reduced the amount of group support available. However the residents stated that they were comfortable and well Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 6 fed, and were enjoying their additional freedom but were very aware it came with responsibilities. The accommodation, whilst communal, is of an adequate quality and there are a variety of facilities available. Comments made on the service questionnaire included the staff are very approachable and treatments with respect and the house is very well-managed and is very safe and secure. 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. The summary of this inspection report can be made available in other formats on request. Kintyre DS0000008104.V321462.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 Kintyre DS0000008104.V321462.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): 2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff consider the residents applications for admission with the team to ensure that the home and programme is suitable for assessed needs. EVIDENCE: All the residents have an assessment undertaken prior to admission in to Western Counselling Services. This covers all aspects of their life including any mental health issues. The residents at Kintyre had followed up the primary care programme by going into secondary care. The 2 residents currently in Kintyre told the inspector that they chose to continue secondary care with Western Counselling Services. Information about the service came from personal recommendation, either from care managers or from people who had already been through the programme. Residents were able to visit the home before moving in, and as the new residents had already met established residents at the day centre, the transition from primary to secondary was easier. Residents also stated that the supported each other through the transition period. The group of residents ages ranged from 17-38; Kintyre is an all female home; the group was of mixed ethnicity. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 9 Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management and staff understand the importance of residents being supported to take control of their own lives. EVIDENCE: All of the residents have an individual care file. The residents had their individual needs reflected on the care plans, and there was evidence that plans were reviewed and evaluated on a regular basis. This is in line with the service specification for tier 4 services from the National Treatment Agency. However the risk assessments should be expanded to the explicit about risk management plans and contingency plans in case of relapse. The files were very detailed, well kept and informative. The home also records any visits to other agencies such as GP, probation officer. The care documentation at the home links together and can be used to track a residents progress from the initial referral with the presenting care needs to working through the programme, and the after care required on discharge e.g. housing. The planned discharge arrangements supported Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 11 residents to take responsibility for moving on from Kintyre. Residents can access the Internet and use the telephone to make enquiries and set up appointments. It is noted that for unplanned discharges, service users will have tickets purchased for them to travel to their home address, and that unless there is a clearly identified place to go, to the organisation will not discharge. The service commissioners are also informed of any unplanned discharges. Individual choice and decision making is subject to the limitations of the programme, however, all the residents stated they were treated as individuals and supported as such. The strict routine and house rules do require a period of adjustment, which varies with the individual. Within the home there are personal choices made about meals etc, and all residents can leave the programme if they wish to. The residents at Kintyre were in agreement that although the programme is strict, the end result was worth working for. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service actively supports residents to be independent and involved in all areas of daily living in the home. EVIDENCE: As part of the programme the residents can attend A A and N.A meetings. The home operates a programme of group therapy and group support so that the residents learn to deal with issues that arise for them and to support others. The resident group at Kintyre stated that they had learnt about themselves, especially through doing their life story, and by receiving feedback from their peers. The residents felt that the smaller group at Kintyre was insufficient to provide enough stimulation and challenge. The larger group in primary ensured that there were people who challenged them about their behaviour and therefore helps them to understand and learn about themselves. The residents were also aware that the programme at Kintyre was giving them additional skills in order to be successful with their recovery after discharge. Residents take responsibility for the planning of the day and all have allocated Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 13 tasks. The residents stated they were not involved in meal planning, although can take part in the preparation and serving of meals. The food was stated to be good, with choices available to them. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to health and remedial services and are supported to be independent in maintaining good health. EVIDENCE: None of the residents at Kintyre require support with personal hygiene however; all of the residents require personal support through the programme, which is provided through counselling on a one-to-one basis and through group therapy. The house rules support the development of personal-care skills and their sense of respect of themselves and towards their peers. All service users are supported to achieve optimum health and well being and are assessed on admission by the GP’s who support the home. Some of the residents have health care needs, which require external appointments such as hospital treatment, and local services are accessed when necessary. Residents are supported to be independent and to arrange and attend health care appointments. This ensures that residents understand how to access services when they have been discharged from the home. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 15 There are homely remedies held at the home such as paracetamol, however these are under staff control. No regular medication was held at the home at the time of the inspection. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents stated that they are very satisfied with the service provision, feel very safe and well supported by an organisation that has their protection and safety as a priority. One resident commented that they were aware of how to make complaints and that the procedure was available in the house. Kintyre ensures that all residents receive a copy of the complaint procedure. No complaints had been recorded at the home. There have been no adult protection issues at the home. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is comfortable and has a rolling programme to improve decorations, fixtures and fittings. EVIDENCE: Kintyre is an older semi-detached Victorian residence. The accommodation is reasonable and meets the needs of the client group for short term rehabilitation programmes. The bathroom and shower were mentioned by the residents as not being very pleasant and in particular the shower room is claustrophobic with limited ventilation. The inspector toured the building with the manager and noted that although the communal areas were very pleasant, the bathroom in particular required upgrading. The residents also mentioned that the heating at the home was variable. This was discussed with the directors for review as none of the radiators have independent thermostatic valves therefore the temperature around the home is dependent on the boiler temperature setting. The inspector also discussed the hot water temperature, which was too hot in the shower and bath; with no apparent anti scald devices Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 18 in place. The directors were advised that thermostatic valves should be fitted to the bath and shower, and all of the hot water taps should have a warning sign. This work will be undertaken as a priority. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service ensures that all staff within its organisation received relevant training that is targeted and focused on improving outcomes for residents. EVIDENCE: The inspector reviewed the recruitment records at the administrative office and the records confirmed that the organisations recruitment procedures are fully implemented. The home is not staffed on a 24-hour basis; out of hours staffing is by support workers, and on call counsellors. There is one dedicated counsellor who works in Kintyre alongside the registered manager. The statutory training for staff generally was up-to-date. The specialist skills training requirements, linked to the DANOS recommendations for support staff working in drug and alcohol rehabilitation, had been met as staff either had or were working toward equivalent counselling qualifications. The external supervision for counsellor staff is continuing, and this is supplemented internally by counsellor staff group meetings and individual supervision. The management ensures that a formal supervision/appraisal is Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 20 undertaken for staff this identifies individual training needs, and development plans for staff. The housekeeper at Kintyre enjoys working at the home and is supported by appropriate training. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach is person centred. EVIDENCE: The registered manager for the home Alun Davies, is very experienced and continues to work closely with the residents in the secondary stages of the programme. The managing director, Amanda Lea, takes responsibility for the quality assurance, budget management, training and staff supervision for Kintyre. The central administration office also deal with the financial accounts and building maintenance. Minutes for staff meetings are held at the organisation’s administrative office. The quality assurance carried out at the home includes collation of information relating to retention rates, service user satisfaction and completion rates. The Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 22 home also holds regular reunions, which are well attended and give an indicator to the success of the programme. Amanda Lea is undertaking regulation 26 visits and reports are currently sent to the commission with a copy being held by the organisation. Amanda Lea undertakes the monthly audits of the home. Other audits for areas such as the buildings and provision of domestic services, are undertaken by the managers responsible for these areas. The business plan for the forthcoming year has been circulated to staff prior to discussion at a staff meeting. The record keeping at the home is well maintained by the counselling staff; residents are aware that they have the right to see all records held on them. Monies are held on behalf of service users who are then supported to manage their finances. Whilst at the home there were two areas of concern about the health and safety implementation, the signage and lack of measure to prevent scalding from hot water, and the smoking areas. Health and Safety Executive policy in exempted premises guidance suggests that, where care homes have two lounges, one could be designated as a smoking area, while the other remains smoke free. Other measures include • Providing suitable ventilation in exempted premises, consistent with maintaining the comfort and functionality of the premises. • Minimising the time spent by individual non-smokers in designated smoking rooms. • Health promotion campaigns on smoking cessation. Currently the smoking policy for residents is that a window must be open when smoking, however, this affects the temperature of the room and the residents were observed to be sat in the smoking lounge in their coats because the room was cold. It was also noted that the door to the smoking lounge was open and an automatic closure may be advisable because of the risk of fire. The inspector was able to see records of testing and maintenance of equipment. The fire alarm system testing had been implemented appropriately, with regular testing of equipment and drills. There is a signing in and out book so that there is an accurate record of people in the building. The inspector reviewed the accident records for residents/staff, which indicated four minor incidents since April 06. The first aid box contents should conform to the contents listed on the guidance card. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 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 X 2 3 3 X 4 3 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 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 24 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 YA42 Regulation 13(4)(c) Requirement Timescale for action 23/07/07 2 YA42 13(4)(c) 23(2)(p) The organisation must ensure that any risks to health and safety of service users from hot water are identified and anti scalding measures fitted in the baths/showers. The organisation, in respect of 23/10/07 cigarette smoking, shall ensure that any unnecessary risks to the health or safety of service users are identified and so far as possible eliminated by employing suitable ventilation systems in areas where smoking is permitted. 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 YA20 Good Practice Recommendations Risk assessments should identify potential risks and possible triggers that may cause relapse or disciplinary discharge. The assessments should outline strategies for safeguarding the health and welfare of service users after DS0000008104.V321462.R01.S.doc Version 5.2 Page 25 Kintyre discharge. Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Kintyre DS0000008104.V321462.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!