Inspection on 17/01/07 for Long Yard

This inspection was carried out on 17th January 2007.

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

Other inspections for this house

Long Yard 08/12/05

Long Yard 24/06/05

Long Yard 12/10/04

Long Yard 20/05/04

Long Yard 03/02/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

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

CARE HOME ADULTS 18-65 Long Yard 8 - 9 Long Yard London WC1N 3LU Lead Inspector Ms Pippa Canter Unannounced Inspection 17 January 2007 10:00 th Long Yard DS0000010346.V287336.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 Long Yard DS0000010346.V287336.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. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Long Yard Address 8 - 9 Long Yard London WC1N 3LU 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) 020 7404 1117 0207 242 2206 jim.mcalpine@rugbyhouse.org.uk Rugby House Project Mr James Duncan McAlpine Care Home 13 Category(ies) of Past or present alcohol dependence (13), Past or registration, with number present alcohol dependence over 65 years of of places age (13) Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The home must amend its statement of purpose in accordance with regulation 4.1 The home must first inform the Commission, by telephone or fax of the prospective referral, if over 65 years old. Prior to the signing of the license agreement the home must first fax a copy of the relevant Needs Assessment to the commission. The home must highlight any incapacity and demonstrate how any physical or psychological need or incapacity is to be met by the home. The home shall have specific regard to regulation 13.6; 14.1 (a)-(d); 14.2 (a)-(b) 8th December 2005 Date of last inspection Brief Description of the Service: Long Yard (previously known as The Rugby House Project Crisis Centre) is registered under the Care Standards Act 2000 by the Commission for Social Care inspection (CSCI) as a Care Home. The project runs a non-medical detoxification programme and is just one of a small number of regulated alcohol rehabilitation services inspected by CSCI. Long Yard is registered to accommodate 13 adults. The lowest fee is £999.30, which is the contract price for Local Authorities and Primary Care Trusts, this includes a service user contribution of £40.01. The non-contract fee is £1147.79. The property is owned by Circle 33 Housing Association and has no disabled access. There are four double and five single bedrooms. Two single and one double are allocated specifically for detoxification of service users on arrival. The registered provider, Rugby House, has a range of innovative specialist alcohol and drug services and there is the opportunity for ongoing referral to access other rehabilitation options within the service. The service is for men and women who for a variety of reasons need a place of safety for stabilisation, a full assessment and detoxification from alcohol as part of an overall care package because they cannot access or make use of a community service. The stay is 2 - 3 weeks. The home provides support to adults who through chronic alcohol misuse have become a threat to themselves or others. Some 50 of the service users who come to Long Yard have more complex needs such as alcohol misuse, mental health problems, some drug misuse or dependency/ long-term use of prescribed drugs and housing instability. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 5 The home is situated in a cul-de-sac off Guildford Street in Central London halfway between Russell Square Tube Station and Holborn Tube Station. The home is in a small area of residential flats and offices and has a small shopping area within walking distance. There is no parking available. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over the course of one day by two inspectors, one of whom was updating her inspection skills. The visit lasted from mid-morning to mid-afternoon, about 5 hours in total. The manager was not available but representatives of the management team assisted the inspectors along with additional input from staff on duty and service users. Records such as care plans, assessments and menus were examined. A partial tour of the building was made. Two service users were asked for their views of the running of the service and talked about their experiences of being in the home. Staff were observed fulfilling their roles and responsibilities and were involved in general discussion with the inspectors. Prior to the inspection we looked at all the information we had about the home, including notifications of accidents or serious incidents, monthly reports about the conduct of the home sent by the provider and previous inspection reports. The manager had returned a pre-inspection questionnaire , which confirmed some useful information about the service. Comments cards were sent out to Care Managers and a GP surgery and two were left in the home for service users to complete. Any feedback received is reflected in this summary as well as the main body of the report. We reviewed all this information and used it to develop an inspection plan to enable us to focus on the important outcomes for service users. At the end of the inspection, feedback was given to a member of the management team and to the service users. A feedback form was left with the deputy following the visit so she could let us know how she felt about the inspection process. What the service does well: There was a lot of positive feedback from the Care Managers about the standard of care provided by this service. Comments from them included, “At present the staff team at Long Yard are particularly good, skilled at their jobs and very caring. All the clients I work with, who have detoxed there since this year (upwards of 20 people) have been extremely positive about the benefits of their stay.” “My experience is that this is a very professional, accessible service. Service users are given clear boundaries within an EOP framework. This friendly service (with its’ wonderful kitchen) is pivotal to my work as a care manager). I regard it as a centre of excellence.” Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 7 A service user recorded “ I am confident I will be listened to.” “Staff always treat me well, with respect and they are pleasant”. “I was made to feel really welcome. The staff are really helpful and supportive”. Long Yard provides an effective and efficient service for people who want to undergo detoxification from alcohol. The referral and admission process is designed to support the prospective admissions in a safe and structured environment. Any restrictions are known to referrals prior to admission. There are clear admission criteria to ensure that this non-medical service can meet service users needs effectively. The provider is keen to invest in the training and development of the staff team. This begins with a thorough and robust recruitment and selection process, induction procedure and training plan. Staff receive appropriate training to support the model of care they provide and are therefore well trained; and because of the Pathway process, the team have complimentary knowledge and skills. There are sound arrangements in place to ensure that service users’ health care needs are met whilst attending this time-limited service. Service users, in particular, acknowledged the excellent quality and variety of the food provided. The service maintains such a high standard and effective service because of the varied and comprehensive quality assurance systems. What has improved since the last inspection? What they could do better: There were no deficiencies recorded at the inspection although three areas of improvement were discussed with the management team. The recommendations are based on improving good practice. Although staff clearly receive in house training on the administration of medication, there are no written records available. There is a delay in minor repairs being completed e.g. a lock on a bathroom door. This can cause anxiety and does not promote privacy or dignity for service users. The inspectors have recommended that the management team negotiate a system of delegated maintenance with the Landlords. An inspection of a sample of policies and procedures showed that a general review and updating was called for. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 8 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. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 9 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 Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 10 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 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Long Yard provides an effective and efficient user focused service based on a comprehensive assessment of need and aspirations EVIDENCE: A requirement had been made at the previous inspection for the statement of purpose to be updated. The service forwarded a copy of the updated document to the Commission for Social Care Inspection prior to this unannounced inspection. It is judged to be a comprehensive document. The service user handbook explains the choices that are available within this time-limited service. As part of the inspection two service users were asked for their views about the service and two care files were looked at. Service users confirmed that they had made an informed choice to participate in the detoxification programme. They confirmed that the admission process is designed to support the new referral rather than be overwhelmed by it. Both said that they had received sufficient information about the service and that staff had taken the trouble to repeat information verbally several times as well have having it backed up in writing. This response bears out what the staff had said about the admission process. The service has clear and comprehensive admission Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 11 criteria. A full assessment is carried out for each new referral. Referrals being screened by the GP, Health Promotion Practitioner and the registered manager to ensure that the service can meet the needs of the prospective admission. As part of the supervision of staff, the management team reviews the case files of the service users being key worked, to ensure that the referral and admission process has been followed. A look at the case files showed that they contained detailed assessments. As the service offers a time limited and structured programme, service users commit to a care contract. This includes any agreed restrictions. A comment received from a care manager was “My experience is that this is a very professional, accessible service. Service users are given clear boundaries an EOP framework.” Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 12 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): Standards 6, 7, & 9 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users’ assessed needs are translated into a care plan, which supports them to face making changes to their lifestyle in a safe and supportive environment EVIDENCE: Service users make an informed choice to take part in the detoxification programme. The assessment and care planning process is ongoing within the first week. This ensures that service users are able to take an active part in the process. Discussions with the two service users identified that they have been fully involved in an assessment of social, emotional, physical, psychological and legal needs. Service users reiterated that they knew the programme would be structured and the reasoning behind the restrictions had been fully explained. Although the programme is structured they felt that choices were available to them. They are fully involved in decision-making processes. This is supported by the Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 13 one-to-one key working sessions and an open file policy so that service users are aware of what is written about them. All service users have full assessments carried out as part of a comprehensive risk management system. These assessments are available on file. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 14 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 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service provides a safe environment for service users to start developing healthier lifestyles as well as improve their self-esteem as part of their personal development process. Service users have access to a well-balanced and varied food selection. EVIDENCE: Two case files were examined and two service users were asked about their experiences of the service. The inspectors also attended a handover and spoke to staff about the ethos of the service and about the programme itself. Participation in the detoxification programme is time limited to three weeks but it is divided into two stages. A prolonged misuse of alcohol means that the first 48 hours can be a period of severe discomfit. Following this is a period of sobriety, in which service users are supported to explore alternatives to their previous lifestyles. Part of this support is for them to be involved in a Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 15 structured group work programme, which encourages social interaction and activities. A programme of activities is available both inside the project and service users are supported to access activities in the wider community. The case files looked at, reflected the development of health support networks and the build up of leisure activities that do not include alcohol. Service users were observed in the communal areas engaging in positive interaction with each other and staff. Within the project service users get involved in the day to day running of the community. This may be taking responsibility for chores e.g. vacuuming, dusting communal and private areas as well as helping out in the kitchen or participating in the weekly house meetings. Where relationships have been assessed as therapeutic, visitors are encouraged the first week… Service users are aware that restrictions are placed on visitors if they are likely to be detrimental to the service users’ progression with the programme and eventual recovery. The service employs a cook for 35 hours a week. Discussions with this staff member, showed that she is not only responsible for the catering arrangements but also has a therapeutic role supporting service users with their cooking and hygiene skills. As the stay is three weeks long, there is a three-week menu. Service users confirmed that there are alternatives available. Arrangements for meeting special diets for medical and cultural reasons are in place .A sample of the meal was taken on the day and was judged in the opinion of the inspector to be very good. All service users spoken to on the day complimented the food, and one expressed every superlative possible about the quality and choice available. A care manager has commented, “ This friendly service (with its’ wonderful kitchen) is pivotal to my work as a care manager.” Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 16 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): Standards 18, 19 & 20 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are efficient and effective arrangements in place to meet the health care needs of the service users. The policies and procedures in place for the administration of medication ensures the safety of service users. EVIDENCE: Two service users were asked for their views and two case files were examined. The inspectors sat in a handover, which included discussion on the physical and emotional care needs of the current group of service users observed staff interacting with them. Service users confirmed that they were very satisfied with the personal support provided. They were clear about what the service had to offer and felt that they had personal choices despite the restrictions imposed by the programme. They felt that staff kept pace with meeting needs and found them to be efficient and effective. One care manager commented, “All the Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 17 clients I work with (twenty plus), who have been detoxed there have been extremely positive about the benefits of the service.” The home has the support and input from a GP surgery. A full pre-admission assessment is part of the referral process and these are screened by the Project Manager, Health Promotion practitioner and the GP. The purpose of the screening is to ensure that the service does not admit any service user whose complex health needs they cannot meet. As an extra precaution accepted referrals are admitted at the beginning of the week so that if complex health issues arise, these can be dealt with promptly. On admission day all service users are seen by a GP. Assessments were seen to cover social, emotional, physical, psychological and legal needs. From the written records, observation of staff discussion during the handover it is clear that the staff have the knowledge and skills to meet the health care needs of the service users. The service has a policy and procedure on the administration of medication. It is clear and accessible although it is recommended that it is reviewed and updated. Staff confirmed that they receive in-house training in respect of administration of medication although there are no written records to demonstrate that staff have been assessed as competent. Please see recommendation 1. The staff group are supported by the Health Promotion Practitioner who is a nurse and has a wealth of knowledge relating to medication. The GP is regularly on site and is accessible to both staff and service users. Medication is ordered, stored, administered and disposed of appropriately. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 18 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): Standards 22 & 23 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users know that their views will be listened to and acted upon. They are protected from potential harm and abuse by the service’s stance on adult protection procedures. EVIDENCE: The complaints procedures was looked at and the complaints log examined. The complaint’s process was discussed with the management team and two service users. The service has a comprehensive and clear complaints procedure, which is known to service users. They confirmed that they feel confident to approach their key workers with any concerns that they may have. Staff were observed to be responsive to service users whenever they were approached. During the handover there were a couple of interruptions but staff dealt with these in a sensitive and proactive way. The pre-inspection information showed that one complaint had been received by the service since the last inspection. An examination of the complaint’s log showed that this complaint, had been clearly documented, thoroughly investigated and the complainant had received a reply. The service has an adult protection policy, which is linked into the local authority procedures. Staff recognise that the service users within the programme can be vulnerable adults because of their alcohol dependence and past abusive relationships. Service users are aware that liaisons are not Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 19 permitted because of the distracting and therefore detrimental effects for their individual programmes. Discussions with staff and the management team demonstrated that the service is clear about the balance of rights, risks and responsibilities. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 20 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): Standards 24 & 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service provides a homely and clean environment for the benefit of programme’s participants. Improvements could be made to the system for dealing with minor repairs. There are plans, which will enhance the accommodation and meet the future needs of the service. EVIDENCE: A partial tour of the home was made. The statement of purpose identifies that the premises are not suitable for service users with mobility problems. The project is reached by an external staircase and accommodation is ranged over two floors. Access to the first floor is via stairs. The service accommodates thirteen service users in a mixture of single and double rooms. This is based on the clinical needs for people who misuse substances. Overall the premises can be described as homely. The landlord is responsible for the cyclical decoration of the premises and the management confirmed that these were due. Rooms can be decorated outside of the planned programme. One area that it troublesome is the response of the Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 21 landlord when responding to minor repairs. There can be considerable delay to replace a lock on a bathroom. The inspection team advised that the provider may negotiate a system of delegated maintenance, whereby the project manager authorises repairs up to a fixed price and the contractor bills the landlord. There is an ongoing issue with establishing a long-term contract for cleaning the windows. Although the management team have looked into the matter, companies are not prepared to take on the job because of health and safety implications. A cleaner is employed at the home and service users contribute to the domestic chores within the project. Overall the standard of hygiene in the home is good. There were no odours detected. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 22 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): Standards 32, 34, 35 & 36 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The organisation is keen to invest in the training and development of the staff team, which in turns benefits the service users. Staff are competent and have an in-depth knowledge of alcohol misuse to ensure the best possible service is available to the participants. EVIDENCE: Training logs were looked at and inspectors observed staff practice and interaction as well as spoke to individual staff members. A comment received was, “At present the staff team at the project are particularly good; skilled at their jobs and very caring”. The pre-inspection information records that 19 staff are employed in the project. Although some of this information may have changed in the interim, discussion with staff identified that there is sufficient staff to meet the needs of the service users. Discussions with the management team and observation showed that the deployment of staff is in line with the needs of the service and ensures that the structured programme takes place. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 23 Staff confirmed that they have access to appropriate training to support the work that they do. The staff team is mixed in terms of gender and ethnicity and they come from a variety of disciplines and backgrounds therefore their knowledge and skills compliment each other. The provider enables ex-service users to become staff members within the organisation through the Pathway and SMART schemes. This brings a valuable dimension of personal experiences to the staff perspective. Although the service does not offer gender specific key working, it will respond to individual requests for a same sex key worker. Supervision is regular with supervision contracts drawn up and annual appraisals take place. Appraisals feed into a training needs analysis that will inform the internal training programme. The home exceeds the national minimum standard for the ratio of staff with an NVQ qualification; all staff have this bar one, who is soon to be enrolled on the course. Staff personnel files are held centrally. An inspector from CSCI examined two files at the providers’ head office. The evidence from the files demonstrated that the organisation has a thorough and robust recruitment and selection process. One that is based on good practice and equal opportunities. Provider is keen to invest in the personal and professional development of the staff within its’ service. There is a training plan available. Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 24 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): Standards 37, 39, 41 & 42 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well-managed service that is both efficient and effective. The service is run in their best interests and influenced by their views and opinions. Overall the service protects the health, safety and welfare of the service users. EVIDENCE: The registered manager was not available at this inspection and he is due to go on a sabbatical. The provider is aware to notify the “Commission” of the manager’s absence. A member of the existing management team has been identified to act up in his absence. She will have the necessary knowledge and skills to fulfil the role. The current manager has achieved the Registered Manager’s Award and has successfully completed the fit person process. He heads a management Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 25 team, with delegated responsibility for different areas of the service. The manager takes responsibility for the clinical, financial and building aspects as well supervising the remainder of the senior team. The remainder of the team is made up of a referrals and contract co-ordinator, who is also the health and safety representative and supervises members of the clinical and administrative team. There are two senior substance misuse practitioners who are responsible for the co-ordination of clinical care such as admissions, case files, care plans, management plans including risk and the supervision of clinical staff. One of these practitioners is a nurse but his role is one of health care promotion and not nursing duties. There is a good and consistent rapport with external managers and the project is supported by an on call duty manager system. Staff described the management as “supportive, empowering and approachable with clear lines of communication and accountability. The views of service users are clearly sought about the running of the service. During their stay service users participate in one-to-one key working sessions; on a Thursday there is a beginner’s group where new admission can talk through their initial experiences; on a Friday there is a house meeting in which service users can feed back about the groups and any clashes that there may have been with staff. At the end of their three-week stay, service users are asked to complete a comment card and any views are included in the discharge summary. The staff in the project are acutely aware that service users are feeling extremely positive about the project but when the euphoria wears off, there may have been areas that individuals may wish to comment on. In this instance the continuous care workers may pick up issues and feed them back to the staff team. The organisation has trained ex-service users to enable them to interview current users of their services with support from a staff member. This exercise is said to have been a very positive one, with virtually no intervention by the staff member. The results are still being collated. Feedback to the person in charge included the recommendation to review policies and procedures and to update where necessary. The pre-inspection information records the dates when some of these policies were last reviewed and an inspection of a sample showed that contact names and information were out of date. Please see recommendation 2. Health and safety records were sampled and these were found to be up-todate and accurate Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 26 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 4 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 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 4 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 X 4 X 3 4 x Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 27 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. 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 YA20 Good Practice Recommendations It is recommended that when staff receive in house training on the administration of medication that this documented. At the end of the training a written assessment of competence is recorded. It is recommended that the provider discuss a system of delegated maintenance with the Landlord in order to speed up minor repairs. It is recommended that the policies and procedures for the service are reviewed and updated where necessary. 2 3 YA24 YA41 Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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 Long Yard DS0000010346.V287336.R01.S.doc Version 5.2 Page 29 - 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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