Inspection on 24/06/05 for Long Yard

This inspection was carried out on 24th June 2005.

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 17/01/07

Long Yard 08/12/05

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 Joanne Sinclair Joyce Grant Unannounced 24th June 2005 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. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Long Yard Address 8-9 Long Yard London WC1N 3LU 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 7404 1117 020 7242 2206 Rugby House Project Mr Radomir Lazarevitch Care Home 13 Category(ies) of Alcohol depend past/present (13) registration, with number A (E) Alcohol depend over 65 (13) of places Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: yes Date of last inspection 12/10/2004 Brief Description of the Service: Long Yard is non-medical based detoxification programme and is just one of a small number of regulated alcohol rehabilitation services inspected by the Commission for Social Care Inspection (CSCI). There are a number of existing standards, which relate to the drug treatment field these include QUADS quality standards and the SMAS Commissioning. Programmes differ and National Minimum Standards (NMS) are interpreted flexibly to ensure they fit the context of the service e.g. restrictions on freedom; environmental considerations and diversity. The National Treatment Agency (NTA), a specialist health authority for expansion and improvement of drug and alcohol services in England, share the aim of improving quality and promoting consistency and ensures the project complies with regulations and national minimum standards. 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 treatment options within the service. Long Yards remit is to provide a three-week detoxification programme which is closely supervised through the monitoring of the effects of alcohol withdrawal. The property is owned by Circle 33 Housing Association and currently has no disabled access. There are four double and five single bedrooms. Two single rooms and one double are allocated specifically for the purpose of detoxification. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted over one half day in the presence of the deputy and registered manager of the project. The home was in full occupancy, with residents preparing to enter groupwork. The inspector reviewed the homes records, spoke to residents and took the opportunity to speak with a group of visiting professionals. The single requirement made at the last inspection was not met and has been restated with a final timescale set. In all other areas the service continues to meet and or exceed national minimum standards and is shown to provide a comprehensive service from referral to discharge. The inspectors would like to thank the staff team, visiting professionals and residents for their comments and co-operation during the inspection. A letter has been sent to the registered provider in relation to failure to comply with conditions of registration in respect of the employment of a person to work at the home in the capacity of Registered Nurse. The Home is registered for the provision of personal care only. What the service does well: Service users all said that someone had visited them from the home to talk about their needs before they made a choice whether to use the service. Service users said the staff team were “excellent”, “listened” to them and “supported” them. The project encourages feedback form referral agencies and other people who use the service. The responses they receive are collected and recorded in a survey, which is available to residents. The project invites professional visitors to the project once a month to introduce them to the service and allow them to ask questions. The project management team maintains a motivated and experienced staff team, through continued training opportunities and the development of the service. The home’s real strength is the relationships that the staff team has built with residents who said they felt valued and respected. One service user summed up the groups feelings about the service by saying, “thank god for places like this”. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 6 The cook provides an excellent service and residents were extremely complimentary about the food several stated they “had put on weight” since their admission. Arrangements for meeting the health care needs are robust and service users said all their health care needs were met. 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. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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 Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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) 1,2,3 & 5 The home’s statement of purpose and residents’ handbook are excellent providing residents and prospective referrals with clear and concise information about the agency to help them choose a service that is right for them, and knowing their individual aspiration and needs will be met. EVIDENCE: The statement of purpose has been updated and a copy is to be forwarded to the commission. The Residents’ Handbook is detailed and the format changed which makes the handbook more reader friendly for residents. There are some minor spelling errors noted which are to be corrected. Professional visitors to the home spoke highly of the service provided they stated it was “ideal for detoxification” and “one of the better alcohol detoxification programmes with little pressure to complete”. They stated they had found the visit useful and informative and would make a referral. The visitor’s day is consistent and it was suggested that the outcomes of visits be recorded. Residents spoke highly of the pre-admission and assessment process and felt the programme and staff team more than met their needs. A resident said she was surprised at the speed of the referral process, and all other residents stated they had received sufficient information before coming to the home. Residents were clear about their individual programmes and felt included in Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 9 making decisions about their future. All residents were able to state clearly their current and future intentions as reflected in their treatment plans. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 & 9 The treatment programme supports people to make choices in a nurturing environment. EVIDENCE: Care planning is a continuous process and a management plan is shown to be in place prior to a referrals arrival. Service users spoken to were able to outline what their individual treatment plans contained, and were confident in discussing plans for discharge. Service users stated they were supported in making decisions regarding their lives and had established good relationships with their keyworker. Care plans viewed were comprehensive and holistic including issues relating to health, physical, social and legal assessment of need. Plans are supported by a full risk assessment, demonstrating an awareness of the needs of individual residents. Risk assessments and management plans are already in place before residents arrive. Staff now attend case conference and provide family groupwork. A continuing care service has been established implemented 48 hours after residents leave the service. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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, 14, 16 & 17 Through partnership working, promotion of opportunities and events service users are able to lead an inclusive and integrated lifestyle in the community. Dietary needs are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. EVIDENCE: A range of community information is collated by staff and made available to residents. In line with residents treatment plans and risk assessment. This allows residents to take part in planned leisure and social activities and engage in support networks outside the project, which helps them maintain links in the community. Residents had been supported to take part in a recent social outing, which included a two-day boat trip, and other events are planned in consultation with the resident group. All residents said their rights were respected, as adults through group and individual decision-making were consequences are discussed and recorded as part of the treatment programme. Individual and group responsibilities are Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 12 recognised through residents particiapation and consultation in the running of the home and through group decision-making and discussion of consequences The home exceeds minimum requirements in relation to access to and the provision of a healthy diet. Residents all agreed that the food was “good” One resident said they didn’t want to leave as they “loved the food”. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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 The health needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis, promoting a good standard of health care. EVIDENCE: Residents were clearly satisfied with the personal support provided, all residents indicated that staff went above and beyond their remit by being “accessible approachable and helpful”. Physical and emotional health care needs were shown to be met through joint care planning and review of care and support needs throughout the programme and after discharge, through the continuing care service. A visiting general practitioner is regularly on sight and is accessible to residents and staff who work closely as a team to discuss issues which may cause concern for residents. An examination of records showed the administration and recording medication is managed well, further attention needs to be given to decisions regarding the administering of extra medication, which is to be incorporated in the medication policy so guidelines are reflected in the policy of the service. The medication policy is due to be revised. Service users reported no problems in this area. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 14 Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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 Overall the arrangements for protecting residents are excellent reducing the risk of possible risk of harm or abuse. EVIDENCE: Records of concerns and complaints are shown to be maintained in the home. There was one resident complaint regarding the infrequency of bed linen changes. The manager outlined the new system, which means new bed linen will be provided for each new resident, valuing residents and ensuring residents are made comfortable in their environment. Protection issues and notifications were discussed following theft in the home. Although the necessary legal and disciplinary steps appeared to have been taken, the local authority commissioners and POVA had not been informed. The manager agreed to take action to notify the relevant authorities. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 16 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 30 The overall quality of furnishings and fittings are to a good standard creating a homely atmosphere and safe environment for residents. Arrangements are in place for renewals and replacement of older furnishings to present a pleasing and clean environment to live in. EVIDENCE: A review of records showed risk assessment for individual residents and for the environment they live in are carried out so that the risk of potential accident is reduced. The manager stated that cyclical decorations were scheduled to take place next year, which will improve the physical appearance of the building for residents. A tour of the building showed it to be clean and hygienic, although the windows in the project were very dirty and clearly not cleaned for some time. The manager explained there had been some difficulty in finding a company who could access the windows, but agreed to follow this up. New furnishing are slowly being purchased, a new television had been purchased for the communal lounge, which residents said they were pleased with. A resident said, “the place is nice.” Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 17 Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 18 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) 32, 33, 34 & 35 Staff have a good understanding of the needs of residents, which is evident from the positive relationships formed between them and residents. Staff are supported to receive good quality induction and training and there are opportunities to achieve above minimum training requirements to enable them to work effectively with the client group. EVIDENCE: Residents were complimentary of the staff team and their work with them. A resident said they were, “gorgeous.” Another described staff as, “brilliant,” and another said, “the staff are fantastic;” demonstrating the effectiveness of the staff team. The home has exceeded the 50 NVQ training requirement, and two staff are now internal verifiers for NVQ assessment. Training is well planned and will support the staff in providing for the varied needs of the resident group. Each member of staff had an individual training profile that clearly showed a commitment to both specialist and mandatory training. The manager outlined the organisations future training and development plans as the organisation moves towards becoming a, ‘Learning Organisation.’ The development of the, ‘New Advanced Modern Apprenticeship Scheme,’ and SMART Training Scheme, demonstrates the providers’ commitment to ensuring all staff will be qualified and competent in the alcohol field. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 19 An examination of one member of staff’s personnel records identified they had been employed as a nurse. The home is not registered to provide nursing care and the provider is therefore in breach of its registration requirements. A letter has been sent post inspection to the provider outlining the breach and action to be taken should they wish to provide this service. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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 40, 41, 42 Notwithstanding the need to undertake regular monthly-unannounced visits to the care home the registered provider regularly reviews all aspects of its performance through a good programme of self review and consultation which includes seeking the views of residents staff and stakeholders. EVIDENCE: Residents’ views underpin self-monitoring review and development of the home, through weekly house group and open group meetings. Residents and visitors made positive comments about the management of the project and home and gave examples of the ways they have been involved and consulted. Records showed one unannounced record of visits by the registered provider in six months, and it is unclear whether the provider is complying with the requirement. Residents’ rights and best interests are safeguarded by the homes record keeping, policies and procedures. Confidentiality and access to personal information is outlined clearly in the resident’s handbook. Expectations and Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 21 responsibilities are also explained in relation to Health and Safety and Hygiene in the home. Plans are in place and dates set for all managers to undertake an Health and safety executive 4 day course with exam. All checks were up to date for annual gas safety and electrical checks; the gas certificate is to be obtained. The water chlorination test has been completed but the certificate was not avaialbe. Fire Safety and equipment checks are show to be regularly undertaken with the last record dated in April 2005. A certificate of insurance liability is clearly displayed. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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 4 4 4 x 4 Standard No 22 23 ENVIRONMENT Score 4 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 x 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 4 3 3 x 4 4 Standard No 31 32 33 34 35 36 Score x 4 4 2 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Long Yard Score 4 4 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 4 4 4 x G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 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 23 Regulation 13(6) Requirement In relation to the theft at the home,follow adult protection procedures by notification of adult protection matters to the relevant Placing Authorities and POVA. The registered person must make arrangements to have all windows in the building cleaned. The registered provider must comply with conditions of registration not to employ a person to work at the home in the capacity of Registered Nurse as outlined in the letter to Responsible Individaul dated 30/06/05 The registered person must comply with regulation 26, to undertake monthly unanounced visits to the care home and maintain and provide up to date reports of such visits on site. Timescale for action 22/07/05 2. 3. 30 34 23 (2)(d) CSA 200O Sec 24 29/07/05 30/06/05 4. 39 26 29/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 24 No. 1. Refer to Standard Good Practice Recommendations Long Yard G58 s10346 Long Yard v211777 240605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Centro 4 20-23 Mandela Street Camden Town 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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