CARE HOME ADULTS 18-65
Nascent House London Road Apsley Hemel Hempstead Hertfordshire HP3 9ST Lead Inspector
Alison Jessop Unannounced Inspection 25th January 2006 10:00 Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 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 Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 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. Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Nascent House Address London Road Apsley Hemel Hempstead Hertfordshire HP3 9ST 01442 251366 01442 251366 nascenthouse@druglink.ltd.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Druglink Limited Ms Jeanette Mandiville Care Home 8 Category(ies) of Past or present alcohol dependence (8), Past or registration, with number present drug dependence (8) of places Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. This home is registered for 8 people with drug or alcohol dependence. Date of last inspection 27th September 2005 Brief Description of the Service: Nascent House is a Stabilisation Unit providing short-term accommodation and therapeutic support to up to eight service users with past or present alcohol or drug dependency. The house is in keeping with the local community and is situated in Apsley, close to a small selection of local shops. It is also allocated near to the town of Hemel Hempstead, which has excellent shopping and leisure facilities. It provides eight single occupancy rooms. The home retains a waiting list and reports a high retention and success rate. Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. One Regulatory Inspector made two visits to the home. The initial unannounced visit was short as service users were unavailable to give feedback as they were in a therapy session. The inspector spent time looking at the environment and talking to the manager and her deputy. The second visit was arranged, the inspector was invited back by a service user who had given feedback during the first inspection of the year and who has now completed the programme. As most of the standards were inspected during the previous inspection, Requirements and Recommendations were followed up during the inspection. What the service does well:
The inclusive and supportive ethos in the home is commendable and due to the nature of the programme rules and boundaries are essential in this crucial stage of rehabilitation. The terms and conditions are fully explained to prospective service users prior to them making a decision to start the programme. The home offers a therapeutic environment where staff are available to support service users through various forms of therapy, including one to one discussions, relaxation techniques and other methods. Due to the nature of the service, service users are living at the home on a short term basis, which means that it is not treated as their permanent ‘home’, however this does not reflect in the appearance of the home which appears to be treated with respect. During the initial inspection visit in June the inspector was invited to join service users in their morning therapy session. One service user read his life story to the other service users. It was a very difficult time for him, however following this he explained to the inspector that this had been necessary in order to progress. Staff had been very supportive both before and after this. During the current inspection the inspector was invited by the same service user to his leaving party. He was able to feedback his views about the home at the end of his programme. During the leaving ceremony, service users and staff said some reassuring and congratulating words to the person leaving the programme, gifts were given and then a buffet was enjoyed, which had been prepared by service users. Feedback was gained from all service users who confirmed that although rules are in place they were fully aware of these before moving in. One service user said ‘we have to stick to the routine of the house in order to learn how to discipline ourselves.’ Another service user said ‘the staff are very supportive, they help us through the difficult times.’ Staff said that they feel a great sense of achievement and satisfaction when someone completes the programme.’
Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 6 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. Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 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 Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were inspected on this occasion. Please refer to the previous inspection report for comments. EVIDENCE: Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. Please refer to the previous inspection report for comments. EVIDENCE: Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. Please refer to the previous inspection report for comments. EVIDENCE: Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 11 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 the following standard(s): None of these standards were inspected on this occasion. Please refer to the previous inspection report for comments. EVIDENCE: Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 22 Information in relation to complaints is now being stored collectively, this enables reasons for complaints to be monitored on a long term basis and common themes can then be eradicated. EVIDENCE: Complaints, which had been made, previously had been archived with service users files when they left the service. Information in relation to complaints is now stored centrally for monitoring and inspection purposes. Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 24 Service users have welcomed the new kitchen and bathrooms which offer a clean, bright area to service users, new showers are available as an alternative to bathing. The stair carpet needs replacing to avoid a risk of trips or falls to service users or staff. EVIDENCE: All of the bathrooms and showers in the home have been fully refurbished. The new bathroom suites are clean and bright. The rooms are decorated in pastel shades of blue and lilac which offer a relaxing environment to service users. The carpet on the main staircase has worn and may need to be replaced in the near future to avoid causing a risk to health and safety. Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. Please refer to the previous inspection report for comments. EVIDENCE: Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. Please refer to the previous inspection report for comments. EVIDENCE: Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 16 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 X 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 3 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X X X X X X Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 17 NO 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 YA24 Good Practice Recommendations The carpet on the staircase is beginning to fray. It is recommended that a plan be put in place to replace this in order to prevent a risk to health and safety. Nascent House DS0000019478.V280606.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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