Inspection on 02/11/06 for Prinsted

This inspection was carried out on 2nd November 2006.

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

Prinsted 18/10/05

Prinsted 20/06/05

Similar services:

Elizabeth House

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

CARE HOME ADULTS 18-65 Prinsted Oldfield Road Horley Surrey RH6 7EP Lead Inspector Kenneth Dunn Unannounced Inspection 2nd November 2006 10:00 Prinsted DS0000063143.V316683.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 Prinsted DS0000063143.V316683.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. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prinsted Address Oldfield Road Horley Surrey RH6 7EP 01293 825400 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) Prinsted Ltd Mr Brian Ballantyne Care Home 15 Category(ies) of Past or present alcohol dependence (15), Past or registration, with number present drug dependence (15), Mental disorder, of places excluding learning disability or dementia (3) Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: Prinsted is a large and recently refurbished detached house situated in Horley Surrey. It has excellent transport links both locally and nationally. Prinsted has a homely atmosphere and was redesigned with the residents in mind. The service offers very flexible and appropriate accommodation. The home is registered to offer care for up to 15 residents in the category of Younger Adult. There are 5 twin bedded rooms and 5 single bedrooms. As part of the therapy process residents are encouraged to share rooms, especially in the initial stages of treatment. This is based on the therapeutic value of residents sharing experiences, strengths, hope and support with each other. In agreement between the inspector and the providers the term service users will not be used in the context of this report, as it has negative connotations in post addiction treatment. The word residents will therefore be substituted for this term. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced site visit to be undertaken by the Commission for Social Care Inspection year April 2006 to March 2007. Mr Kenneth Dunn Regulation Inspector carried out the site visit. Mr Brian Ballantyne the registered manager for the home was present. On the day of the inspection there was 11 residents already living in the home, and during the inspection two further people were admitted. A full tour of the buildings took place with. The menus, care plans, staff rota, recruitment information, maintenance records, activity schedules, medication storage and records, safety check records and staff training records were all sampled. The inspector would like to thank the residents, manager and staff for their time, assistance and hospitality during this inspection. What the service does well: 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. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 6 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 Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 7 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): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service Guide are designed to ensure prospective residents have up to date information about Prinsted and the suitability of their admission to the home. The arrangements for assessing needs are robust ensuring the aspirations of prospective residents are where ever possible assessed prior to admission to the home EVIDENCE: Prinsted has a well-designed statement of purpose and service guide, which is professionally presented, written in an appropriate format for the residents and arranged to be very accessible. The manager stated that prospective residents are normally admitted to the home only after a full assessment of needs has been completed by one of the services trained assessors. The manager explained that whoever the need to accept residents from overseas has required them to conduct telephone assessments of prospective residents and make use of the professionals at the individuals primary treatment centre to develop the assessment. The individual is then subject to a two week in house assessment and a peer review prior to being accepted into the service. A review of records indicated the home had a robust admission, discharge and treatment policy for residents. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 8 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems in place for the consultation of residents have been carefully and methodically designed with the specific resident group in mind. There was strong evidence to indicate that resident’s views are sought in relation to their needs and their lives. There was clear care planning and risk assessing in place and these were kept under consistent review. EVIDENCE: The residents have their individual care plans and care programmes drawn up following the initial assessment of needs. A review of the service’s records indicated both documents are regularly reviewed, dated, signed by staff and residents. The inspector was informed that the process of continual reviews promotes consistency of care offered to the residents and reinforces the treatment being offered. The care plans clearly reflected specialist treatment programmes the residents have to participate in to enable them to recover from their addictions. All residents at Prinsted must attend daily meetings as part of the ongoing therapy offered by the service. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 9 The home had a policy on risk taking to enable service users to take responsible risks. A review of records indicated risk assessments promoted the independence of the residents and covered domestic and household tasks. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 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. 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 residents are enabled and empowered to participate in valued activities. The service has forged excellent community links and affiliations ensuring the residents are part of the local community. The residents are expected to engage in all aspects of life at the home as part of their basic rehabilitation. EVIDENCE: The services professional therapists have devised a schedule as part of the core rehabilitation of the residents. The inspector noted residents participating in valued and fulfilling activities attending local colleges for art therapy, voluntary and charity work for local organisations. The service has developed strong community links and the residents have access local shops, theatre, leisure facilities, church’s and parks. The inspector was informed that as part of the rehabilitation of the residents there are robust procedures in place for contact between the resident their Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 11 families and friends to ensure that the relationship is conducive to the progression of the rehabilitation of the residents. The statements of purpose and service guide contain a full and detailed explanation of the restrictions placed by the service upon the residents and the reasons why they are rigorously adhered to. The service is dedicated to the ethos providing the residents with privacy and reinstating their dignity at all times, however these rights maybe restricted if it is felt that the rehabilitation process id being compromised in any way. Again the statement of purpose contains detailed explanations about any such restrictions and why they are in place and the therapeutic value of the restrictions. Observations made during the inspection confirmed that the residents have unrestricted access to the home and grounds. Further evidence indicated staff addressed residents by their preferred names. The home had written menu plans and the resident’s help to plan, prepare and serve the meals. Observations confirmed that the residents had a selection of cold meats, a variety of cheeses and salads for lunch and hot and cold drinks were available. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 12 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, 20 & 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents of Prinsted do not require personal care, however they do all have a full healthcare check and support and assistance is offered if necessary. Sound policies and practices are in place for the administration and management of medications although not fully followed. EVIDENCE: The service employees care staff however they are not involved in physical personal care of an intimate nature. The residents are able to and expected carry out all of their own care needs. The care staff are there to offer support and assistance if and when the residents require it. The service has a comprehensive policy and set of procedures for the safe storage and handling with medications. However when the inspector carried out an audit of the medication cabinets, items of prescribed medication were found without their original pharmacy labels. The inspector was informed that they had been brought into the service when the two residents were first admitted and from their primary treatment centres. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 13 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. The complaints process is good with complaints information available to residents, staff and relatives. The arrangements for protection are safeguarding the welfare of the residents are good. EVIDENCE: The service had well designed complaints policy, which was fully detailed in the statement of purpose and service guide. The inspector noted no complaints were recorded about the home. The home had a policy on safeguarding adults and a whistle blowing policy to protect the residents from harm. A review of records indicated staff have training in safeguarding vulnerable adults. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 14 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&30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for it’s stated purpose. It is accessible, safe and well-maintained with a pleasant and homely atmosphere. The arrangements for hygiene are good ensuring the home is clean and hygienic to promote health. EVIDENCE: During the tour of the home the premises were seen to be well maintained with the residents able to access all areas of the home and grounds. The service has recently employed a handyman to manage all of the day-today problems within the home. Residents spoken with expressed their satisfaction with the accommodation provided at the home. On the day of inspection the home was found to be, clean and bright with a homely atmosphere. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 15 Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 16 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 adequate. This judgement has been made using available evidence including a visit to this service. The staffing arrangements are good ensuring the residents are fully are supported by competent and well-qualified staff. The overall recruitment and vetting procedures in operation need to be strengthened to protect the residents from harm. The systems for training and development are good ensuring service users individual and joint needs are met by appropriately trained staff. EVIDENCE: The staff team have the exceptional knowledge and skills base in the field of rehabilitation therapy. Observations made during the inspection confirmed staff were approachable, understanding and empathetic towards the residents. The home employees several specialist in therapeutic roles to promote the treatment of the residents and there ultimate recovery. The service has a policy on staff recruitment and recruitment records were kept available on site. The inspector sampled recruitment files which had completed application forms, training records, personnel details, report on health checks and terms and conditions. The inspector noted a shortfall in POVA (Protection of Vulnerable Adults); one file had only one reference, and recent photographs of employees were not included in recruitment files. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 17 Following discussions with the administrator action has been required in respect of these matters to protect the residents from harm. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 18 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 & 41 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The day-to-day management of the home is good ensuring residents benefit from a well run home. The systems for quality assurance are well established affording the residents the ability to fully engage and to participate in the review of the home and the service provided by Prinsted. The arrangements for health and safety are good promoting and protecting the welfare of residents. EVIDENCE: The registered manager and his team are dedicated to ensuring the stability, of the service. The manager stated he plans to have completed his NVQ level 4 by the end of December 2006. Further evidence indicated the manager has an appropriate qualification in assessing the residents for rehabilitation and therapeutic needs. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 19 The residents are expected to participate with regular house meetings where they are invited to discuss any issues and to help plan the day-to-day running of the home. Further evidence indicated the home used questionnaires to obtain feedback about the home and a service the residents received while they stayed at Prinsted. The home has a set of policies and procedures on all health and safety matters, all members of staff have training in health and safety, fire safety, food hygiene, first aid and additional relevant training for specific tasks. Further evidence indicated the home had a policy on COSHH (control of substances hazardous to health) and information on health and safety legislation displayed in the office. There was a good understanding about the health and safety guidelines regarding the products used in the home. The kitchen appeared clean and hygienic and food was appropriately stored. Fridge and freezer temperatures were within normal limits to promote food safety. Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 20 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 3 2 3 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 3 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 3 33 X 34 2 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 2 X 3 X 3 X X 3 X Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 21 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. 1. Standard YA20 Regulation 13(2) Requirement The registered person must ensure that medications are only retained and dispensed from a container whit an appropriate pharmacy label. No loose medications are to be stored on the premises. The registered person must ensure employees have all appropriate checks and disclosure in place prior to commencing employment at Prinsted. In addition, employees must have a recent photograph on recruitment files and a copy of GSCC (General Social Care Council) code of practice booklet to protect service users from harm. Timescale for action 02/12/06 3. YA34 19 Schedule 2 02/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 22 Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Prinsted DS0000063143.V316683.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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