Inspection on 20/06/05 for Prinsted

This inspection was carried out on 20th June 2005.

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Prinsted 02/11/06

Prinsted 18/10/05

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 20/06/05 10:00 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. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Prinsted Address Oldfield Road Horley Surrey RH6 7EP 01293 825400 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) Prinsted Ltd Brian Ballantyne CRH 15 Category(ies) of A - Alcohol Dependent past/present - 15 registration, with number D - Drug dependence past/ present - 15 of places MD - Mental Disorder - 3 Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection n/a Brief Description of the Service: Prinstead is a large and recently refurbished detached house situated in Horley Surrey. It has excellent transport links both locally and nationally. Prinstead has a homely atmosphere and was redesigned with the residents in mind. And 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 h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours and was the service first inspection since being registered by the Commission for Social Care Inspection in February 2005. At present there are only 6 residents living at the home the service is determined to slowly build up the number over the coming months. The residents have extremely complex needs and come from a variety of backgrounds and countries. Prinstead is the second stage of the residents recovery from addiction after their initial primary treatment has been successfully completed. The home is very open and the residents are happy to talk at lengths to the inspector about a vast array of subjects. The manager and administrator maintain a good standard of records, which are retained in a secure manner. A full tour of the premises took place. All care plans and staff files were inspected. The inspectors would like to thank the manager, staff and service users 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: Health safety and environmental checks must be completed by a designated member of staff on a regular bases. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 6 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. Prinsted h09-h58 s63143 Prinsted v226895 200605 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 Prinsted h09-h58 s63143 Prinsted v226895 200605 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, 4 & 5 The quality, quantity and the availability of information about the home was of a high standard and would easily help prospective residents to make an informed choice as to whether the home would be a suitable place to continue their treatment. The home has an appropriate admission procedure in place and offers the person an opportunity to visit the home on several occasions. Contracts were in place for residents whose files were looked at. EVIDENCE: The statement of purpose and the residents guide are both frequently updated to ensure that they reflect the latest theories and therapy’s for enabling people with addictive disorders. During the inspection this document was updated to include a new option for the residents to receive art instruction from the local college. The admission procedure talks about pre-admission assessments that must be carried out and offers trial visits to the home on numerous occasions. The inspector was present during one such visit by a potential resident, these visit are all fully documented even in the event of the placement not being taken up. However it is essential that the manager introduces a policy for admissions from out of area residents and practically from overseas where trial visit are not an option. Clear guidance must be established to assist both the new resident and the staff. Residents’ files that were reviewed contained contracts between the home and the resident and were signed by the residents, acknowledging their understanding of the agreements. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 9 Prinsted h09-h58 s63143 Prinsted v226895 200605 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 & 8 The systems for resident consultation was good, with clear evidence that indicated that residents views are sought in relation to their needs and every aspects of their lives in the home. There was clear care planning and risk assessing in place and these were kept under consistent review. EVIDENCE: The resident’s files reviewed all contained a ‘treatment plan’ which was noted to be appropriate to their individual need. The file clearly reflected that all of the residents were fully involved in the process designing their individual plans. The plans seen included reference to their individual and group rehabilitation, which is fundamental to this service. The files all contained a full set of signatures indicating that they had been agreed by all of the parties involved in their design. Residents are encouraged to take responsibility and to be accountable for their own actions. Any restrictions placed on the residents are agreed with residents and only necessary for therapeutic reasons, these are fully detailed and listed within the resident’s guide. As part of the programme of therapeutic activity in this home, all residents are expected to participate in a rota for domestic duties such as cooking and cleaning. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 11 Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 15 & 17 The fundamental core to this service is to ensure that the residents have opportunities for personal development, to take part in appropriate activities within the home and in the local community. They are supported and enabled to maintain and develop appropriate personal and family relationships. Meals are well-balanced and varied. Systems are in place to ensure that service users’ rights are respected. EVIDENCE: The residents stated they were well supported by the staff and their peers, this support is clearly encouraged and an integral part of the service to residents. A weekly programme of activities was available for residents and included cleaning, shopping, meetings/groups inside the home and external meetings such as AA and NA, voluntary work, exercise, assignments, weekend planning, yoga and artwork. There appeared to be every opportunity for residents to maintain and develop social skills through contact with one another and through outside activities. There is great emphasis on community participation for the residents and the monthly programme clearly demonstrated this. Residents confirmed this and Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 13 the inspector noted residents were enabled to socialise together, appropriately for their needs, outside of the home. There are restrictions if contacts are likely to be damaging to residents progress, but this is made explicit to residents from the outset of their admission to the home. Otherwise, positive contacts amongst friends and family are encouraged. There are certain rules, which residents agree to abide by when they are admitted to the home, and are fully documented in all the homes literature. It is also expected residents will undertake domestic duties on the basis of a rota, as part of promoting independent living skills and providing a service to others with whom the home is shared. Times of meals are not generally flexible without good reason. This is to encourage responsibility in residents and a degree of discipline necessary to assist in recovery from addiction. The menu was varied and residents also decide on what they require. A list is produced and they undertake the shopping for this, again on a rota basis. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 20 & 21 Personal care, healthcare support and assistance are not required by the residents of Prinstead. Sound policies and practices are in place for the administration and management of medications although not fully followed. EVIDENCE: No personal care of an intimate nature is carried out in this home. The residents are able to carry out all of their own care needs. The home has a comprehensive policy for the storage and dealing with medications. However when the inspector carried out an audit of the medication cabinets it was clear that they had not been followed by staff. The inspector found one item prescribed to a particular resident who had left, and two further items prescribed for a person who had never been a resident at the home. On this occasion the items in question were for a stop smoking product but they had clearly been overlooked by staff for some time. It is essential that all prescribed items be handed over to the residents when they leave or that they are returned to the pharmacist for destruction. Prinsted h09-h58 s63143 Prinsted v226895 200605 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 Complaints are responded to appropriately and staff are aware of that residents must be protected from abuse, neglect and self-harm. EVIDENCE: The complaints procedure was very clear and included the details of the Commission, should a resident wish to talk to an inspector about a particular issue. The procedure is made available to all residents. Staff indicated that they have a clear understanding of the issues around protection of the residents. The service has access to the local authority Vulnerable Adults procedure. Prinsted h09-h58 s63143 Prinsted v226895 200605 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, 25, 26, 27, 28, 29 & 30 Prinstead is a new service, which had been completely redesigned to a very high specification and fully meets the needs and expectations of the residents. The private and communal areas within the home are furnished to a very good standard and offer the residents a comfortable and safe area to live. However there were areas where the home failed to maintain these high standards, specifically in food storage and fire safety. EVIDENCE: The standards throughout the premises was considered by the inspector to be very high. All the rooms were well furnished with items that reflect the average age of the residents. The number of toilets and bathrooms fully met the needs of the service. At the time of this inspection there was no need for aids and hoists in the home. The standard of cleanliness within the home was high however when the inspector looked inside the fridge it was very disorganised and did not follow guidelines for the safe storage of food. In addition there was food products found that were well over their sell by dates by almost 12 days and one item, which was unidentifiable as it was in the fridge without its correct container. During the tour of the home the inspector found one bedroom to contain numerous burnt candles this was not only a health and safety issue but also in Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 17 direct contradictions to the homes own policies. The manager must ensure that the correct checks are maintained to ensure that the standards of the home are maintained. Prinsted h09-h58 s63143 Prinsted v226895 200605 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) 31, 32 & 34 The staff in the home demonstrated a good understanding of the needs of the residents. All staff are appropriately supported by the manager on a regular formal and informal basis. EVIDENCE: All staff have a job description and the roles and responsibilities of staff were clearly understood. A number of staff of the home are either trained counsellors, therapists or teachers. Other staff are to be offered NVQ level 2 training. The recruitment procedure is detailed and satisfactory and was based and complies with the National Minimum Standards. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 19 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) 37, 38 & 42 Prinstead has only been in operation for 4 month but it would appear to managed in an open and inclusive atmosphere, creating a homely place for residents to complete their treatments. Health and safety checks have been undertaken but were not available during the inspection. EVIDENCE: All interactions observed between the manager, staff and residents at this inspection evidenced an open, positive and inclusive atmosphere. Various systems are in place to ensure that the staff are able to obtain the service users’ views on all issues concerning their life at the home. The residents spoken to during the inspection confirmed that the home was run in an open way and respected them as individuals. Decisions about daily living are made jointly between staff and residents and regular house meetings are held. The home contracts out it’s electrical testing and was unable to evidence what had been tested and when they might of been carried out. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 20 Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 21 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Prinsted Score 3 x 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 22 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) Schedules 3.3 (i&k) 13(2) Schedules 3.3 (i&k) 16(1), 23(1 & 2) Requirement All prescribed items be handed over to the residents when they leave or that they are returned to the pharmacist for destruction. A member of staff must audit the medication cabinet on a regular bases. The manager must ensure that the correct checks are maintained to ensure that the home meets all health, safety and fire regulations All test on equipment in the home must be checked by a trained person and evidence of these tests must be retained on the premisses The manger must ensure that item brought into the home are tested before the residents can use them. Timescale for action immediate 2. 3. YA20 YA24 21/07/05 immediate 4. YA42 5. YA42 13(3-6), 23(2)(b & c) Schedule 3.3(j) 13(3-6), 23(2)(b & c) Schedule 3.3(j) immediate immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 23 No. 1. Refer to Standard Good Practice Recommendations Prinsted h09-h58 s63143 Prinsted v226895 200605 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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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