Inspection on 16/05/06 for Priory Road

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Priory Road 15/11/05

Priory Road 08/07/05

Priory Road 01/03/05

Priory Road 05/10/04

Priory Road 12/03/04

Similar services:

Oakmount Hostel

Ark House

St Anne`s Alcohol Services - Leeds

Lynwode Park

Parkfield Rest Home

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

CARE HOME ADULTS 18-65 Priory Road 9 Priory Road Nether Edge Sheffield South Yorkshire S7 1LW Lead Inspector Paula Loxley Unannounced Inspection 16th May 2006 09:30 Priory Road DS0000003003.V293895.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 Priory Road DS0000003003.V293895.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. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Priory Road Address 9 Priory Road Nether Edge Sheffield South Yorkshire S7 1LW 0114 281 3183 0114 281 3183 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) None Sheffield Alcohol Advisory Service Mr Stuart Hawkshaw Care Home 6 Category(ies) of Past or present alcohol dependence (6) registration, with number of places Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: The Sheffield Alcohol Advisory Service at Priory Road project is a residential home with facilities to care for up to six men and women with alcohol related problems. Priory Road is a large detached house located in an attractive residential area of the city, situated close to local amenities and public transport. The home has one double and four single bedrooms and all rooms are individually furnished and arranged according to the personal preferences of each service user. There is a large garden to the rear of the home with a pond, attractive paved areas, garden ornaments and seating provided. One to one support and group counselling is provided by the staff of the home, with the aim of reshaping lifestyles and routines to enable service users to learn to enjoy life without drink. Service users are not provided with 24-hour staff support on site, however an on call system is operated by the home to ensure that staff are always available when needed. Information relating to the fees charged by the service, and details of what is/ is not included, can be found in the service user guide and in the individual contract provided to service users at the time of their admission to the home. The current fees charged of £395 per week are inclusive of staffing and all facilities and services. The manager, and contracts checked, confirmed that Social Services paid the majority of the fee with service users paying a contribution from their allowance towards this and a small additional amount towards food. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day between 9:30 am and 16:30 pm. The home is currently fully occupied and as part of the inspection process the inspector met with five service users and interviewed the registered manager and deputy who were on duty. Several areas of the building were inspected and the redecoration and maintenance plans for the home were discussed with the manager. A number of records were examined in detail and this included two service users files (with care plans, full needs assessments, contracts and details of staff support), complaints record, accident records, service user and staff meeting minutes, staff training and recruitment files and a selection of policies and procedures. Five service user questionnaires were completed and returned to the inspector during the inspection, and information from these has been included in the relevant section of this report in-addition to information from the preinspection questionnaire completed by the registered manager and the monthly regulation 26 reports completed by the responsible individual. Feedback on the inspection was given to the manager before the inspector left the home. Staff interaction with service users, was observed by the inspector, and it was positive to note that service users appeared relaxed and comfortable with staff with whom it was obvious they had developed positive and supportive relationships. Five service users were spoken to and they all said the manager and staff were extremely approachable, available when needed and sensitive to their needs, anxieties, fears and feelings. The inspector would like to thank service users and staff for their time, openness and commitment to the inspection process. The inspector checked the progress made on any previous requirements outstanding from the last inspection and checked all key standards as detailed further in each section of this report. What the service does well: Since the last inspection the manager and staff at the home had worked hard to address any issues and eight of the nine requirements made had been actioned as required. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 6 The home is homely, comfortable and welcoming and service users said they were happy to be at the home that in the main is clean and well maintained. They said they had everything that they needed in their rooms that they were able to furnish and decorate as they wished. House rules, and an agreed group contract between individual service users, ensured that service users were respectful of each other and complied with the agreed terms and conditions of their stay. Service users said they were extremely well supported by staff who are approachable, respectful and encouraging. They confirmed that staff were sensitive to their individual needs and that it was positive that they were encouraged to become independent and manage their own lives a day at a time to ensure that they could then live independently in the community. Service users attended regular individual and group counselling sessions and they said this helped them to identify their goals and any issues that may be creating anxieties or concerns. ‘Daily feelings’ meetings provided them with the opportunity to discuss coping mechanisms that they may need to develop to ensure that they could cope with individual situations outside of the home without dependency on alcohol. Invaluable on-going support continues to be provided by the ‘floating support worker’ once service users leave the home and service users were reassured that this facility was available. The health care needs of each service user had been identified and service users said that staff had accessed the relevant information and specialist support that they needed. Staff training had been provided to ensure that staff had the knowledge they required and service users said they valued their commitment in undertaking this and in developing links on their behalf with other agencies such as health, education, housing, education and benefits. The home is well managed and all staff employed by the home have a wealth of relevant experience in working with service users who have been dependent on alcohol. The manager is keen to continue to develop the service to ensure that they can meet the changing needs of service users and he is committed to developing links with other relevant organisations and agencies that can effectively support service users with their rehabilitation. What has improved since the last inspection? One bathroom had been refurbished to provide a walk in shower. This will ensure that service users with mobility problems can safely access the shower as previously it was sited over the bath. Some of the records had been updated to ensure that they contained the required information and detailed full needs assessments had been received by the home for each service user prior to their admission. The medication policy and procedures had been updated and service users had been made aware of these. Medication profiles had been completed and they were available on individual care plans checked. All policies and procedures had been dated and the Adult Protection procedures included details of the current local protocols. Written risk assessments had been completed for the homes environment and service users had been made aware of these. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 7 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. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 8 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 Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 9 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): 1 and 2. Quality in this outcome area is good. This judgement has been made using available written evidence and following discussions with five service users and the manager. A detailed statement of purpose and service user guide had been produced and minor amendments to update the service user guide would ensure that service users had the necessary information regarding the service, staff support and current facilities provided. Service users individual care needs had been fully assessed prior to their admission to the home and this ensured that the service was appropriate to meet each persons needs and that staff were aware of their identified needs. EVIDENCE: The statement of purpose and service user guide, were available in the home for service users and staff. Four service users confirmed that they had been made aware that this information was available at the time of their admission to the home. They said they clearly understood the terms and conditions of their stay, the house rules, the roles of staff and the nature of the staff support provided during their stay. Details relating to the current fees charged were in need of updating as these had recently been increased. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 10 Discussions with the manager and service user files checked confirmed that detailed full needs assessments had been completed by the referring social worker from the homeless or substance misuse team and the manager had ensured that he had received these prior to the individuals admission to the home. The manager said that these assessments were vital to ensure that each newly referred service user was appropriately placed at the home and that they were compatible with service users already living there. He confirmed that prospective service users were able to visit the home prior to their admission to meet with service users and staff if this was appropriate to their situation at the time. The full needs assessment had been used to develop the initial care plan and service users said they had been involved in this process. Any restrictions imposed, because of any associated risks or due to issues linked into their individual treatment programme, had been discussed at the time of their admission when they had also been made aware of the daily routines and house rules. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 11 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): 6, 7 and 9. Quality in this outcome area is adequate however the service must be commended on how the staff continue to encourage and support service users with making decisions about their own lives. This judgement has been made after checking the available written evidence and following discussions with service users and the registered manager. Several sections of the care plans checked did not contain the required information and some sections had not been updated recently. The current care plan format was inappropriate to accurately record the individual needs of each service user. As a consequence of this there was insufficient written evidence to confirm that staff had all of the relevant information regarding the changing needs and personal goals of each service user. Service users confirmed that they were always encouraged and supported by staff to make decisions about their lives as needed and that the appropriate levels of staff support were provided throughout the duration of their stay at the home. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 12 Service users said they were encouraged and supported by staff to develop and maintain their independence throughout the duration of their stay at the home. They confirmed that staff supported them to take risks as part of their on-going development and rehabilitation however written risk assessments had not been completed for each service user and therefore the health and safety of service users could not be ensured. EVIDENCE: The inspector checked two service users plans of care. Service users said they had been involved in the development of these and were aware of the content. They knew that they could access them when they wished and had agreed a confidentiality policy regarding sharing appropriate information with other professionals as appropriate to each person. Documentation included a statement by the service user detailing why they wanted a placement at the home and all aspects concerning their stay at the home had been agreed and signed by the service user and the manager. The care plan format in place had been used for several years and discussions with the manager confirmed that it was no longer appropriate to record the identified needs and personal goals of the current service users. The format concentrated heavily on the personal and physical care needs, rather than the emotional and more specialist therapeutic rehabilitation aspects of the staff support required by each individual. The manager said he was keen to develop new care plans that could support each person more effectively. Several sections, of the plans checked, were not up to date (for example one medication profile) and not all entries had been signed or dated by staff. There was insufficient evidence to confirm that the plans had been reviewed and it was not easy to identify the individual goals for each service user. Files were disorganised and information could not easily be accessed. Five service users spoke extremely positively of the support provided by the manager and staff employed by the home. They confirmed that they were encouraged each day to make decisions about their own lives, routines and ‘personal goal for the day’ as they were supported with taking control over their own lives and with managing situations, in and outside of the home, without dependency on alcohol. Two service users said “the staff have helped us to find and develop our own support networks and each day we discuss what we are going to do and what support we might need to do it”. Other service users stated they could do what they wanted during the day and that they were well supported by staff with achieving their daily goals. One service user said “we have to work out our own coping mechanisms and I think the staff here empower us to achieve our goals and that’s why this place works for me where others have not. It’s very positive here because you have to cope with difficult situations which helps when you leave and re-enter society, but staff are always there for you”. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 13 Service users managed their own finances. Any restrictions or limitations had been agreed with each person and were documented in the ‘house rules’ or ‘group contract’. Discussions with the manager and service users confirmed that these were in place to ensure individuals best interests. Discussions with service users and documentation checked confirmed that service users were supported by staff to take risks as part of their daily routines and activities. Service users were encouraged to do an “emotional check” before they entered a new situation to ensure that the necessary support systems could be put in place. Staff said that they were available at external social events when required to offer the appropriate encouragement and to enable service users to take responsible risks where it had been identified that this would positively help them with their rehabilitation. Written risk assessments had been completed for the home and the general environment. It was obvious from discussions with the manager and staff that they were aware of individual risks for each service user however these had not been documented in the care plan. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made following discussions with five service users, the manager and deputy, using available written evidence and from observations made during the inspection. Service users said the staff supported them with accessing appropriate activities, college courses and voluntary or paid employment that they wished to participate in and this ensured that they were fulfilled. Service users confirmed that they were supported appropriately by staff to participate in activities in the local community according to their personal wishes and preferences. Service users were effectively supported by staff to ensure that they developed and maintained links, inside and out of the home, with their family and friends, as appropriate to the needs and wishes of each individual. Service users confirmed that their rights were respected and that their daily routines encouraged and developed their independence. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 15 Service users were provided with nutritious food that they confirmed they enjoyed and ensured that they maintained a healthy diet. EVIDENCE: Discussions with four service users confirmed that they were encouraged by staff to find voluntary or paid employment or to undertake training courses of their choice. One service user said he had attended an interview for voluntary employment with a charitable organisation and he was pleased that he had recently been offered a post with them. He said this experience would give him the opportunity to develop new skills that would hopefully help him with a new career in the future. One service user had started a training course with learn direct and he said staff had supported him with this. The ‘floating support worker’ employed by the home had developed links with a number of local organisations and service users said he was keen to ensure that they were given the opportunity to access any training or employment that may be available. Service users were seen accessing the homes computer to support them with their training and to develop their contacts with local employers. All service users spoken too, said staff were incredibly supportive and were keen to encourage them to become integrated into the local community when they felt able to do so with the necessary support. Service users discussed their community links and activities with staff on a regular basis as part of their on-going development and rehabilitation. Service users said they had to learn how to enjoy social situations and activities without alcohol. One service user said “its positive that staff are aware that everyone has different routines and interests that they want to establish in preparation for living alone again in the community”. It was confirmed that staff were available to support service users outside of the home as identified and planned with each individual. Service users said any issues or concerns identified were fully discussed in individual or group counselling sessions prior to the activity being undertaken. Service users said they were able to have regular contact with their family and friends if they wished. Overnight stays with their family members had been organised and all visits had been planned and agreed with staff. Service users were aware that, as part of their contractual agreement with the home, they could not be absent from the home for more than four nights per month. Staff confirmed that service users could develop and maintain personal relationships as they wished and arrangements for visitors were discussed with staff on a regular basis. Details regarding contact had been included in the care plan. Service users said they had developed positive relationships with each other during their stay at the home and they valued the support they could give one another as they were all at different stages of their rehabilitation and coping with life without alcohol. The group contract they had agreed to included details of respect for each other, confidentiality, safety and self-awareness. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 16 Service users spoken with confirmed that they were happy with the house rules and daily routines. They said the systems in place encouraged them to be independent, take responsibility for their own lives and make individual choices that initially could be very difficult to do. The routines included a daily breathalyser test (as service users must maintain their sobriety for the duration of their stay at the home), domestic tasks, house and group meetings and individual and group counselling sessions. Service users had signed at the time of their admission to the home, to confirm that they understood and agreed to the house rules and that they would comply with them as part of the terms and conditions of their tenancy at the home. The signed agreements were seen on the service user files checked. Service users said they could choose how they wished to spend their time at the home and they were happy that they had their own private space because they did not always want to be with others in the communal areas. Observations and discussions with service users and staff confirmed that service users could choose what they wanted to eat and when and where they wished to eat it. Five service users spoken to said that they catered for themselves and that they thought they ate very well and very healthily. Service users stored their food, delivered weekly to the home by a charitable organisation, in their own section of the fridge/freezer or store cupboard. The manager confirmed that records of meals were not maintained as service users took full responsibility for their meals based on their individual preferences and dietary requirements. Any special requirements relating to specific health issues, or allergies, were also taken into account and details relating to this could be found documented in the care plan. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 17 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): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made following discussions with five service users, the manager and deputy and from the examination of available written evidence included in service user files. Service users confirmed that they received personal support from staff that promoted their independence and privacy and was flexible and sensitive to their needs and current situation. Service users healthcare needs had been assessed and the appropriate action had been taken by staff to ensure that each service users needs had been met. Service users were able to take responsibility for retaining, administering and controlling their own medication where appropriate. The homes policies and procedures for dealing with medicines had been updated and this ensured that service users were protected. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 18 EVIDENCE: Service users said that staff would support them with their personal care if they required this. Service users were encouraged by staff to take responsibility for their own personal care as this helped them to develop their independence and take control over their own life. Discussions with service users and staff and information seen documented in care plans, confirmed that the healthcare needs of each individual had been assessed and any specialist support or advice had been accessed when required. Staff had effectively supported with the initial referrals or consultation if the service user wanted this. Service users had the opportunity to discuss any anxieties they had about their health in their individual counselling sessions. Service users had been encouraged by staff to have regular optical and dental checks. One service user said that they had recently been diagnosed with a serious medical condition. All staff had been extremely supportive as they had accessed a range of health information for that person and had organised for a specialist health worker to visit the home to undertake training with staff and provide the person with more information. The deputy confirmed that this training had highlighted many issues that that they were able to address to ensure that the appropriate control measures were put in place to protect the individual and other service users. The manager confirmed that currently all service users self-administered their medication and that this was the usual practice for individuals living at the home. (The exception to this was usually where an individual had been prescribed a more intensively controlled programme of medication relating to substance addiction). Service users were responsible for ordering their own medication via their GP and lockable facilities had been provided in bedrooms for safely securing any items. Service users had been provided with a copy of the homes new medication policy and procedures and signed agreements were seen on service user files checked. Service users were aware that they had to inform staff of any changes to their medication as this would be recorded in their care plan. Any sensitivities or allergies had been recorded on their medication profile and this also included details of any possible side effects or reactions with specific foods. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 19 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 and 23. Quality in this outcome area is excellent. This judgement has been made following discussions with service users, the manager and staff and from checking available written evidence in the complaints record, staff training records and policies and procedures file. Service users confirmed that they were comfortable with staff as they were sensitive to their needs, accessible and good listeners. The home had the appropriate adult protection policies and procedures in place to ensure that service users were fully protected. EVIDENCE: Service users stated that they were aware of the homes complaints procedure. The complaints record confirmed that no major complaints had been received by the home since the last inspection and none had been reported to the Commission for Social Care Inspection (CSCI). Two minor complaints, regarding cleaning issues, had been recorded in the complaints book. The subsequent action taken and outcome had been documented and signed off by the manager who regularly monitored the records. Service users said minor issues were usually raised at the house meetings and their experience was that staff were keen to ensure that all issues were dealt with satisfactorily and as quickly as possible before they became a bigger problem. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 20 Since the last inspection the homes adult protection policies and procedures had been updated to ensure that they contained all of the required information including whistle blowing, the Department of Health Guidance ‘No Secrets’ and details of the current local procedures. Since the last inspection there had been no allegations of abuse. Staff interviewed, and training records checked, confirmed that staff had completed the required training on Adult Protection They were clearly aware of the different forms of abuse and of the current procedures for the reporting or investigation of any allegations. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 21 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 and 30. Quality in this outcome area is average. This judgement has been made following discussions with the manager and service users and from visual observations of a number of areas within the home on the day of the inspection. All areas seen were homely and suitable for their purpose. The home was reasonably well maintained however two areas were in need of redecoration to ensure the comfort of service users. Most areas of the home checked were clean and fresh smelling. However a carpet and some window blinds were in need of cleaning to prevent infection and to promote the health and safety of service users. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 22 EVIDENCE: Service users said they were very happy at the home and that they were pleased with their bedrooms that they could decorate and furnish as they wished. The premises appeared safe and the manager confirmed that there was a planned maintenance and renewal programme for the home. Plans were ongoing to develop the cellar into a staff office and a further communal room for service users to use when they wished. Since the last inspection one bathroom had been refurbished. The bath had been removed and a walk in shower had been installed to ensure that service users with mobility problems could shower safely. All furnishings and decorations at the home were domestic in style and service users had been involved in choosing the furniture and colours for the decoration. It was noted that the bathroom and main lounge were in need of redecorating. Service users shared the responsibility for cleaning the communal living areas of the home in-addition to their own rooms. They said there were no issues relating to this as it had been agreed at the time of their admission to the home and any minor problems could be discussed and sorted out at the house meetings that were held weekly. All areas of the home checked were free from offensive odours although the blinds fitted to the window in the shower room were in need of cleaning. The hall carpet was heavily stained and discussions with the manager confirmed that he had arranged for them to be cleaned the following week. Laundry facilities were sited away from food preparation areas and the appropriate measures were in place to control infection. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 23 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): 32, 34 and 35. Quality in this outcome area is excellent. This judgement has been made following discussions with the manager, staff and service users and from checking available written evidence and documentation in the staff training records and staff files. The services commitment to staff training ensured that service users had a competent staff team to support them to meet their personal goals. Service users were well supported by the robust recruitment policy and practices in place at the home and this ensured that their safety and welfare were protected. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 24 EVIDENCE: Service users said that all staff were very approachable and supportive. They confirmed they were comfortable with staff as they were sensitive to their needs, accessible and good listeners. Observations of staff interaction with service users confirmed that positive and respectful relationships had been developed with each service user. Two service users said that they had progressed at the home because staff had encouraged them to take responsibility for their own lives and they did not create a false situation where they did everything for them. Staff had completed a range of training relevant to the specialist nature of the service and a consistent staff team had been maintained. Service users spoke positively of the support provided by the ‘floating support worker’ who would, if they chose, continue to support them once they left the home to live independently in the local community. The support worker had completed NVQ level 3 training in care and the deputy had completed NVQ level 4 in management and is currently undertaking level 4 in care which she hopes to complete by the Autumn of 2006. Three staff files were checked and all of the required documentation had been obtained for all staff employed by the home. All staff had completed a satisfactory CRB check at the enhanced level and they had received from their employer a copy of their job description and a statement of their terms and conditions. Staff files were well organised and included evidence of training undertaken. The manager and staff had completed a range of training courses specific to their role and the service. Since the last inspection training undertaken included child protection, moving and handling refresher, care manager’s award, first aid and hepatitis/ health issues. Training on equal opportunities had been arranged for May 2006. Discussions with the manager and staff confirmed that they were committed to further training to further develop their skills and to ensure that they could continue to meet the changing needs of service users. The manager said that the registered organisation were constantly developing the service and this was providing greater opportunities for accessing specialist training and to work closely with other professionals and ‘experts’ skilled in working with people with addictions. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 25 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): 37, 39, 41 and 42. Quality in this outcome area is good. This judgement has been made following discussions with the manager, staff and service users and from checking available written evidence and documentation in fire records, regulation 26 reports, risk assessments, care plans and staff training records. The manager’s commitment to developing the service benefited the service users as it ensured that their needs were met. Service users views of the service provided were sought on a regular basis and this ensured staff were continuing to meet each individuals needs in line with the stated aims and objectives for the home. However the results had not been published and therefore service users, their relatives and other relevant parties had not been made aware of the information received. In the main records checked were well organised and information could be easily accessed. However some records were not available or did not contain all of the required information and therefore the rights and best interests of service users could not be fully promoted. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 26 The home had the appropriate health and safety policies and procedures in place at the home and staff had completed training. One accident had not been recorded as required. Written risk assessments had been completed for all areas of the homes environment but not for all chemical substances and therefore the health, safety and welfare of service users and their visitors could not be fully ensured. EVIDENCE: Since the last inspection the manager has completed his NVQ level 4 training in management and is currently undertaking NVQ level 4 in care which he said he aims to complete by Autumn 2006. Discussions with him confirmed that he is committed to developing the service further to ensure the changing needs of service users can be met, especially as a number of alternative services providing care for people with alcohol dependency, had recently closed. The manager has years of experience of working with people with alcohol related problems and he is positive about the developments within the registered organisation SAAS (Sheffield Alcohol Advisory Service). The manager was clear of his roles and responsibilities and of those of his staff team. He confirmed that he received regular support and supervision from his external line manager in-addition to regular clinical supervision. Service users confirmed that they were regularly asked for their views of the care provided by the home. They said this was completed during the group and individual counselling sessions. Discussions with the manager confirmed that the results of these surveys had not been published but he said that this was an area of work that he wished to develop further in the future. It was planned for an independent person to be allocated to produce questionnaires for other professionals and specialists who work with service users that live at the home. A number of records were checked and in the main the required information was available for inspection. All records were securely stored as required. Detailed monthly regulation 26 reports had been completed by the responsible individual and copies of these had been forwarded to the CSCI. Improvements had been made to a number of records since the last inspection and several of the homes policies and procedures had been reviewed. Issues found in relation to care plans and other records checked have been reported on under the relevant standard elsewhere in this report. The fire safety log confirmed that the fire equipment had been serviced as required and that weekly tests of the fire alarm system were being conducted. The records of fire instruction and drills for staff had improved and included details of the procedures and of the action taken by staff. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 27 A service user accident, recorded in one care plan checked, had not been recorded in the accident book. The manager confirmed that this was the only accident that had occurred since the last inspection. An external health and safety officer had recently conducted an inspection at the home and he had made a number of recommendations that were in the process of being actioned by the manager. Written risk assessments had recently been updated fro the home however none had been completed for the chemicals used in the garden and stored in the laundry. The manager confirmed that service users had been made aware of the risk assessments for the home and that health and safety issues were discussed regularly at house meetings. All staff had completed the required statutory training on health and safety including food hygiene, first aid, fire safety, moving and handling and infection control. Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 28 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 2 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 4 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 4 X 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 2 X 2 X 2 2 X Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 29 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 4 Requirement Timescale for action 30/06/06 2 3 YA6 YA6 17 17 The service user guide must be updated to include details of the current fees charged by the home. A detailed care plan, in an 31/08/06 appropriate format, must be developed for each service user. All sections of the care plan must 30/06/06 be kept up to date and files must be well organised to ensure that information can be easily accessed when required. All plans must be regularly reviewed and records of this must be maintained. All entries made by staff must be signed and dated. The care plan must include the identified goals being worked towards for each individual. The manager must sign to confirm that he is monitoring the care plan. (Previous timescale of 31/01/06 not met). Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 30 4 YA9 13 5 6 7 8 YA24 YA30 YA37 YA39 23 23 9 24 Risk assessments must be completed for each service user and copies of these must be available on individual files. All risk assessments must be regularly reviewed. The lounge and bathroom must be redecorated. The blinds in the shower room must be cleaned. The registered manager must achieve a qualification at NVQ level 4 in care. The results of service user surveys must be published and made available. 30/06/06 31/08/06 20/06/06 30/09/06 30/09/06 9 YA42 17 10 YA42 13 Effective quality assurance systems must be developed by the service to obtain the views of friends, relatives and other professionals. All accidents must be recorded in 20/06/06 the accident book. A copy of the accident report, involving service users, must be retained on their individual file. Written risk assessments must 20/06/06 be completed for all chemical substances used by the home. 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 Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 31 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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. Extracts may not be used or reproduced without the express permission of CSCI Priory Road DS0000003003.V293895.R01.S.doc Version 5.1 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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