Inspection on 15/01/07 for Rugby House Project

This inspection was carried out on 15th January 2007.

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

Other inspections for this house

Rugby House Project 03/03/06

Rugby House Project 03/11/05

Rugby House Project 10/02/05

Rugby House Project 27/05/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

City Roads Crisis Intervention

Long Yard

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

CARE HOME ADULTS 18-65 Rugby House Project 21 Ravenswood Road Walthamstow London E17 9LY Lead Inspector Harun Rashid Unannounced Inspection 15th January 2007 9:30 Rugby House Project DS0000007251.V326152.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 Rugby House Project DS0000007251.V326152.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. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rugby House Project Address 21 Ravenswood Road Walthamstow London E17 9LY 020 8521 4486 020 8521 5235 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) A Rugby House Project Mr Philip Cox Care Home 8 Category(ies) of Past or present alcohol dependence (6), Past or registration, with number present drug dependence (6) of places Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd March 2006 Brief Description of the Service: Ravenswood Road is a registered care home that provides support and rehabilitation to people recovering from drug and alcohol abuse. The premises are two neighbouring purpose built houses with a central garden and patio. Each house has four bedrooms, all with en-suite facilities. Opened in February 1999, it is run by the Rugby House Project, a small charity that operates residential homes and other support services for those recovering from addictions. The properties are owned and maintained by Circle 33 housing association. The practice approach is based on an intensive programme of group meetings and individual counselling. Service users make a commitment not to use alcohol or drugs, and accept the restrictions and sanctions that are part of the recovery regime. Successful service users usually spend six months living at the project. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on a week day morning on the 15th of January 2007. The inspector interviewed a newly appointed member of staff and the registered manager. The inspector also spoke to six service users during the inspection process. 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. Rugby House Project DS0000007251.V326152.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 Rugby House Project DS0000007251.V326152.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): 1,2,3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has developed satisfactory statement of purpose and service users guide. Staff have knowledge, skills and experiences to carry out specialist assessment of needs of the service users and meet those complex needs. EVIDENCE: Ravenswood Road has developed satisfactory statement of purpose and service users guide. The statement of purpose included all information required by regulations, for example, the aims and objectives of the specialist service. The service users guide provided all information, for example information regarding service delivery, qualifications of staff and the address of the local CSCI office. Staff of Ravenswood Road who have relevant qualifications, knowledge and experiences to carry out a pre-admission assessment of the service user prior to the admission. On the day of the inspection a service user was admitted in the home. The inspector observed the admission process, which was found to be satisfactory. A member of staff carried out an assessment of needs by completing an assessment tool called’ Alcohol and Drugs Needs-led Assessment Form’. The staff group of Ravenswood Road have relevant qualifications and experiences to meet service users assessed needs. Staff have counselling and NVQ level 3 qualifications in care. All staff have working experiences in this Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 8 area and are capable of running various groups, for example, life skills, relapse prevention, anger and stress management. The home also closely works with the National Treatment Agency, Drugs and Alcohol Concerns and local Drug and Alcohol Teams in order to provide treatment and care for the service users who suffered from drug and alcohol problems. Each service user is provided with a contract. The contract set out the statement of terms and condition with the home and individual service user. All service users are required to sign a ‘Room Search Agreement’ with the service. If any service user is suspected of having drug or alcohol in his/her possession or in the bedroom staff will then search that individual’s bedroom in order to ensure that the home is remains drug and alcohol free at all times. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have individual care plan which is reviewed on a ten weekly basis. Risk factors are identified and a strategy is in place to manage these. Service users are encouraged to make decision about their lives. EVIDENCE: From the examination of care files it was evident that each service user has an individual care plan. A care plan is developed from information gathered from ‘Alcohol & Drugs Needs-lead Assessment Form’, service user’s self-assessment from and care manager’s assessments of needs. Service users allocated care managers from Waltham Forest’s Drug Services Team or Redbridge Drug and Alcohol Services Team review care plans on a ten weekly basis. There is a system in place to consult service users on a regular basis. Each morning 9.30 am to 9.45 am staff meet with service users and receive feed back regarding previous day’s group activities. In addition to this the home conduct service users weekly meeting called ‘the community meeting’ in every Friday afternoon. Service users are encouraged to make decision about their lives within risk assessment frameworks. Service users are encouraged to Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 10 mange their own finances during their stay at home. Staff refers service users to Citizen Advice Bureau who has bad debts and other legal problems. The risk factors are identified during the admission process. Pre-admission assessment covers all areas of risk factors. Then staff develop individual risk assessment plan for each service user to eliminate or reduce those identified risk factors. Care files suggest that risk management strategies are agreed, recorded in the care plan and reviewed. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Ravenswood Road offers a structured and therapeutic group sessions to all service users. Service users are encouraged to maintain family links. The home offers individual menu for each service user. However, it is required that the manager to liaise with service users care managers to apply for freedom pass. The manager to ensure that service users have access to free local newspapers and he purchase a weekly local newspaper for service users. EVIDENCE: Ravenswood Road offers a structured and therapeutic group programme for all service users which is made up of 13 different groups, for example, relapse prevention, anger/stress management, communication, assignment, men’s and women’s group. The home encourages service users to begin the process of rehabilitation after the admission to the home. In the first week of stay a service user is not allowed to leave the premises with out accompanying by a member of staff and in the second week a service user is only permitted to go out with a senior service user. After that a service Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 12 user is able to visit community, however he/she is expected to return by10pm at night. During the interview a service user informed the inspector that it would be beneficial to them to visit local community more frequently if they can obtain freedom passes. The inspector feedback this to the registered manager who informed that he would take this issue with service users care managers in order to apply for freedom passes. Other service users informed the inspector that they would like to read free local newspapers and weekly Walthamstow Guardian. The registered manager advised the inspector that he would ensure that service users have access to free local newspapers and he will buy a weekly newspaper for them. Service users are encouraged to maintain family link and friendships inside and outside the home. Family members and friend are encouraged to visit service users at home. Two of the service users informed that they have children and have contact with them. Other two have regular contact with family members. All service users are offered single bedroom accommodations and they hold bedroom keys. Staff interaction was observed and noticed that staff use service users’ preferred form of address. Staff talk to and interact with service users in appropriate manners. Staff encourage service users to carry out their house keeping tasks, for example, cooking, cleaning bedrooms and laundry tasks. As part of service users’ rehabilitations programme the home does not offer group menus. All service users are encouraged to do their own shopping and cooks individual meal of their choice. A service user is encouraged to buy halal meat and cook curry. The home does not offer a microwave to heat up frozen meals instead teach service users how to cook hot meals on a daily basis. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. 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 using available evidence including a visit to this service. All current service users are able to maintain their personal hygiene independently. There is a system in place to address service users health issues. Staff were provided medication administration training and they are able to teach service users how to selfadminister medications. EVIDENCE: All current service users are young and they are able to maintain their personal care independently. Therefore, no staff input is required to support service users to maintain personal hygiene. All service users are able to perform bath/shower independently. Staff encourage them to do their laundry tasks on a regular basis. At the time of the admission service users health care needs are assessed. There is a system in place to address this. Service users can use their own G.P service and staff accompanies service users as and when required. The home also closely works with the National Treatment Agency, Drugs and Alcohol Concerns and local Drug and Alcohol Teams in order to provide treatment and care for the service users who suffered from drug and alcohol problems. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 14 Staff keep record of all medication administration on Medication Administration Record (MAR) sheets. MAR sheets were examined and found to be satisfactory. Staff were provided medication administration training. As part of service users rehabilitation programme staff teach them to self-administer medication as and when they are able to do so. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an accessible complaint policy and procedure is in place. However, it is recommended that the management should provide a complaint/suggestion box to service users. The home has an adult protection policy and procedure is in place. All staff have attended adult protection training. EVIDENCE: Ravenswood Road has a clear and accessible complaint policy and procedure is in place. The home has displayed a complaint procedure in the hallway of the home. Staff maintain a complaint folder and keep record of all complaints received and how investigation is carried out within timescale. However, it was suggested by service users during the interview that the home should provide a complaint/suggestion box for them should they wish to suggest any matter to the management. The registered manager advised the inspector that he will provide a complaint/suggestion box within a short period of time. The home has an adult protection policy and procedure in place. The procedure provides sufficient guidance for staff to protect service users from various forms of abuses. Following the requirement of the previous inspection report, all staff have attended adult protection training. Staff have awareness of adult protection issues. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are suitable for its stated purpose, it is safe, accessible and comfortable for its service users. The home is free from offensive odour. EVIDENCE: Ravenswood Road premises are suitable for its stated purpose. It is a purpose built house. It is accessible, safe and well maintained. The home has a planned maintenance and renewal programme for fabric and decoration of the premises, with records kept. Circle 33 are responsible for the decoration of the communal areas of Ravenswood Road. Since the last inspection the old kitchen units of the far house were completely replaced. All bedrooms have en- suite shower and toilet facilities. In addition to this there is a communal toilet in the rear house. At the time of the inspection a tour of the premises was conducted. The premises were found to be cleaned, hygienic and free from offensive odour. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 17 Circle 33 Housing Association carried out checks on all water outlets and received a certificate, which confirmed that, the Water Supply (Water Fittings) Regulation 1999. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service carries out all relevant checks on staff before the appointments. The home provides staff training for their professional developments. They are receiving regular supervision. A newly appointed staff is provided a structured induction training. EVIDENCE: Staff files were examined during the inspection. All staff have sign contract letters with the home and all have job descriptions. A newly appointed staff informed that he has read code of conduct set by General Social Care Council. Staff of Ravenswood Road are qualified. The senior practitioner has nursing and counselling qualifications, two of the practitioners are qualified counsellors and have NVQ level 3 qualifications. At time of the inspection two members of staff were on duty. Staff rota confirmed that two members of staff were on duty in the morning shift in addition to the registered manager and two staff were on duty in the afternoon. One staff sleeps in the premises at night shift. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 19 Ravenswood Road operates a thorough recruitment procedure based on equal opportunities and ensures the protection of service users. Two written references were available in the staff files. The management carried out Criminal Record Bureau checks prior to the staff being appointment. The home has a training and development plan and training budget. A newly appointed staff received a structured induction and this is linked to the aims and objectives of the home stated in the Statement of Purpose. All staff receives fortnightly group supervision and fortnightly individual supervision. Minutes of supervision were available for inspection. The inspector considers this standard is exceeded the National Minimum Standards. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has adequate training, knowledge and experience to meet the stated purpose of the home. There is an effective quality assurance system in place to measure the service delivery. The registered manager ensures the health, safety and welfare of service users and staff. EVIDENCE: The registered manager has 11 years of working experience in this field and has been at this setting since February 1999. He has a diploma in counselling and completed NVQ level 4 qualifications in management. The manger has obtained A1 assessors for NVQ training award. The manager is experienced and suitably qualified to run the service to meet its stated purpose, aims and objectives. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 21 The project is signed up to the ‘QuADS’ framework standards for alcohol and drug treatment services. There is an eight weekly service users’ feedback schedule that the registered manager analyses. This influences decisions on an aspect of the programme. Staff were provided health and safety, first aid, food hygiene, moving and handling and adult protection training. The registered manager ensures that all electric, gas appliances and portable appliances are regularly checked. Staff carry out fire alarm tests on a weekly basis. A fire drill is carried out on a three monthly basis. The registered manger carried out a fire safety risk assessment of the premises. The service has a valid insurance cover in place against loss or damage to the assets of the business. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 3 32 3 33 3 34 3 35 3 36 4 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 2 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x x x x 3 x Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 23 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 YA13 Regulation 16 Requirement It is required that the registered manager to liaise with service users care managers to apply for their freedom passes in order to make their community visits more accessible and affordable. Timescale for action 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. YA13 2. YA22 Refer to Standard Good Practice Recommendations The registered manager should ensure that service users have access to free local newspapers and the home to buy a weekly local news paper in order to provide information about the local community. The manager to provide a complaint/suggestion box to service users should they wish to suggest any matter regarding the service delivery. Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Rugby House Project DS0000007251.V326152.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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