Inspection on 03/11/05 for Rugby House Project

This inspection was carried out on 3rd November 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rugby House Project 15/01/07

Rugby House Project 03/03/06

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 3rd November 2005 10:00 Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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.V262660.R01.S.doc Version 5.0 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.V262660.R01.S.doc Version 5.0 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.V262660.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th February 2005 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.V262660.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted on a weekday morning on 3/11/05. The inspector spoke to all six-service users and interviewed three members of staff including the registered manager. They all expressed their satisfaction with the high standards of service provided in the specialist service. 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. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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.V262660.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 and 5 The service carries out a comprehensive needs-led assessment prior to an admission to the service. Staff have adequate skills, experience and knowledge to meet service users specialist assessed needs. EVIDENCE: The registered manager ensures that a service user’s pre-admission assessment is carried out prior to the admission into the home. The registered manager or the senior substance misuse practitioner, carry out a need assessment of the service user prior to the admission. The service has developed a new assessment tool in June 2005 called ‘Alcohol & Drugs Needs-lead Assessment Form’. This assessment is very comprehensive with detailed information, for example it covers the reason for considering residential treatment, history of alcohol/drug use, risk issues, emotional and psychological functioning. On the day of inspection, a service user was admitted into the home and the inspector observed the admission process. From the discussion with six service users, staff and viewing documentations it was clear that the specialist service is able to demonstrate that therapeutic framework is based on current good practice. The service network works effectively with national umbrella organisations specialising in dependency rehabilitation such as the National Treatment Agency, Drug and Alcohol Concerns, and local Drug and Alcohol Teams. Service users admitted receive clear information about the therapeutic regime, duration, and requirements of Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 8 the programme. All staff working have at least two years of experience in addiction work, and all have relevant qualifications, for example, qualifications and experience in psychotherapies and counselling services. All service users are short-term, the maximum successful stay being six months. They are issued with a licence agreement from the landlord, Circle 33. Service users sign to a programme agreement that structures the therapeutic approach. This includes agreeing to breath and urine tests, room search if staff suspect that a service users might have drug/alcohol in his/her possession, observing curfews and attending group meetings. What is expected, and the range of sanctions are well set out in the ‘Residents’ Handbook’. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 The registered manager develops and agrees with each service user an individual care plan, which includes treatment and rehabilitation. Risk assessments are carried out in order to minimise/ eliminate risks factors. EVIDENCE: Staff collect information from service users self-assessment forms and care records for developing care plans are incorporated in the action plans. Individual care plans are reviewed by the dedicated key workers on a 12 weekly basis. Care managers of the placing authorities also carry out external reviews at eight and twenty weeks. Care files were well organised with a front index and a good system of modulating the information. There is a section in these files for service users who are on ‘Drugs Testing and Treatment Orders’ (DTTOs), included reports to the court on the test reports. Staff respect service users rights to make decisions, and their rights are limited only through the assessment process, involving them and recorded in the individual care plan. For example service users sign agreements that on their first week they would not leave the premises unless accompanied by staff, Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 10 second week only are permitted to go out with senior service users and from the third week they are able to visit in the community as long as they return to the home by 10 pm. Weekdays are structured around compulsory and punctual attendance at programmed sessions. Such conformity is seen as essential to achieve physical and mental freedom from former substances of addiction and destructive lifestyles. Risk issues are identified during the assessment process prior to the admission. Staff of Ravenswood Road enable service users to take responsible risks, ensuring they have good information on which to base decisions within the context of their care plans and risk assessment strategies. Risk assessments are reviewed in every eight weeks. ‘Missing Person Procedure’ detailing essential information and a description of the service users were held on files. This is triggered in after 24 hours, but in reality this is rarely used as it typically means a person has lapsed in their commitment to the programme. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. The group and individual sessions are geared towards developing service users social, emotional, communication and independence skills. EVIDENCE: The home offers service users to attend in excess of 18 hours of sessions during the week restricts options to work or to attend some courses. The home encourage service users to begin the process of rehabilitation at any time after one month of their admission. This period varies from individual to individual depending on their emotional and physical health. The structured programme for the week was seen which included training on relapse prevention, communication, health education, anger management, men’s group and women’s group. There is initial restriction about going out accompanied. In week one service users must be accompanied by staff and in week two they must be accompanied by an escort who will a senior and responsible service user. However, the restriction gradually reduced and most participate in activities away from home during the evening and weekends, for example, Buddy Schemes and voluntary work at hospital. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 12 Staff support service users to maintain family links and friendships inside and outside the home, subject to restriction agreed in the care plans. Service users can meet their friends, however, in accordance with aims and objectives of the service, those who are under the influence of alcohol or drugs are not welcomed. The home’s routines and house rules allow service users to take appropriate responsibilities in their lives. Minutes of service users meetings and records demonstrate that they are consulted and included in planning decisions in accordance with their care plans. All service users prepare their own meals and do their own shopping. One of the weekly group sessions covers health issues, including healthy eating. Key workers monitor service users diet and encourage cooking meals, which is nutritious, varied and balanced. Staff do not encourage service users to use microwave to heat up frozen meals instead teach them how to cook hot meals on a daily basis. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Service users are encouraged to make themselves independent and to take control over their lives. Staff teach service users to self-administer medications. EVIDENCE: Individual care plans demonstrate that specialist support is made available to service users. For example anger/stress management, relapse prevention and art therapy. Current service users are young and capable to maintain their own personal hygiene. They did not need any support in this area. Service users individual work records set out the preferred routine likes and dislikes. The registered manager ensures that the health care needs of the service users are assessed and procedures are in place to address this. Service users have access to G.P and dental services. The local G.P provide temporary medical services as and when required. Staff administer medications for service users and record medication administration on Medication Administration Record (MAR) Sheets. At present two service users self-medicate. Staff monitor service users medication administrations. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 14 Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 The complaint policy and procedure of the service is easy to understand and is made available to all relevant parties. All members of staff are required to attend adult protection training. EVIDENCE: The service has a clear and accessible complaint policy and procedure available in order to deal with complaints received. A record of complaint was kept by writing in a complaint book including details of investigation and any action taken. Service users interviewed confirmed that they were aware of the complaint procedure, however, they did not have any reason to make complaint against the service. The service has an adult protection policy and procedure. However, discussion took place regarding the clarity of the adult protection procedure with the registered manager and two members of staff. Members of staff including the registered manager agreed with the inspector that all staff would benefit from adult protection training to update their knowledge on adult protection in order to protect service users from all form of abuses. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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 the following standard(s): 24,27 and 30 The premises is suitable for its stated purpose, it is safe, accessible and comfortable for its service users. Decoration works were carried out this year. 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 only responsible for the decoration of the communal areas of Ravenswood Road. Complete decoration works inside and outside the buildings were carried out this year. However, the registered manager informed that the old kitchen unit of the far house had still to be replaced. There are no communal toilets on the first floor of the rear building. However, all bedrooms have on suite shower and toilets. At the time of the inspection a tour of the premises was conducted. The premises were found to be clean, hygienic and free from offensive odour. Following the recommendation of the previous inspection report, Circle 33 Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 17 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.V262660.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 and 35 At the time of the inspection the number of staff was sufficient to meet current service users assessed needs. Members of staff are qualified and have experience in the relevant field. The service carries out relevant checks on staff prior to all appointments. EVIDENCE: Staff of the project are qualified counsellors. Currently three members of staff have achieved their NVQ level 3 in health and social care, the manager has achieved his RMA. Two of the senior members of staff are undertaking A1 award. All the team members are educated to degree level in relevant disciplines. At the time of the inspection the staffing level was satisfactory. Staff rota confirmed that there were two members of staff on duty in addition to the registered manager. One member of staff sleeps in the premises at night. Staff and service users interviewed were satisfied with the current staffing level. All staff are given copies of code of conduct and practice set by GSCC. The registered manager obtains two reference letters for each member of staff. The human resources department of the project carry out all relevant checks including the CRB checks prior to the appointment of new staff. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 19 The service operates a thorough recruitment procedure based on equal opportunities. The service has a training and development plan and dedicated budget for its staff. All newly appointed staff receive an induction programme including visit to other of the project’s homes. The programme covers the philosophy and structure of the recovery programme, alcohol and drug testing, dealing with difficult situations and safety arrangements such as fire safety. The registered manager advised that all staff are undertaking training at least to level 3 NVQ. However, the registered manager must ensure that all staff attend adult protection training by a trainer. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 The registered manager has adequate training, knowledge and experience to meet the stated purpose of the project. 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 ten 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. Therefore, he is experienced and suitably qualified to run the service to meet its stated purpose, aims and objectives. 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. Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 21 The Regulation 26 visits are being undertaken and were observed to be thorough. The inspector spoke to all six-service users and staff members on duty who expressed their satisfaction with the standard of service provided by the project. From the examination of documentation and discussion with staff and registered manager it was evident that the manager ensures, so far as is reasonably practical, the health, safety and welfare of the service users and staff. The staff training included manual handling, fire safety, first aid, and food hygiene. The registered manager ensures that all electric, gas appliances are regularly checked. Staff carry out fire alarm tests on a weekly 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.V262660.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 4 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rugby House Project Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x DS0000007251.V262660.R01.S.doc Version 5.0 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 YA23 Regulation 18 Requirement The management must ensure that all staff attend adult protection training in order to update their knowledge in this area. Timescale for action 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Rugby House Project DS0000007251.V262660.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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