Inspection on 22/09/05 for Smithfield Detoxification Unit

This inspection was carried out on 22nd September 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Smithfield Detoxification Unit 21/04/08

Smithfield Detoxification Unit 12/10/07

Smithfield Detoxification Unit 05/12/06

Smithfield Detoxification Unit 23/02/06

Smithfield Detoxification Unit 10/11/04

Smithfield Detoxification Unit 08/06/04

Similar services:

Littledale Hall Therapeutic Community

Bennett House

Padgate House

Mary & Joseph

Westcliffe House

Richards House

Hamer Cottage

Turning Point (Hoole Road)

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

CARE HOME ADULTS 18-65 Smithfield Detoxification Unit Thompson Street Collyhurst Manchester M4 5FY Lead Inspector Leslie Hardy Unannounced Inspection 22nd September 2005 10:00 Smithfield Detoxification Unit DS0000021657.V256981.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 Smithfield Detoxification Unit DS0000021657.V256981.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. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Smithfield Detoxification Unit Address Thompson Street Collyhurst Manchester M4 5FY 0161 839 8829 0161 839 8825 ruth.anson@turning_point.co.uk 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) Turning Point Ruth Elizabeth Anson Care Home 32 Category(ies) of Past or present alcohol dependence (0), Past or registration, with number present alcohol dependence over 65 years of of places age (0), Past or present drug dependence (0), Past or present drug dependence over 65 years of age (0) Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users require care/treatment by reason of either past or present drug dependence (maximum 10 places) or past or present alcohol dependence (maximum 22 places) Service users requiring care by reason of past or present drug dependence wil be accommodated for a maximum of one month. Service users requiring care by reason of past or present alcohol dependence will be accommodated for a maximum of ten days. 10th November 2004 2. 3. Date of last inspection Brief Description of the Service: The Smithfield Project is a registered service providing a detoxification service with 22 places for people with primary alcohol problems and 10 places for people with primary drug problems. The Alcohol detoxification service offers 23 places. 15 of these places are available to potential residents on a self-referral basis; the other 7 places are for residents that are referred by professional alcohol workers. The alcohol detoxification service was based on a 10-day programme. The drug detoxification service offers places based on a 28-day programme. The project is situated very close to Manchester City Centre, with easy access to public transport routes. The building also contains administrative offices. Bedroom accommodation is based on the ground floor for the alcohol unit and first floor for the drug unit. All bedrooms are single with hand washbasins. People with restricted mobility would not be able to access the drug unit on the first floor. Both units are completely separate. Communal space is provided in both units along with a range of kitchen and laundry facilities. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, was carried out on Thursday 22 September 2005, beginning at 1000am and lasted for 6 hours. During the inspection, 10 residents, and 8 staff were spoken with. The home had undertaken most of the improvements from the last inspection report. During this inspection only a selection of key National Minimum Standards were assessed therefore to gain the full picture of how the home meets the needs of residents, this report should be read with the previous and any future reports. What the service does well: What has improved since the last inspection? Residents now sign a contract with a member of staff that clearly sets out the terms and conditions of the admission and any restrictions this may impose along with what they can expect from the unit and its staff. Bedrooms in the alcohol unit have been redecorated. Records of complaints investigations are now kept separately and securely. Staff receive regular supervision and these records are securely kept. Recruitment policies that follow the required practices are now in place. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 6 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. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, and 5. Appropriate assessments ensure that residents’ needs are understood and met. Discuss over and issue of a contract ensure that the purposes of admission are understood. EVIDENCE: Where the potential resident self refers the unit undertakes the primary assessment of need. Where a professional refers the potential resident, both the referrer and the unit undertake an assessment. The assessment is based around the individual’s substance dependency, and the effects that this has on them both psychologically and physically. Any urgent physical problems are dealt with by the units doctors; otherwise they are referred to the residents own GP on their discharge. Residents sign a contract on admission, which is also signed by the member of staff completing the admission process. This clearly identifies the expectations of the admission, any expectations and restrictions on the resident, and behaviour that could lead to early discharge. It also states what the resident can expect from the unit and it’s staff team during the admission. Smithfield Detoxification Unit DS0000021657.V256981.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 unit delivers a programme of detoxification and rehabilitation that starts to offer support to individual residents in gaining some order to their daily lifestyle. EVIDENCE: Care plans are developed and reviewed in conjunction with residents and include residents desired outcomes from the stay. Risk assessments are undertaken for any risks identified from a standard admission assessment pro forma. Once residents have detoxified, and on the alcohol unit particularly the resident has some choice over the amount of medicine they agree to take to support them through this programme of detoxification, they are required to take part in programmed activities. As one resident said “ this is good because it starts to establish a regular pattern that can be continued on discharge”. The whole ethos of the unit is for residents to discuss and make choices on how they live their life on discharge. This leads to the resident regaining independence in their lifestyle, which it is planned to be alcohol or drug free. Self-referral residents did comment that they had to arrange support from Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 10 external agencies following discharge, though staff did assist in this, they felt that on discharge they were somewhat on their own. This could lead to any progress that had been made during the stay being put at risk.. Residents referred for admission felt more confident that support was available from networks already in place. Smithfield Detoxification Unit DS0000021657.V256981.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): 15 Agreed external contact helps the resident maintain or rebuild and develop appropriate relationships. EVIDENCE: The unit had adopted a new Turning Point organisational policy on relationships. Residents relationships and contact with the community had to be agreed with staff as part of their care plan because of the possible negative effect some of these relationships might have, but contacts particularly with family were enabled if this is jointly agreed to be in the residents best interest. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Residents received appropriate support from nurses and carers with a wide knowledge base to provide holistic care. Current practices for the receipt administration and disposal of medication could put residents at risk. EVIDENCE: Due to the nature of the unit and the treatment provided, support is given in a formal structured way with some curtailment in personal choice and freedom. This is necessary to give an order and structure to the centre and treatment; given the limited time residents stay there and to enable them to make the most of this time Due to the number of findings and requirements identified by the pharmacy inspector during this inspection an additional inspection report has been issued on these matters. A copy of this report is available on request from CSCI. Residents physical health needs were met by not only the registered nurses in the home but by a GP practice contracted to the unit that gave medical input if this was required for a physical condition. Some of the registered nurses had a background in physical health. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 13 All staff had received moving and handling training so that this could be undertaken safely in an emergency, but the manager pointed out that they would only take residents who did not have any moving and handling needs. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 14 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 Staff listened to residents and addressed any concerns appropriately. Systems were in place for the protection of residents. EVIDENCE: Residents were able to make their views known to staff both in groups and individually. Staff were found to take the concerns and views of residents seriously and act upon these and apply sensible flexibility to house rules if it was appropriate to do so. The unit did have a formal complaints procedure and the manager kept the documents relating to resolved and ongoing complaints securely. These documents described the complaint and action taken to resolve it. Staff were found to be aware of the meaning of adult abuse and the action they would take in the event of any concerns being raised. The unit had appropriate procedures in place covering action to take in the event of suspected adult abuse. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 15 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 The ambiance of the alcohol unit has been improved by some redecoration and new furniture but this remains in need of general refurbishment to provide appropriate facilities for the residents. EVIDENCE: Some work has been undertaken to improve the environment in the alcohol service since the last inspection. Bedrooms have been redecorated and new furniture such as comfortable suites and armchairs has been provided. This part of the building is now about 14 years old and as raised in the last report is in need of general refurbishment. The manager confirmed that Turning Point is in discussions with the buildings owners, The Guinness Trust, on this matter. It is important that those discussions are concluded swiftly to ensure that the building continues to be appropriate to meet residents needs. The drug unit is much newer, but the carpets in the bedrooms were found to be soiled and action must be taken to clean or replace. The building was found to be generally kept clean and odour free. Residents were encouraged to do their own laundry in the laundry facilities provided. Staff support was available if necessary. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 35 and 36 Residents receive good focused care from an experienced staff team. The team is well supervised and recruitment procedures ensure that staff’s backgrounds are checked to ensure that they are suitable. EVIDENCE: The work experience of the nurses working in the unit was not only in dependency related services, but also associated physical conditions giving a good spread of knowledge. This helped ensure that residents received good care. Some of the carers had a previous history of dependency themselves and used knowledge they had gained positively for the residents. The staff team were well managed and were now allocated to one of the two areas on a long-term basis to give themselves and the residents stability and encourage the formation of a staff team. The centre employs sufficient staff to meet the needs of residents and at least two staff take part in any community therapeutic meetings. The unit used Turning Points recruitment procedures. Staff files seen contained the required information. Criminal Records Bureau (CRB), including Protection of Vulnerable Adults (POVA) clearance is undertaken by a central Turning Point HR team who inform the manager when this has been obtained. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 17 To ensure good levels of care the National Minimum Standards require homes to have at least 50 of care staff, in addition to trained nurses, to have obtained NVQ level 2 in care. The unit does not currently meet this requirement. The manager stated that they are taking action to train care staff to this level. The arrangement for this training needs to be undertaken as a matter of priority. All staff received regular supervision at least 6 times a year, and records are kept securely. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 40 and 41 Policies and procedures are in place to guide staff in practices that should keep residents safe. EVIDENCE: Since the last inspection a policy audit has been undertaken to ensure that the units policies are fit for purpose, protect residents and are understood by staff. The unit’s record keeping is satisfactory and residents’ files contain a photograph of them. This is important given the rapidly changing resident populations and ensures that records are available for staff to be aware of residents background and need, and the photograph means that residents can be identified in the event of no staff being on duty who have previously met the resident. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X x 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 x 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Smithfield Detoxification Unit Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score X X X 3 3 X X DS0000021657.V256981.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13 Requirement The requirements on medication contained in the additional inspection report dated the 29 September 2005 regarding medication must be met. The bedrooms and communal areas of the alcohol unit must be refurbished. The service must provide the CSCI with an action plan setting out how this is to be achieved. The carpets in bedrooms in the drug unit must be deep cleaned and if this is unsuccessful replaced. Timescale for action 01/11/05 2 YA24 23 30/12/05 3 YA24 23 30/11/05 Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 21 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 Refer to Standard YA7 2 3 YA20 YA32 The manager should work with the PCT’s whose residents can self refer to develop a follow up system after discharge that residents can feel confident in to get continued support. The manager should review the recommendations contained in the additional inspection report dated the 29 September 2005 regarding medication. The registered provider must ensure that at least 50 of support staff complete NVQ level 2/3 by 2005. Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Smithfield Detoxification Unit DS0000021657.V256981.R01.S.doc Version 5.0 Page 23 - 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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