Inspection on 23/02/06 for Smithfield Detoxification Unit

This inspection was carried out on 23rd February 2006.

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 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 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 22/09/05

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 23rd February 2006 10:00 Smithfield Detoxification Unit DS0000021657.V278910.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 Smithfield Detoxification Unit DS0000021657.V278910.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. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 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.V278910.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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 will 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. 22nd September 2005 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.V278910.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, which was carried out on Thursday 23 February 2006 at 1000am and lasted for 4 hours. The inspection consisted of a review of records and procedures and a tour of the building. Time was spent in discussion with staff and residents to gain a picture of what it was like to stay at the centre. During the inspection 9 residents and 8 staff were spoken with. The centre provides a good level of care for individuals detoxifying from drugs or alcohol and provides groups to address these problems. During this inspection only selection of key National Minimum Standards were assessed therefore to gain a full picture of how the centre needs the needs of clients, this report should be read in conjunction with previous reports. What the service does well: What has improved since the last inspection? The manager and staff are to be commended on the large amount of work undertaken to ensure that medication practices within the centre are safe. Carpets in the drug unit have all been deep cleaned. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 6 Work has been commenced with local purchasers to develop and ensure more effective follow up in the community of clients who self refer. Ongoing discussions are taking place to upgrade the alcohol unit. 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.V278910.R01.S.doc Version 5.1 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.V278910.R01.S.doc Version 5.1 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): None of these standards was assessed at this inspection. EVIDENCE: Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 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): 7 Ongoing work to provide more robust support on discharge should continue. EVIDENCE: At the previous inspection in September 2005 clients who self referred to the centre felt that on discharge they were somewhat on their own. A recommendation was made concerning this and the centre is now in discussion with the referring agencies to ensure that more robust follow up, help, advice and support is available. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 10 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, 16 and 17 Clients are enabled to start to get their life on track in a supportive setting with a range of therapeutic and recreational activities available. A good range of food is available to assist recovery. EVIDENCE: The main aims of admission to the centre are to detoxify clients from the effects of alcohol or drugs and to help them address the use of these substances, the effect they are having on them and to introduce a different lifestyle. During the first three days of admission the client concentrates on detoxification and for the rest of the stay group meetings twice a day should be attended. The centre does offer other activities including therapeutic massage and acupuncture, art, creative writing and computer classes. The main lounge has a snooker table and other activities such as cards are available. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 11 Clients felt that their needs were being met very positively whilst in the centre, but one did comment that some of the activities were not available free of charge in the community so could not be continued which “was a shame given the positive nature of them”. Clients confirmed that they felt they were treated with dignity and respect and that the centre expected and enable them to start to regain control of their lives if this had been lost. Clients on the alcohol unit remain on the unit during their stay but clients on the drug unit have regular trips out as a group, the nature of the activity being decided by them. Alcoholics Anonymous and Narcotics Anonymous hold regular public meetings at the centre. Clients spoke highly of the food available at the centre. Main meals are served in a self-service style cafeteria with at least three choices of main course available at each main meal. Special diets are catered for and healthy options are available. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 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): 20 Medication practices are in place to ensure the safety of residents, but attention to a detail is needed to ensure total effective management and control. EVIDENCE: At the previous inspection in September 2005 a lot of concerns were raised about the way medication was handled by the centre and a number of requirement were made for the centre to change its practice. The centre has since made a lot of changes to meet those requirements and the registered manager and staff are to be commended for the work undertaken to ensure that practices do not put clients at risk. The centre has new medication procedures that include updated legislation on disposal of medication and instruction on the disposal of illegal substances. All records are clear and an audit trail can be followed for all medication. The home have good procedures for the collection and verification of clients medication. There are good procedures in place for the ordering, receipt and Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 13 disposal of medication. These procedures are effective in highlighting any dispensing errors and regular internal audits and checks should highlight quickly any errors by staff or irregular shortfalls in medication. Discussions have taken place with and regular contact is maintained with the supplying pharmacy. The homely remedies section of the policy needs to be written so that it is clear and accords with the instructions on the Medicine Administration Record. The temperature of the medication room and the drugs refrigerator are recorded daily and the fridge was found to be kept within the correct temperature range. Medications are maintained in the office on each unit. It recommended that a separate room be used for the storage of medication because of the need to prevent access by staff and clients whenever this is used and the open accessibility of these cupboards. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 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): None of these standards was assessed at this inspection. EVIDENCE: Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 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 26 The home still needs general refurbishment to maintain an appropriate environment, but action is taken to keep the centre clean and as presentable as possible. EVIDENCE: The manager reported on progress on general refurbishment of the building particularly the alcohol unit, refurbishment of which had been a requirement in the last two inspection reports. Discussions between Turning Point and the Guinness Trust, the owners of the building, which the manager felt showed there was a commitment to refurbishment occurring. This requirement is reiterated. The carpets on the drug unit identified in the last report required cleaning or replacement, have undergone deep cleaning and are now in a satisfactory condition. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 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 The centre needs to ensure that carers are appropriately trained, but the use of carers with previous addiction problems is very positive. EVIDENCE: The centre is required, apart from the trained nurses, to have at least 50 of the carers with a National Vocational Qualification level 2. At this inspection it was stated that 10 of the carers were undertaking a course leading to NVQ level 2, and 5 staff were also undertaking the assessors training. It is important that the centre meets the required level so that care is delivered by suitably trained staff. A number of the staff has previously had problems with alcohol and drugs and clients were particularly positive about the role these staff played because they understood first hand the challenges facing clients. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 17 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): None of these standards was assessed at this inspection. EVIDENCE: Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 18 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 X 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 2 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X X X X X X Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 19 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 YA20 Regulation 13 Requirement The homely remedies policy must be rewritten to accord with the policy on the Medicine Administration Sheets. 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. (Previous timescale of 30/12/05 not met) The registered provider must ensure that at least 50 of support staff complete NVQ level 2 Timescale for action 01/04/06 2 YA24 23 01/09/06 3 YA32 18 01/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations The manager should work with the PCT’s whose residents DS0000021657.V278910.R01.S.doc Version 5.1 Page 20 Smithfield Detoxification Unit can self refer to develop a follow up system after discharge that residents can feel confident in to get continued support. 2. YA20 Consideration should be given to medication being kept in a separate room and not in the unit offices. Smithfield Detoxification Unit DS0000021657.V278910.R01.S.doc Version 5.1 Page 21 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. 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