Inspection on 06/11/08 for St Anne`s Alcohol Services - Leeds

This inspection was carried out on 6th November 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Anne`s Alcohol Services -... 15/01/07

St Anne`s Alcohol Services -... 05/01/06

St Anne`s Alcohol Services -... 18/08/05

St Anne`s Alcohol Services -... 06/10/04

St Anne`s Alcohol Services -... 24/06/04

Similar services:

Oakmount Hostel

Ark House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Anne`s Alcohol Services - Leeds Ashton House 186 Woodhouse Lane Leeds West Yorkshire LS2 9DX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Dawn Navesey     Date: 0 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 35 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: St Anne`s Alcohol Services - Leeds 186 Woodhouse Lane Ashton House Leeds West Yorkshire LS2 9DX 01132434486 01132451526 detox@st-annes.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Jonathan Philpott Type of registration: Number of places registered: St Anne`s Community Services care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence Additional conditions: Date of last inspection Brief description of the care home Leeds Alcohol Service provided by St Annes is situated in St Marks House, a large two storey detached Victorian house. Four of the 19 beds are currently used for acute detoxification and 15 for rehabilitation. This has been a reduction in the overall service due to the withdrawal of funding by the PCT. Offices, medication room and training rooms remain in the adjoining Ashton House. The purpose of the service is to provide acute nursing care and a structured programme of rehabilitation for people with alcohol related illnesses and associated problems. The care home is well located in the university area of Leeds within walking distance of the city centre. There is a small area for visitor parking in front of the building. All bedrooms are below the minimum size requirement but all offer single accommodation and are regarded as fit for purpose. St Marks House has two lounges, dining room and a games room, which offer communal space. A bed sitting unit offers a stepping stone for people preparing Care Homes for Adults (18-65 years) Page 4 of 35 Over 65 0 27 Brief description of the care home to move back out into the community. Meals are provided from a central kitchen in St Marks House with facilities to enable people to make their own drinks and snacks. The service has a nurse on duty for 24 hours working in partnership with a team of experienced alcohol support workers. The fees for the home are 491 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The Commission for Social Care Inspection (CSCI) inspects services at a frequency determined by how the service has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk One inspector who was at the home from 10:30am until 4:10pm on 6 November 2008 carried out this unannounced visit. Care Homes for Adults (18-65 years) Page 6 of 35 The purpose of the inspection was to make sure the home was providing a good standard of care for the people who use the service. Before the inspection, evidence about the home was reviewed. This included looking at any reported incidents, accidents or complaints. This information was used to plan the visit. The manager of the home completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information. We looked at a number of documents during the visit and visited areas of the home used by the people who live there. We spent a good proportion of time talking with the people at the home, staff, the manager and the deputy manager. Comments made to us during the day appear in the body of the report. Survey forms were sent to people using the service, staff and health professionals involved with the service. A number of these have been returned. Information from those returned is reflected in this report. Feedback at the end of the visit was given to the manager and deputy manager. The last inspection of this home was 15 January 2007. What the care home does well: The assessment process for people using the service is thorough and carried out by people who are properly trained. People who use the service spoke highly of it. These are some of the things they said: They are wonderful here, more than up to scratch. The staff take time to see how you are doing and this really helps to build your confidence back up. Peoples health needs are met well and the service has good links with other health professionals. One said, Excellent and efficient service. The structured programme that people who use the service follow gives people good opportunities to develop personal and life skills. This means that many people are successful in their rehabilitation and recovery. Peoples comments included: It is the best thing I have done in my life The lessons learnt definitely work People who use the service also spoke highly of the food at the home. Comments included: Always lovely and in fact too much of it Always an alternative if you dont like whats on Plenty of snacks and drinks available whenever you want them The food is excellent and plenty of choice Always nice The staff team are trained, motivated and committed to their role. People who use the service spoke highly of them. This is what they said: They are wonderful, so kind They know exactly what they are doing, they are so focussed They take time to ask you how you are They are very cheerful and help you build your confidence back up Its a busy place, a lot going on but the staff cope really well Care Homes for Adults (18-65 years) Page 8 of 35 There is a super team spirit All the staff are very approachable and very helpful in any way possible The staff here at st annes are all dedicated in helping the residents in any way possible I never feel like what I say to any of the staff gets dismissed The staff at st annes are a dedicated group of people The manager of the home is well organised and leads the staff team well. Staff said they felt well supported in their role. People who use the service have plenty of opportunities to voice their opinions. They said they felt valued and listened to. What has improved since the last inspection? The manager has addressed the small number of requirements and recommendations made at the last inspection of the service. The laundry door has now been fitted with an automatic door closure which is linked to the fire alarm system. This means it is now safe to be left open and will close automatically in the event of a fire. Staff are now receiving regular supervision to make sure they are carrying out their role properly. They are also receiving updates in training to make sure their practice is up to date. The system for medication being returned to the pharmacy has been improved. This means it is now safer. In the AQAA, the manager also identified other improvements made to the service. These included: We have increased the availability of the visiting medic to the service, thereby increasing the access to medical support and advice for both service users and staff. We have created a Respect Charter which is a permanent reminder for staff and for service users regarding the standard of service that they should be giving and receiving. The service underwent an extensive refurbishment in 2007. This included the installation of new heating and hot water facilities, redecoration, new furniture and soft furnishings, new lighting and electrical work, and improved bathroom facilities. He also said that some staff had achieved accredited motivational interviewing training Care Homes for Adults (18-65 years) Page 9 of 35 that has assisted them in carrying out assessments. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 35 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with excellent standards of pre-admission assesment which makes sure the service can fully meet peoples needs. Evidence: In the AQAA, the manager said, All service users undergo an assessment prior to admission. This is normally done face-to-face with a competently trained member of staff, though in exceptional circumstances it can be done over the telephone or by using information from the referrer. For the very short-term detoxification placements, a triage assessment is conducted. For service users requesting access for the 13-week rehabilitation programme, a comprehensive assessment is completed. He also said, The assessment of each person before they enter the service includes asking about and identifying issues of diversity to assist in enabling the service user to have their individual needs fully meet when they enter the service. This includes, amongst other things, asking questions of culture and belief, as well as issues of disability, communication and any other social needs. Any issues that are identified at Care Homes for Adults (18-65 years) Page 12 of 35 Evidence: this stage that require particular care or support are put into a care plan. Issues such as providing a menu for meals that reflects the diversity of the service user group is important, as well as allowing service users to practice their own cultural and religious beliefs. People who use the service said they were pleased with their decision to commence the programme. One person said, They are wonderful here, more than up to scratch. Other comments we received included: When I came for my assessment the staff were thorough in setting my expectations and outlining the 13 week programme. I was sent a complete outline of how the home is run that included some of the sessions, rules and what a typical day might consist of. I knew on the visit that St Annes was right for me. People are referred to the service from a variety of sources such as their GP (General Practitioner), hospitals or other drugs and alcohol agencies. Assessment of people thinking of using the service is thorough. The assessments are undertaken by the manager or deputy nurse manager, both of whom are experienced and quaified in this area. In the AQAA, the manager said that they had achieved accredited motivational interviewing training that has assisted them in carrying out assessments. The initial assessment establishes whether people want acute detoxification only or are wanting to move on to the 13 week rehabilitation programme. The assessment is comprehensive and looks at peoples motivation to change their patterns of behaviour and at setting goals for their future and recovery. People who use the service are fully involved in the assessment process. People had signed the assesments to show they were in agreement with them and any restrictions on their freedom. The affects of peoples addiction are set out in terms of how addiction affects the person as an individual. For example, relationships that are affected, employment and housing issues. Assessments are multi- disciplinary which means information is gathered from a variety of sources. A medical assessment is also conducted by the services visiting GP and a nursing assessment is carried out by the nurse in charge. This means that health needs are assessed right at the start of treatment. The assessment information is reviewed frequently as people move through the Care Homes for Adults (18-65 years) Page 13 of 35 Evidence: different stages of the programme. During detoxification, peoples needs are assessed every 15 minutes through observation for the first 72 hours. We looked at three peoples assessments and saw they had been carried out properly. It was clear that assessment information leads on well to the care plans for people and makes sure their needs are met properly. Also as part of the admissions process, people sign a licence agreement which sets out clearly what people can expect from the service and what the service expects of them. Care Homes for Adults (18-65 years) Page 14 of 35 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in decisions about their lives, and play an active role in planning the care and suppport they receive. Evidence: In the AQAA, the manager said, Each service user has a care plan or care plans that reflect their needs and their goals. All care plans are agreed between the service user and the member of staff responsible for the care plan, with the service user having the care plan described to them in a way in which they understand.The care plans are set so that they can be reviewed on a regular basis. Where necessary, adjustments are made to the care plan to reflect changing needs or goals. Again, this is done with the service user being fully involved in the process. He also said, Many service users are able to fulfill goals that they would not have reached without the interventions of the service. For example, service users have been able to return to work or find new work after lengthy periods off sick from work. Care Homes for Adults (18-65 years) Page 15 of 35 Evidence: People who use the service have a care plan developed by the home and based on their pre-admission assessment. The care plans are comprehensive and tailored to the needs of the individual person. They are linked to the 13 week treatment programme. We looked at three peoples plans. People who use the service have been directly involved in the development of their care plans and were aware of the contents. There was recorded evidence that the care plans had been continuously reviewed and where necessary amended as peoples needs changed or risks had been identified. One person who uses the service said that staff, Always write positive and personalised reports which made them feel valued. Whilst all of the people using the service have common needs associated with alcohol dependency, several also have additional problems such as depression and low self esteem. These additional needs are all incorporated into the individuals care plan. Staff said they developed plans on a very individual basis even though all people who use the service are following the same treatment plan. This is good person centred practice. People are provided with frequent one to one sessions from their allocated worker where they can discuss their progress and treatment. One person said how this was beneficial to them. They said, The staff take time to see how you are doing and this really helps to build your confidence back up. Everyone we spoke to in the service spoke highly of the service they were recieving and how they are involved. Comments included: I make decisions at the home all the time. Obviously at st annes some decisions are made for me, but I still have others to make. The daily community meetings mean we get to say what we want on a daily basis. Staff said they felt there were plenty of opportunities for people to have a say in the running of the home. One said, I feel residents have plenty of opportunities to voice their opinions. In the AQAA, the manager said, The service is aware that, at the same time as sometimes limiting service users choice, we are promoting service users independence. This is done by improving the service users decision-making skills, and assisting service users in making decisions that are going to have long-term positive outcomes for them and the people around them. Care Homes for Adults (18-65 years) Page 16 of 35 Evidence: The service also conducts interviews with people when they leave the service to see if people have been satisfied. The manager said comments had been very positive. Some of these were displayed in the home and included: It is the best thing I have done in my life. It has made a lot of difference. I feel as though I have a fresh and new start to my life. Care Homes for Adults (18-65 years) Page 17 of 35 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle and supported to develop their lifeskills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: In the AQAA, the manager said, The rehabilitation programme includes providing service users with access to educational and training opportunities.The services that we provide take into account the community that the service is based in, and service users are encouraged to be active members of the community. Service users access other local facilities, such as shops, cinemas, educational, religious and cultural facilities. Voluntary work is encouraged as part of the rehabilitation programme. The lifestyle of people who use the service is directly linked with the structured Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: programme of treatment and recovery. People follow a compulsory weekly programme. This starts with a set rise and shine time and any housekeeping such as cleaning that has to be done. This is followed by a community meeting where people have opportunity to discuss anything that may be bothering them. People spoke very positively about these meetings and said how much support they gained from each other and the staff in this way. The day is then structured around groupwork, individual sessions or community activity. During the initial stages of the programme people may be subjected to certain restrictions to their independence and contact with friends and family. These have been agreed by the person using the service and are seen as important in their aim of achieving sobriety and preventing relapse. As the programme develops these restrictions are relaxed in order that people can develop greater independence and reestablish links with the community. Home visits are arranged as people move through the programme. In the AQAA, the manager said It is recognised that support from families and friends is very important to a person in overcoming difficulties with substance misuse. We involve, where appropriate, families and friends all the way through the persons involvement with the service. People are given assistance in obtaining or getting back into employment. Staff said employment is discussed in future options sessions. They said they have developed links with local employment resources and back to work programmes. They also said they see voluntary work as a good opportunity to getting people back into working. Staff also said they try to encourage people to develop new interests and hobbies as part of relapse intervention. They said the issue of what needs to change in a persons life to prevent relapse comes into all the sessions they do with people. People were currently attending courses in jewellry making, creative writing and computers. People were also using community resources such as the University gym and local shops and cafes. Routines in the service are structured to fit in with the treatment programme. This means that people are comitted to the programme from 9-5pm, Monday - Friday. This lack of flexibility is seen as beneficial to peoples recovery and future independence. One person said, As far as Mon- Fri 9am - 5pm is concerned our day is planned out for us in the form of a weekly rota. After that and weekends the decision on what to do is up to me. People we spoke to said they were treated with respect by the staff and that they felt valued as people. There are good policies in place to protect peoples privacy. For Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: example, if a room search has to be conducted it is done by two staff and in the presence of the person using the service. People confirmed they had their own key and could open their own mail. We saw staff interacting well with people who use the service. In the AQAA, the manager said,Service users health is promoted in a number of ways in the service, including the supply of healthy, nutritious and balanced meals. Full-time and part-time staff have responsibility for menu planning, food preparation and serving of food. Service users participate in menu planning by making suggestions to the staff through a simple form or through verbal communication.As part of the rehabilitation programme, service users have the opportunity to prepare and cook meals for themselves and other people, and our independent living flat provides the full range of facilities for self catering. The menus are displayed in the dining area and showed that the meals are varied and provided a balanced diet. People who use the service spoke highly of the food. Comments included: Always lovely and in fact too much of it Always an alternative if you dont like whats on Plenty of snacks and drinks available whenever you want them The food is excellent and plenty of choice Always nice The cook said she based menus on peoples likes, dislikes and suggestions. Special diets such as diabetic, vegetarian or Halal can be catered for. The cook uses the Internet to gain information on dietary needs. Some consideration should be given to providing the cook with formal training in peoples dietary needs to make sure needs are fully met. Care Homes for Adults (18-65 years) Page 20 of 35 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: In the AQAA, the manager said, We provide a good level of personal support to service users. Service users are made aware during the assessment and admission process of the personal support that they will receive when going through the detoxification programme.Service users have their health care needs assessed at various stages in their programme.In rehabilitation, service users maintain support from their own GP, or if this is not possible, are referred to be registered with a local GP practice. Both the detoxification and rehabilitation programmes have emphases on health care, and promoting service users own responsibilities towards their health care. All the people we spoke to felt that the programme of recovery provided by the staff at the service was good. Comments included: Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: It is the best thing I have done in my life The lessons learnt definitely work Always someone to help you. Staff always come back to you even if they have got called away. Health professionals who are involved with the service also spoke highly of it. Their comments included: Always good communication & liason with our service Any concerns are discussed by phone or face- to- face Prompt in responding to any concerns Once the patient has been referred they seem to be perfectly independent and capable of dealing with the patient/client. We asked health professionals what they thought the service does well. One said,Advice to clients, support through detox and rehab, motivation of clients. On admission the majority of people have health care needs associated with substance abuse. These health needs are highlighted through assessment and appropriate referrals are made to health practitioners. When we loked at records we saw that peoples health care needs are closely monitored and appropriate timely action taken if needed. In the AQAA, the manager said, We have increased the availability of the visiting medic to the service, thereby increasing the access to medical support and advice for both service users and staff. The manager said the visiting GP had good experience of substance misuse. Staff said they had received training in the health care needs of people who use the service. One person we spoke to said they had completed DANOS (Drug and Alcohol National Occupational Standards) units, alcohol awareness training and a 2 day mental health awareness course. They also said they had covered topics such as hepatitis, depression and anxiety. One staff member was about to start an accredited training course in addictions and mental health. Another staff member said that the affects of acute detoxification and the health needs of people at this time had been covered well during their induction. They said they had received good support. Care Homes for Adults (18-65 years) Page 22 of 35 Evidence: In the AQAA, the manager said, We have comprehensive guidelines for staff in the receiving, storage, administration and disposal of medication. Checks of our medication are undertaken by a community pharmacist. We looked at medication storage and administration and found everything to be in good order. The system for returning medication to the pharmacy has been improved as the person collecting it now has to sign to say they have done so. This is good safe practice. The deputy nurse manager told us of plans to improve the service by developing a self medication policy for people who use the service. This is to aid peoples independence in managing their own medication when they leave to service and will be subject to robust risk assessment. Care Homes for Adults (18-65 years) Page 23 of 35 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, and are protected from abuse. Evidence: In the AQAA, the manager said At Alcohol Services, service users have many different opportunities to have their views listened to. A complaints procedure is made available to all service users so that they are aware of what to do in wanting to make a complaint. We saw there is a proper complaints procedure in place which is clear and identifies timescales for responses to complaints. We looked at the complaints book. There had been one complaint received since the last inspection of the service. This had been properly and thoroughly investigated. Most people we spoke to said they knew how to make a complaint. One person said, It can either be brought up in our morning meeting or you can have a private meeting with one of the staff. One person said they didnt know how to complain but said they would speak to staff or their keyworker if they were unhappy about something. The daily community meeting was mentioned by a number of people as a good place to air any niggles or grievances. People thought this meeting was a very important Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: part of the day where they could express their views safely and be supported by staff and their peers. In the AQAA, the manager said, We have created a Respect Charter which is a permanent reminder for staff and for service users regarding the standard of service that they should be giving and receiving. People who use the service and staff were aware of this charter. Comments received included: Its about politeness and respecting each other. It is used as a good reminder for anyone in breach of it. It is discussed at the daily meeting. People said they were confident that the staff took their views seriously and promptly acted upon them. People who use the service said they felt the manager was readily available to them and always listened to their concerns. One person said, I feel validated, valued and listened to. There is a responsible attitude to safeguarding adults. In the AQAA, the manager said, The staff induction training includes Safeguarding Adults, and is repeated every two years so that staff are refreshed and kept up to date. The service follows organisational policies regarding safeguarding adults and whistleblowing. Staff are also trained in Child Protection, as some of the work brings them into direct or non-direct contact with the children of service users. The organisation has a comprehensive policy on safeguarding adults. This makes sure that any investigations into allegations of abuse are dealt with thoroughly and properly. All staff spoken to were aware of their responsibilities to report any allegations or suspicions of abuse. Staff spoke highly of the training they have received in safeguarding adults and were able to describe the different types of abuse. Staff confirmed that their training was updated regularly. The manager is aware of the local authority safeguarding referral procedures. We recommend that the contact details for the local authority are made available to all staff so that they can report concerns outside of the organisation. This will protect people more thoroughly. Care Homes for Adults (18-65 years) Page 25 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design and layout of the home encourages people to live in a safe, wellmaintained and comfortable environment, which encourages independence. Evidence: In the AQAA, the manager said, The home is a comfortable environment in which service users can live. As part of the detoxification and rehabilitation programmes, light cleaning duties are given to the service users. Service users have responsibility for the cleanliness of their own rooms, and are given assistance where necessary. Domestic and other staff carry out cleaning duties to maintain high standards, as well as supporting the service users in their light cleaning duties. He also spoke of the improvements made to the service since the last inspection. He said, The service underwent an extensive refurbishment in 2007. This included the installation of new heating and hot water facilities, redecoration, new furniture and soft furnishings, new lighting and electrical work, and improved bathroom facilities. On the day of the visit we found the home to be warm, clean and totally free of any offensive odours. People who use the service and staff clearly work hard to maintain good standards in the service. Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: People who use the service said: Between staff and the residents the home is always being cleaned. We all do our chores every morning,in addition to this there is a paid cleaner for the other areas. People who use the service said they felt the home had good facilities and was comfortable for them. Staff said they had plenty of options for rooms to use for group work or individual work with people. There are a number of communal areas for people to socialise in. There is also a small kitchen area where people can make drinks and snacks for themselves. There are a number of bathrooms in the home. One of these is a shower room with full access for a wheelchair user. People have access to a laundry room to enable them to do their own laundry as part of furthering their independence. The manager said the door for the laundry had now been fitted with an automatic door closure which is linked to the fire alarm system. This means it is now safe to be left open and will close automatically in the event of a fire. There are good sytems in place for the control of infection. Staff had been trained in infection control and could talk about the measures in place to prevent the spread of infection. Care Homes for Adults (18-65 years) Page 27 of 35 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service and to support the smooth running of the home. Evidence: People who use the service spoke highly of the staff team. This is what they said: They are wonderful, so kind They know exactly what they are doing, they are so focussed They take time to ask you how you are They are very cheerful and help you build your confidence back up Its a busy place, a lot going on but the staff cope really well There is a super team spirit All the staff are very approachable and very helpful in any way possible Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: The staff here at st annes are all dedicated in helping the residents in any way possible I never feel like what I say to any of the staff gets dismissed The staff at st annes are a dedicated group of people Sometimes they speak to certain individuals as if they are children, but to be honest, it is with good reason People who use the service said they felt there were enough staff available to them. Staff said they never felt rushed and had enough staff to meet peoples needs well. There is always a qualified nurse in charge on each shift. The area manager said the organisation had recently had some difficulties in recruiting and retaining nurses. However, they had identified this and were making new proposals to the organisation to address this matter. These proposals should be given serious consideration. Agency nurses are used due to the current nurse vacancies. Staff and managers said they try to use a small number of regular staff from the agency for continuity for people who use the service. Rotas showed this to be the usual case. However, on the day of the visit, an agency nurse who had not worked at the service before was to be in charge on the afternoon shift. It was clear they did not have the experience of this sort of work and peoples needs could be overlooked. The deputy manager did however, give a thorough handover and made sure they were working with an experienced alcohol support worker. We looked at the recruitment processes for people working at the home. The files had the relevant information to confirm these recruitment processes were properly managed. This included application forms, references and CRB (criminal records bureau) checks. In the AQAA, the manager said, The recruitment procedures at St Annes are based in the principles of equal opportunities and the protection of service users. Service users also take part in the recruitment procedure, through short-listing, question setting and being on the interview panel. Also in the AQAA, the manager said, A core principle of St Annes is to have staff teams that want to learn together. St Annes provides a range of training opprtunities for staff to access. We looked at staffs training records and saw they were up to date and regularly reviewed by the manager. One staff member spoke of their induction saying, Its really good here, a great Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: induction, learnt a lot and feel a lot more confident. Other staff said they felt well supported by St Annes and their committment to training and training updates that are given. The organisations training plan is comprehensive and training courses are widely available. The manager also told us in the AQAA that, 3 staff have completed NVQ (National Vocational Qualification) 3 and DANOS awards in the last 12 months. This means staff are qualified to carry out their role. Staff confirmed they received regular one to one supervision meetings. They said this gave them a good opportunity to discuss their role and progress. Care Homes for Adults (18-65 years) Page 30 of 35 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. The interests of people who use the service are seen as important to the manager and staff and are safeguarded and respected. Evidence: In the AQAA, the manager said, The service is managed by an experienced and competent individual, supported by a comprehensive senior line management. The registered manager has many years experience in this service. He has now almost completed the Registered Managers Award and is also undertaking a Diploma in Addiction which he expects to finish in 2009. A deputy manager supports the manager. He is a qualified mental health nurse and he also has a degree in counselling. Staff spoke highly of the management team. Comments included: I have no complaints, one of the managers is always available to us There is good communication, regular team meetings and supervisions make sure of Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: this A health professional who visits the service said, Excellent and efficient service. The manager receives regular supervision from the area manager of the home. The area manager visits the home at least one per month to carry out monitoring visits. They speak with people who use the service and the staff during these visits. The manager sends out surveys to people who use the service asking for their views on any improvements that could be made. He then develops an improvement plan from any suggestions that people have made. The results of these surveys are displayed in the entrance hall of the home. The manager had completed the AQAA to an excellent standard. It gave us all the information we had asked for and had identified well the improvements made to the service and future improvements he wanted to make. He said, I found it very useful to reflect on where you and the service are. In the AQAA, the manager indicated that all health and safety matters in the home are up to date. He said, Health and safety is an important area of the registered managers work. Monthly health and safety inspections are conducted by the home manager. Arrangements are in place to make sure of safe working practices. The home has a comprehensive range of health and safety policies and procedures in place. Care Homes for Adults (18-65 years) Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 33 of 35 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 Some consideration should be given to providing the cook with formal training in peoples dietary needs to make sure needs are fully met. Some serious consideration should be given to the proposals by the area manager on how to recruit and retain qualified nurses in the service. This will make sure that people who use the service have their needs met properly. 2 33 Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 35 of 35 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!