Inspection on 11/10/07 for Stanfield House

This inspection was carried out on 11th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stanfield House 11/11/08

Stanfield House 09/10/06

Stanfield House 07/03/06

Stanfield House 20/09/05

Stanfield House 16/03/05

Stanfield House 17/06/04

Stanfield House 25/02/04

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 Stanfield House 4 Stainburn Road Workington Cumbria CA14 4EA Lead Inspector Nancy Saich Unannounced Inspection 11th October 2007 10:00 Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stanfield House Address 4 Stainburn Road Workington Cumbria CA14 4EA 01900 65737 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) www.turning-point.co.uk Turning Point Limited vacant post Care Home 12 Category(ies) of Past or present alcohol dependence (12), Past or registration, with number present drug dependence (12) of places Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 12 service users to include: up to 12 service users in the category of A (past or present alcohol dependence) up to 12 service users in the category of D (past or present drug dependence) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 9th October 2006 2. Date of last inspection Brief Description of the Service: Stanfield House is an older property located in a residential area of Workington. It is within walking distance of the town and has good local and national connections. The property has three floors and is adapted to take one person with physical disabilities. The home takes people between the ages of 18 and 65 who have had problems with substance abuse but who are no longer using drugs or alcohol. The home is not staffed twenty-four hours per day so residents must be able to function fairly independently. The home is registered to Turning Point, a national charity who run different types of home throughout the country and who have other services for people with problems of addiction. No one is currently registered as manager but the person who is running the home is applying to be registered. Further information on Turning Point can be accessed through their website on www.turning-point.co.uk. Costs range from Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the main or ‘key’ inspection for the year. We asked the residents’ representative to give out postal surveys to the other residents, their families, social workers and health care professionals. We had a good response with generally positive responses. We also asked the manager to complete a detailed document telling us how they reach good quality standards of care and services in the home. This Annual Quality Assessment (the AQAA) was returned promptly and was very detailed. It contained a lot of evidence of improvement that we checked out during the inspection. The lead inspector went out to the home and spent the day with residents and staff talking and observing the life of the house. We also read documents and walked around the home to confirm what the manager had said in the AQAA was a true reflection of the way things were progressing. What the service does well: This service is good at giving people information through their brochure, their website and locally produced guides. They make sure that new people are ready to benefit from the opportunities on offer in the house. We judged that the service is good at finding out what individuals want and also in making sure that the views of the group are discussed. They are good at helping residents look at risks and at finding new ways to manage risk. We judged that the service is very focussed on personal development for each person in the house and do this through group and individual work. Residents were happy with the range of activities and training opportunities on offer. They spoke about educational opportunities, going to the gym, fell walking, hobbies and building on daily living skills like cooking. There was a lot of evidence of how the staff help people to rebuild family relationships that may have been damaged by substance abuse. We learnt of one family’s experience: • • ‘We are so pleased with how well our son has done in the project…it’s a pleasure when he comes home…’. ‘My mum and dad are so proud of how I am doing and I am not going to let them down again’. The project encourages healthy eating and teaches practical skills like budgeting, shopping and cooking. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 6 The staff are good at giving residents personal support in as sensitive a way as possible. We judged that the service is good at encouraging people in healthy living and in finding the right kind of health care for their individual needs. The staff are trained in a range of alternative therapies that residents really enjoy and say are very much part of their recovery. The staff team and the organisation are good at listening to people and dealing with any complaints. We also judged that they are aware that their residents may well be vulnerable to different sorts of harm and know how to prevent and deal with anything of the sort. We have evidence to show that they have managed this in an excellent way. The home has good management systems in place that are working well. They are good at ensuring the basic things like fire and food safety are in place, that records are up to date and that the building is properly maintained. What has improved since the last inspection? Residents have been encouraged to provide their own guide to living in the house. Care plans have been made more centred on the individual and show promise of further improvement. The staff team has made a lot of new contacts with some very specialised services that provide specific help for people who have suffered particular losses or traumas. The house has become a smoke free zone and people are encouraged to reduce or stop smoking. The staff team have really helped to allow residents to manage the kind of prescription drugs we might all need in a more responsible manner. The environment has been improved and the home now has four rooms with en-suite shower and toilet, the disabled access has been improved and major improvements have been made to the gas and electric services and to the insulation of the building. The acting manager now makes sure that there is staff in the home seven days a week and that there is someone in the house during the evening. Residents said they were happy with having someone in the house every day. We saw a fairly new staff team that is developing an open approach to improving their individual and group approach to how they work with residents. We judged that this team has the promise to grow in strength, commitment, skill and knowledge. They are supervised in a way that puts the emphasis on how they work with residents. The acting manager, the company and the staff team gave us evidence that the home has what one person called: Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 7 • ‘A passionate commitment to get things right for users – not just to please inspectors or people who buy services.’ This can be seen in the way they have measured what people judge to be good quality in this setting and more importantly have put changes into place. The management are continuing to check that they are getting things right for residents and are working hard to establish new systems and practices. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 8 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 Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. This home gives information about the service in different ways so that new people can be properly informed and they also make sure the new person will fit into the existing group and benefit from the support available. EVIDENCE: Turning Point has very good information about all their services available in all types of formats. Their website is kept up to date and gives details of the organisation. This house has a brochure and also has a service user guide. They also provide a ‘what to do if…’ guide that helps new people to get over the problems of settling in. These were available in each bedroom. Residents in the home have just produced their own guide to living in Stanfield House that will be used with new admissions. Every person in the home is asked to fill out their own assessment of their personal and substance use history and to state what they think they want and need from the project. These were seen in individual files along with a rating scale that the staff do with residents at the start, middle and end of their stay. We saw other very good assessments and initial plans to help new people settle in. Most people spoken to have come to the home to visit – although at times the assessment is done at a distance. There were social work Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 10 assessments and other professional assessments on file. The staff in the home also do a thorough assessment form prior to and at the start of the stay. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This service deals with risk and rights in a straightforward way that helps people face their future with confidence. EVIDENCE: When we spoke to residents they were fully aware of the written plans everyone has that helps them to mark out the steps they need to take to recover from substance abuse. They said they felt they ‘owned’ these and they were encouraged to follow these by the staff. We read the plans and found that they were very much centred round what the person wanted – not what other people felt they should do. We saw plans that included social, psychological and emotional needs. We also saw plans that included how people would deal with either physical or mental health needs. Everyone had included in their plan details of education or activities because as someone told us: Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 12 • ‘We need to move forward and we need to fill our time with things to replace the habits we had before…this place helps us to do this’. All of the plans were of a good standard yet we were told that the staff team felt they needed to keep working on the format and talking to residents about how they felt about them. The plans showed very strongly that the residents were encouraged and supported to make decisions about how their recovery would progress. They told us that when they were not making progress this was discussed in their one-to-one sessions with their own worker. They also said that they had to learn to deal with difficulties and used the care planning approach to help them to do that without returning to using drugs or alcohol. The files showed us that the staff team are very careful about risks. We judged that the staff dealt with risk in a very matter of fact way. For example we all take our own prescription medicines and it is accepted that people will manage their own pills unless there is a need the person has identified themselves. We were pleased to note that this has now become good practice in the service. They respected residents enough to know that we all take risks and that residents will face the risk of returning to previous habits almost every day. There were good plans in place that gave people strategies for dealing with these. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are encouraged by the staff and by the opportunities on offer to reshape their lifestyle so they are not reliant on substance use. EVIDENCE: This home is very focussed on personal development. Learning to live with people is part of the assessed needs of almost everyone who comes to the project. Each day there is a ‘house meeting’ and people are encouraged to talk about the minor frustrations of life so that they don’t want to start using again. Residents must also attend regular drug and alcohol discussion groups led by a member of staff. There is a residents group that they conduct themselves. These groups and the regular meetings with their ‘key worker’ are all designed to promote personal development. Residents said they enjoyed these groups, found them challenging and allowed them – sometimes for the first time – to think about other peoples’ cultural, sexual, spiritual or political needs. They judged that this was where the service was most successful. We noted that Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 14 there was a lot of humour amongst the group and people were very relaxed together. Residents spoke about going out to the gym, to classes, going fell walking, shopping, going to the library and generally having a diverse range of individual and group activities. People went out during the inspection and there was evidence of their hobbies around the house. These are all things that might be included in the lives of people with the age and cultural backgrounds of the group in the house. Many of their activities are done in the local community and people have made connections with local groups. They also use specific groups and are part of the local Turning Point community in that they have connections with people who have moved on from the project. They have also been involved in a project with a theatre in Keswick and were asked to talk to actors about their experiences. This helped to inform the actors but was also used as a discussion topic for their groups. Together all of these things help people to have individual rights and to deal with the responsibilities that rights bring. Residents who were near the end of the stay said that just being in the house and doing the group and individual work had brought them to the stage of really feeling that: • ‘ I am ready to go out there and deal with life without drink…I have learnt how to keep away from that old life and how to manage a new way of living. I am determined to put myself back together…’ Residents make their own meals and cook dinner together every night. They shop to a budget and develop their own menus. People told us that this can be daunting but has had great benefits for moving forward. One resident is particularly good at catering and has really helped other people by cooking with them and developing a recipe and methods book for everyone in the home. He said: • ‘Some of us may not have eaten properly for years and might never have cooked real food…I am glad to help out…’ We thought that doing this had helped everyone in the home and had built confidence in a skill. Residents were committed to eating healthily on a budget and a lot of work went into staff and residents looking at this. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. This service encourages residents to deal with any physical or mental health problems in a way that will create good health habits for the future. EVIDENCE: Most people in the home do not need direct personal care but may need prompting and support. Some people have completed some basic daily living skills work with their key worker – that includes some of the things that help people move away from a lifestyle that was fairly chaotic. We judged that residents in this service had been supported and encouraged to have a sense of personal dignity that drug taking and drinking might have taken from them. There was a sense in the home that the residents were taking a pride in themselves and their surroundings. Residents said that anything intrusive – like drug testing - was done • ‘…in as sensitive a way as possible given what they have to do…and it’s only done when necessary…’ Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 16 Staff expect residents to register with health care professionals when they come to the home. If necessary they are helped to get the kind of health care they may not have had in the past. The residents were hopeful that they and Turning Point could deal with the problems getting dentistry. Their care plans and daily notes showed that healthy lifestyles were being promoted and chronic problems dealt with. The home has become smoke free and the residents agreed that this was an improvement. They also showed that people’s mental health and psychological problems were dealt with in an effective way. Residents confirmed those specialists were used to help them. The files showed that the staff had access to counsellors from Cruise, Rape Crisis and a local agency that helped with self-harm. They also help contact experts in health eating, smoking cessation, district nurses and doctors. Staff in the home are trained in alternative therapies – Reiki, aromatherapy and acupuncture – and residents particularly enjoyed a therapy called ‘black box’. These along with relaxation sessions were very popular especially in the evening as many of them have real problems sleeping. The home has improved its access for people with mobility problems and this means they can take people who may need wheelchair access. Residents are expected to deal with their own prescription drugs and the staff check on a regular basis that people are managing this. Each person has a secure medicine store in the home. This home doesn’t allow certain prescription drugs – so for instance people cant come in if they are reliant on methadone. All of this is checked thoroughly and explained before admission. Medication disposal and management is properly documented. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are ready to listen to any concerns and complaints and are good at recognising where people might be vulnerable to abuse and act on this efficiently. EVIDENCE: We asked the staff how they would help people who had complaints and how they would protect them from harm. They said that the home was now a very open place and that they were confident that they would notice any changes that might point to people being worried or unhappy. They said that any complaints were always dealt with properly following company polices and any allegations taken seriously and followed through. They knew how they would report and deal with adult protection issues. All the staff had received training in this and a new member of staff could discuss how to report abuse in detail. We also asked the people who lived in the home and checked something highlighted in the surveys. This had been noticed, dealt with properly and recorded in detail. Residents were happy that staff would notice anything like bullying or intimidation and would help people face their behaviour. They also knew that anyone in the home who was behaving in an offensive way might be asked to leave the project. They also trusted that a staff member or a volunteer who did something abusive would be dealt with properly. They understood that things like racism and sexism were never tolerated in the project. They could talk to people from outside the home if they were worried. The ‘What will I do if…’ guide and the complaints procedure was quoted as how they would act on concerns. They also said they would use Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 18 the house meetings and their own meeting to decide on what they wanted to do as a group. People acknowledged that for minor complaints they were encouraged to solve them as a group. Currently they were working on a couple of things (dentistry and travel passes) that they might have to deal with once they leave the service. We also had evidence of how a particular matter had been dealt with in a way that showed good practice in protecting people. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The house gives residents a comfortable and safe base to live in as they start to develop a new lifestyle. EVIDENCE: This home is situated about ten minutes walk from the centre of Workington. It is on a bus route and there is a rail station on the other side of town. This allows people to use local amenities and makes it convenient for people to visit. The home has its own garden with greenhouse and vegetable plot that residents have been maintaining. The home has CCTV cameras outside for added security. The home was closed for some months earlier in the year so that the house could be upgraded and improved. The house benefited from a new electrical installation and upgrade to central heating. The builders also insulated the roof. The downstairs office has been spilt in two with one half being the manager’s office and the other is a quiet room. This room has a computer with Internet access. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 20 The home has two double bedrooms and the rest of the accommodation is in single rooms. Four bedrooms now have ensuite shower, toilet and sink. Residents said how much they appreciated this extra bit of privacy. One of these rooms is now on the ground floor and has been especially adapted for wheelchair users. There is now a ramp at the front door to help people with mobility problems. The top floor bathroom has been completely refurbished and residents said it was much more relaxing and comfortable. We judged that these things have really improved the environment for residents. We walked around the building and found that a lot of areas had been decorated and improved. Generally the house was clean and tidy. Residents do the household chores themselves and we judged that they were doing a very good job in looking after their environment. Both residents and staff are aware of how to prevent cross infection. Residents also complete food hygiene training and food in the kitchen was being stored properly and all the work surfaces were clean and orderly. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in the home are supported by a fairly new team that has the promise of delivering creative and flexible ways of helping people to recovery. EVIDENCE: The home has three full time and one part time member of staff as well as the acting manager. There have been some vacancies in the team but temporary staff have covered these. We checked on the rosters since April this year and we found that there is now staff presence in the home seven days per week and in the evenings. Residents said they liked having someone around every day and that it had improved the ‘atmosphere’ in the home, as staff were more in touch with what is going on. The rosters are written so that there is a good mix of staff in terms of gender, training, experience and qualifications. The staff are suitably qualified and trained and have diverse backgrounds that help them understand the people in the home and give them the skills and knowledge to work with them. We saw the notes of supervision sessions with staff. These were very detailed and showed that work with individual residents is discussed and practice issues shared with the acting manager. The staff also said they had ‘peer support’ Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 22 meetings where they felt they could talk together about their work and challenge or make suggestions in a safe way. This regular review of practice is a very good way of developing staff. It is included in a new system being developed by Turning Point that is looking at performance and outcomes for all staff. We judged that these things alongside the very good staff training programme have helped this team to grow in confidence and ability. Residents were very complimentary about the staff and had a lot of trust and respect for them. • ‘The staff are very good and really try to understand what my problems are …I can see my key worker whenever I need…I know that they will help me look at where I am going and will challenge me if I need it…’ We checked on how new people are recruited to the staff team and we saw that residents are protected from unsuitable staff through a robust checking procedure. We also found that the company policy about employing people who have recovered from substance misuse problems is a ‘live’ part of their recruitment strategy. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The systems in the home are working well to give residents good standards of care but someone now needs to be registered as the manager of the service. EVIDENCE: We judged that the home has improved in a number of ways since the last inspection. Turning Point had made suitable arrangements for the registered manager’s absence in that an acting manager was carrying out the role. The lead inspector was kept informed of these arrangements though regular monthly reports. The post of Registered manager is now vacant. The company must now submit an application to the Commission for Social Care Inspection by the due date. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 24 In the past two years everything about this home has been looked at by staff and by service users. The organisation itself wanted to make sure that the home is keeping up to date in terms of the environment, treatment and approach. This has meant that the service underwent a very thorough review of the quality standards. The way the home is staffed was changed quite radically. This has meant that there have been staff vacancies – including that of registered manager. All of these were covered by temporary appointments. We saw evidence to show that the company are now working on making permanent appointments. We judged that there was evidence in all areas of the operation that showed that the person who is managing the home and her line manager have not just let the home ‘tick over’ during this period but have introduced things like new strategies for self medication, sought funding for refurbishment, dealt with deployment of staff and looked at things like issues of equality in the service. The lead inspector has been kept fully informed of all the consultations and the changes. The residents and former residents said they had been fully involved and they said that their wishes had been taken into account. It was also noted that many of the changes also meet the government guidelines for this type of therapeutic residential rehabilitation as well as meeting Turning Points own long-term aims. This home has a very well organised approach to the more ordinary day-to-day things that keep people safe and well. We saw evidence that not only do staff work on the rehabilitation tasks but they also look after the fabric of the building and the systems that keep it safe. For example the fire safety is done by a member of staff who makes sure that residents have a thorough understanding of how this needs to be managed but is also able to advise senior staff about fire safety. Residents were able to take responsibility for their own health and safety. They live in a home that has had a thorough review of all the basic safety issues that mean the house is as safe as possible. Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 25 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 4 2 4 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 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 4 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 2 X 4 X X 3 X Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO 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 YA37 Regulation 8 Requirement Turning Point must submit an application for registered manager by the due date Timescale for action 30/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stanfield House DS0000022602.V346179.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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