Inspection on 11/10/05 for The Ley Community

This inspection was carried out on 11th October 2005.

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 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

The Ley Community 12/12/06

The Ley Community 28/02/06

The Ley Community 14/03/05

The Ley Community 25/02/05

The Ley Community 26/03/04

Similar services:

Flint House

Yeldall Manor

Cherwood House Care Centre

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

CARE HOME ADULTS 18-65 The Ley Community Sandy Croft Sandy Lane Yarnton Oxfordshire OX5 1PB Lead Inspector Nancy Gates Announced Inspection 11th October 2005 09:50 The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Ley Community Address Sandy Croft Sandy Lane Yarnton Oxfordshire OX5 1PB 01865 378600 01865 842238 bev.smith@tey.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Ley Community Mr Paul Goodman Care Home 58 Category(ies) of Past or present alcohol dependence (58), Past or registration, with number present drug dependence (58) of places The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 58 14th March 2005 Date of last inspection Brief Description of the Service: The Ley Community is a ‘therapeutic community’ situated within a village on the outskirts of Oxford, accommodating up to 58 people. The Community provides a structured and specialist programme for individuals to overcome drug and alcohol problems. This includes opportunities for change, re-building self-esteem and subsequently to move on to independent employment and accommodation. The accommodation comprises of three large residential units with a further smaller house for re-settlement, set within large and exceptionally wellmaintained grounds. An outdoor swimming pool and multi purpose sports pitch are available for recreational activities structured within the programme. Staffing is provided within guidance from the CSCI and uses peer support to manage the day to day running of each building. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was in the home from 9.50am until 3.45pm on a weekday. The majority of residents were in the home at the time of inspection. There were appropriate levels of staff members on duty including management and administration staff. All staff and residents were welcoming and friendly. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The standards in this section were not inspected on this occasion. EVIDENCE: The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&9 Residents have a clear understanding of the restrictions of the programme and the impact on decisions and independence. Risks are measured appropriately. EVIDENCE: The decision to enter the community falls to the prospective resident following a stated understanding of the restrictive nature of the programme. Privacy, choices and freedoms are significantly restricted. Discussion with service users throughout the inspection provided strong evidence that the ‘community’ (peers and staff) feel that the restrictions are an essential element and underpin the success of the programme. “I’ve had a difficult programme, it’s been hard at times because of how restricted we are, but it’s about what you want and how you want the rest of your life to be.” Progress through the programme to re-settlement allows for the strictness of the limitations to be lifted to start the process to independent living. Risk is determined within the remit of the programme at the community. Occupational risk assessments i.e. use of the laundry, gardening equipment, The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 9 use of the kitchen, are overseen by senior residents and if needed staff members. The admissions process determines if an individual would pose a risk to themselves or others. A risk management policy remains available within the community for reference and guidance. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 & 16 & 17 An exceptional level of support and structure is provided, balanced by the direction of the rehabilitation programme and the peer support. Restrictions are clearly understood by residents before admission to the home. EVIDENCE: A Programme Liaison Co-ordinator (PLC) is employed at The Ley Community to manage and oversee education and training for residents. Residents are encouraged and supported throughout the programme to access skills courses through a college network. Course subjects include English and numeracy facilitated by a local college tutor. Access to courses at an external Adult Education Centre continues to be facilitated within the appropriate stage of the programme. The rehabilitation programme requires residents to take more responsibility for planning a future beyond The Ley Community, which includes finding employment; to produce a curriculum vitae (CV), to write letters of application and to undertake training in interview skills. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 11 Voluntary employment opportunities are available with local businesses/groups. Opportunities include becoming a member of auxiliary staff at The Ley. Application and interview for the posts are undertaken. Residents confirmed that future planning is an essential element of ‘moving your life on’. “I can’t wait to move on and build a new life, whilst this has been challenging for me it’s given probably the last opportunity to change my life around. I want a job, to find somewhere decent to live, to learn to drive legally and eventually have a relationship.” Leisure and recreational elements are closely linked to the structure of the programme; responsibility for the care of animals and birds is ‘built into’ the recognised stages. A swimming pool and astro-turf pitch are available for recreation. Stage four of the programme provides the remit for residents to access the local community. Accessing the wider community at weekends is restricted, although there are no ‘locked gates’ that prevent individuals from leaving. Maintaining good relationships with the wider community is facilitated within ‘open days’ and through the ‘liaison officer’. Family visits to service users are carefully facilitated and monitored. Restrictions are stated within service users’ contracts. Telephone and written communication are encouraged and welcomed but carefully monitored by staff i.e. outward and inward mail is read by staff, telephone calls are closely monitored. Residents confirmed that this is stipulated upon admission to the community. ‘Exclusive relationships’ are not permitted, clearly stated within the home’s brochure. This can present issues due to the nature of being human but residents recognise that ‘relationships can also be used to manipulate situations and could have an impact on the success of the programme for those individuals’. The ‘rules’ of the programme define the restrictions and are stipulated at the point of self-referral to residents. The terms and conditions provided to each resident clearly detail the commitment required to complete the programme. The rules stipulate the requirements for mail to be opened and telephone conversations to be observed by staff. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 12 Residents are responsible for catering, including ordering of supplies and the preparation of meals. Comments regarding the standard of the food were positive. An expectation of the programme is for service users to dine together. Three meals a day are provided, plus supper. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Residents are appropriately supported to meet their health care needs. Medication is stored and administered appropriately. EVIDENCE: The programme requires a high level of personal responsibility for personal hygiene and the community; peer support ensures that levels are maintained. Female service users are supported within single sex groups to ensure their needs are being listened to. A GP can be accessed on a weekly basis within the home. All other primary health care needs can be meet upon request. Dental treatment is available. Healthcare plans are written as required dependent on changing need. A monitored dosage system (blister packs) for medication administration is used alongside individualised boxes/bottles. Medication administration records are based upon a local pharmacy format. Medication administration records were generally accurate. Medication is stored appropriately. Surplus medication was stored for two individuals that did not match the stored amount recorded on the administration record. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 14 Following the inspection a staff member stated that this medication was no longer in use and would be returned to the pharmacist. Staff knowledge regarding types, uses and side effects of medication has improved since the last inspection. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 A clear and robust complaints process is available to residents and their representatives. Complaints are managed efficiently and within appropriate timescales. Protection of residents is assured by the availability and knowledge of the local adult protection guidance. EVIDENCE: Complaints received at The Ley Community are clearly investigated and comprehensively responded to within 28 days in line with The Ley Community policy. Full explanation of the investigation, its findings and additional information are included within the complaints records. It is the inspector’s view that a clear and robust complaints procedure, available to both service users and their representatives remains. The home has a copy of the Oxfordshire multi agency guidance for the Protection of Vulnerable Adults. The Ley Community has produced policy documentation relating to the protection of vulnerable adults. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The standards in this section were not assessed on this occasion. EVIDENCE: The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 A clear and robust recruitment process ensures the protection of residents. EVIDENCE: Four staff files were viewed. Clear, consistent and up to date records are held reflecting the requirements of the standards and legislation. A photograph is included within staff files. It is recognised that the employment of previous residents may highlight a number of issues within recruitment checks, but acknowledgement is made of a valuable experience and support that can be provided from people who have completed the programme. The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The standards in this section were not assessed on this occasion. EVIDENCE: The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 4 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Ley Community Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000013104.V252761.R01.S.doc Version 5.0 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 The Ley Community DS0000013104.V252761.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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