Inspection on 26/02/08 for The Progress Project

This inspection was carried out on 26th February 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Progress Project 26/05/09

The Progress Project 15/09/08

The Progress Project 06/09/06

The Progress Project 31/01/06

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 The Progress Project 22 Winchester Road Worthing West Sussex BN11 4DH Lead Inspector David Bannier Key Unannounced Inspection 26th February 2008 09:30 The Progress Project DS0000064669.V347417.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 The Progress Project DS0000064669.V347417.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. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Progress Project Address 22 Winchester Road Worthing West Sussex BN11 4DH 01903 233390 01903 208857 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) Hemmingrod Ltd trading as The Progress Project Mrs Kate Brady Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (17), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (4) The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2006 Brief Description of the Service: The Progress Project is a care home registered to provide accommodation and personal care for up to seventeen residents with mental illnesses between the ages of 18 to 70 years. Within this number residents with past or present alcohol and drug dependency may also be accommodated. The home is a detached two-storey property, which has been adapted and extended for its current use. The care home is situated in a residential area of Worthing, local shops and other amenities are within walking distance. Communal facilities include two lounges and dining room located on the ground floor. Private accommodation consists of seventeen single bedrooms and is located on the ground and first floors. There is ramp access into the care home. However, access to the first floor is via two staircases. There is a patio garden to the front of the premises and a courtyard to the rear, which are available for residents to use. Fee levels range from £550 to £997 per week. This does not include such items as chiropody, toiletries and hairdressing, The service is privately owned by Hemmingrod Ltd, trading as The Progress Project. At the time of our visit Mr David Hall was the Responsible Individual who supervises the management of the care home. Since then we have been informed that Mr B Schiavone has taken over this role. The registered manager is Mrs Kate Brady who is responsible for the day to day running of the Progress Project. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. The registered provider returned an Annual Quality Assessment Form (AQAA) prior to the inspection. The information obtained from this document will be referred to in this report. An unannounced visit to The Progress Project was made on Tuesday 26th February 2008. The visit was carried out by David Bannier, Regulatory Inspector, and lasted approximately nine hours. We met and spoke to six residents in order to form an opinion of how it is to live at the care home. We also met and spoke to six staff on duty in order to find what it is like to work at The Progress Project. In addition, we met and spoke to two health care professionals who were visiting The Progress Project at the same time. We viewed some of the accommodation, and observed care practices and some records were also examined. A representative of the registered provider was present during our visit and kindly assisted us with our enquiries. Prior to this visit we have been made aware of a recent investigation conducted by West Sussex Caring Services into allegations of abusive practices against three members of staff. The investigation found that the majority of the allegations had been substantiated. The registered provider has confirmed that their employment at this care home has been terminated. They have also confirmed that the members of staff have been referred for inclusion on the POVA (Protection of Vulnerable Adults) register. However this regime had been operating for 4 months before the registered providers became aware of what was going on in their home. There are issues and concerns about the management of the home, lack of experienced and trained staff, lack of assessments being carried out prior to residents being admitted to the home and an absence of quality monitoring systems. We found that the providers are in breach of Regulations 6(a)(b), 14(1)(c)(d), 15(1), 18(1)(c) and 24(1). The Commission has serious concerns about the running of this home and they are now part of the Commission’s Enforcement Strategy. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Information about the home and the care and services it provides is still not accurate and up to date. This means that prospective residents, or their representatives, are not given appropriate information about The Progress Project to help them decide if they want to move there. The needs of prospective residents have not been assessed before they are admitted. This means that it is not clear if The Progress Project is able to meet their needs. The needs of newly admitted residents have not been recorded, together with information and guidance with regard to how they should be met. This means staff do not have the necessary information they require to ensure they take appropriate action to meet residents’ needs. Staff have not been provided with appropriate training to ensure they have the necessary knowledge and skills to meet residents’ needs. The management of the care home has not set up a system for monitoring and, where necessary, improving the care and services provided, to ensure it is being run in the best interests of the residents. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 7 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. The Progress Project DS0000064669.V347417.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 The Progress Project DS0000064669.V347417.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 and 2 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There was no evidence, which confirmed residents had been given appropriate information about the care home in order to make an informed choice about where they want to live. There was no evidence to confirm that prospective residents’ aspirations and needs are assessed. EVIDENCE: During our previous visit we found that, the information provided to prospective residents did not accurately reflect the services provided at The Progress Project. During this visit we were given a copy of the revised Statement of Purpose. Whilst this document has not been dated it states that The Progress Project is registered to accommodate seven residents. However, according the certificate of registration, dated 3rd January 2007, this care home is registered to The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 10 accommodate up to seventeen residents. This indicates that the information is not up to date and still does not accurately reflect the services provided. The document goes on to list the staff employed at the care home, including the registered manager, along with their qualifications and experience. We were informed that the registered manager along with all of the senior and more qualified staff are no longer working at this care home. We spoke to a health care professional about their views of the care home. This person advised us there remained a lack of clarity with regard to what services, particularly group work, was available to residents. The purpose of their client’s placement at the Progress Project was to make use of the groups that the provider has stated will be made available. According to the Statement of Purpose, specific therapeutic techniques that are delivered by qualified staff include medication education and compliance, Tai Chi, motivational interviewing, relapse prevention, stress and anxiety management and an occupational therapy service. However, the health care worker had been told by senior staff that most of this is not being delivered as the care home does not have the qualified staff. We asked the staff on duty about the aims and objectives of the care home. Their responses were very vague. They said that, whilst they had not been told about this, they thought their role was to support the residents in having a more independent lifestyle. However, they were not able to discuss with us how they would achieve this. During our last visit we found that there was no evidence to confirm that prospective residents’ aspirations and needs had been assessed. During this visit we identified two residents to case track. They had been admitted since our last visit. When we looked at their care records we could find no evidence that the needs of either resident had been assessed before they had moved into the care home. In one instance a risk assessment had been completed on the day they had moved in. These identified two specific areas of risk and the interventions staff would be expected to take. There was no other record of any assessment undertaken to identify the care needs of each resident or how they should be met. We spoke to staff on duty, who were clearly motivated to provide the best possible care to residents. They were unable to discuss the specific care needs of residents or how they should be met. This is because they had been given no information or direction. However, they understood that they should provide a caring and supportive environment for residents. The residents we spoke to were relaxed and well supported. They told us they were satisfied with the care and services they were receiving. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 11 Information supplied by the registered provider confirmed that a, “thorough assessment is carried out by two RMNs (Registered Mental Nurses) to identify the appropriateness of the placement. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 12 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 and 9 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Individual care plans have not been drawn up. Residents can make decisions about their lives with assistance as needed. They are also able to take risks as part of an independent lifestyle. However, the level of assistance or support required by individual residents has not been documented. EVIDENCE: During our last visit we found that care plans had not been developed as required and shared with individual residents. This meant it was not clear if The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 13 staff had appropriate information with regard to the identified needs of each resident and the action they should take to meet them. We looked at the records of two residents who had been admitted since our last visit. A care plan had been drawn up for one resident. As mentioned in the previous section, this identified two specific areas of risk and the interventions staff would be expected to take. This document had been drawn up when the resident had first moved in, which was approximately eight months ago. We noted with concern that the information provided identified the resident was at risk as they had complex mental health needs. There was no other information about the care needs of this resident. There was no care plan for the other resident we had identified. We were shown care plans for another resident who had been at The Progress Project for some time. In this instance, information about their care needs was comprehensive and included guidance and direction for staff to follow with regard to how their needs should be met. However, we also noted that the care plan had been drawn up some 15 months ago. During our previous visit we found that residents were enabled to make decisions about their lives with assistance as needed. However, care plans and records did not support this by providing staff with guidance about the level of assistance required. We also found that residents were supported in taking risks as part of an independent life style. However, care plans, risk assessments and records were not available to support the work of staff. We spoke to several residents during this visit. They appeared to be very relaxed and comfortable. They told us about their plans for the future that included moving into their own accommodation and starting up a new life in the community. We also spoke to the staff on duty who described in general terms their role in the care home. We noted that they wanted to make sure residents are well cared for. However, they were unable to explain to us in any detail the specific needs of individual residents and the action they should take to provide the support each resident needed. Information supplied by the registered provider confirmed that, “All care plans are agreed with residents and they are actively encouraged to contribute. Residents attend reviews and all changes are agreed.” The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 14 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): 12, 13, 15, 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in appropriate activities and are able to become part of the community. However, there is no evidence of residents being supported in accordance with individual needs. Residents have maintained family relationships. Residents’ rights have been respected. Residents have been provided with an appropriate diet. EVIDENCE: The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 15 During our last visit we found that, whilst residents were able to take part in activities there appears to be no structure to this. We found no evidence during this visit that each resident has an individual activity programme, or that information about their interests and hobbies is recorded as part of their assessment before entering the care home. Residents who we spoke to told us they are encouraged and supported in taking up individual interests and hobbies. One resident is currently learning to drive whilst another resident is learning to speak Spanish. We saw that residents are able to come and go freely. One resident told us they like to go out for walks along the beach. We noted that residents are able to watch television and listen to music in the care home. There is also a second lounge, which has been equipped with a pool table. Residents told us a pool tournament has been organised and that residents and staff are taking part. Information supplied by the registered provider confirmed that, “Clients are accessing college courses and applying to do voluntary work. Clients actively use the local facilities e.g. the library and sports centres.” We were informed that, where possible, residents are encouraged to maintain contacts with family and friends. One resident told us that, when they moved out, they expected to find accommodation near to where their family and friends lived. The resident told us they visit their family at the weekends on a regular basis. Another resident told us that they do not visit their family. We were told this is because it is not in their best interests to do so. During our last visit we recommended that this information should be included in the resident’s care plan. This would ensure all staff are made aware of this and would be able to support the resident as necessary. We could find no evidence to confirm that this information had been recorded. Information supplied by the registered provider confirmed that, “Clients’ families and friends are always welcomed at the home to visit. Clients spend short breaks away with their families.” We observed staff and residents interacting with each other. It was clear that staff on duty wanted to ensure residents have been provided with the best possible support. Staff treated residents with respect and ensured their dignity has been maintained. The main cooked meal is provided in the evening. A snack meal such as sandwiches or soup is provided at lunchtime. We were provided with copies of the menus to examine. This consisted of a two week rolling menu covering five days of the week. There was no evidence that residents are afforded a choice of menu to take into account personal preferences. When we asked about the weekend, a senior member of staff informed us that residents are expected to cater for themselves with support. However, we The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 16 could find no evidence of the support required by each resident and how staff are expected to provide this. We were also informed that this arrangement is currently under review. We observed the main meal being eaten. Residents appeared to be enjoying the meal provided. This consisted of a selection of Mexican style food including chilli con carne, sweet corn and fajitas. One resident commented, “The food is good. I quite like what we have. ” We also noted that there is a facility for residents to make themselves hot and cold drinks. We were informed that food is left out for residents to make themselves snacks such as sandwiches if they want. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 17 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 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was no evidence that support and personal care provided takes into account the wishes and personal preferences of each resident. The physical and emotional health care needs of residents have been met. Staff deal with medicines in a way that protects and supports residents. EVIDENCE: We spoke to several residents during our visit. Residents said the staff were helpful and supportive. We also observed interactions between staff and residents. Residents appeared to appreciate discussions with staff, whose interactions were sensitive and respectful. However staff have told us they have not been given any direction with regard to methods of working with and the support they should provide individual residents. We were given a copy of the home’s current statement of purpose. This states that. “We aim to provide a unique service that clearly maps out pathways The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 18 towards more independent living for individuals who may not be sufficiently equipped to succeed in mainstream residential care.” We could find no evidence that this service provides clear pathways for individual residents. We spoke to two health care professionals who were visiting their clients. We discussed the care the care home was providing to their clients and their views of the service. One person told us that the reason their client had been admitted to The Progress Project was because of the group work that was to be provided. However, groups have not always been provided as there as been insufficient qualified staff to run them. This person also informed us that they have frequently had to keep a close eye on the placement to ensure the care and support that was agreed, continues to be provided to their client. The second health care professional we spoke to confirmed they had no cause for concern with regard to the care and support provided to their client. However, in discussion, this person was of the opinion that nursing staff employed at this care home provided support. This is despite that fact that The Progress Project is not registered to provide nursing care. Further discussion revealed that the level of care expected included testing urine on a regular basis. This person also observed that the atmosphere in the office can be chaotic. This often meant that their client’s appointments did not always appear in the office diary. Information supplied by the registered provider confirmed that, “All clients have GP’s and are supported in accessing them when they believe it is necessary.” During our last visit we found that, work was still required to ensure the practice of administering medication ensures the safety and wellbeing of residents. This was because there was evidence that the practice of administering medication to residents was unsafe. We noted that, during the course of this visit, arrangements had been made to transfer the medicine cabinet to another part of the premises. We discussed this with senior members of staff who informed us that the purpose of this was to ensure residents have their medication administered to them individually and in an environment where the member of staff can spend time with each resident. We were informed that, where appropriate, residents are asked to sign when they receive their medication. We were advised that this is done to prepare residents who will be moving back into the community in the own accommodation. Senior members of staff explained to us how medication is administered. Practices have changed since our last visit; they now ensure the risk of residents receiving the wrong medication has been reduced. We saw that medication is being stored safely and appropriate records were being maintained. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 19 The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 20 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 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has set up a system for ensuring residents’ views, concerns and complaints are listened to and, where necessary, appropriate action has been taken. Residents have not been protected from abuse, neglect and self-harm. EVIDENCE: During the course of our last visit we found evidence that appropriate steps had been taken to ensure residents’ views were listened to. However, there was no evidence to confirm that complaints received had been fully investigated. During this visit, we were shown that a record of complaints had been compiled. This included details of the complaint, any investigation carried out and the outcome. According to information supplied by the registered provider, two complaints have been received in the last twelve months. They have been resolved to the satisfaction of the person making the complaint. The registered provider also confirmed that, “A clear complaints procedure is in place. All residents’ The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 21 complaints are taken with the utmost seriousness and the complaints process is explained.” During the course of our last visit we formed a judgement that the registered provider needed to provide all staff with appropriate training to ensure residents were protected from abuse. We spoke to staff on duty who were unable to confirm they had received training in identifying and reporting instances of abuse. We also spoke to a representative of the registered provider who also confirmed staff had not received training in this area. Information supplied by the registered provider confirmed that, “All residents are safeguarded from all types and forms of abuse.” We have been made aware of a recent investigation conducted by West Sussex Social Services into allegations of abusive practices against three members of staff. The investigation found that the majority of the allegations had been substantiated. The registered provider has confirmed that their employment at this care home has been terminated. They have also confirmed that the members of staff have been referred for inclusion on the POVA (Protection of Vulnerable Adults) register. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 22 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have been provided with a homely, comfortable and safe environment in which to live. The premises has been decorated, maintained and furnished to a good standard. The home has not been kept to a good standard of cleanliness and hygiene. EVIDENCE: Since our last visit The Progress Project has been re registered to accommodate up to seventeen residents. The original premises has been adapted and extended to provide additional private and communal accommodation. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 23 We visited the communal areas and several bedrooms, which are currently vacant. These areas were decorated and furnished in a comfortable manner meeting the needs of the residents accommodated. We were informed that residents have been encouraged to bring personal effects and small items of furniture in order to make bedrooms as individual as possible. Residents told us they were satisfied with the accommodation provided. They told us they were very comfortable and found The Progress Project to be very homely. We also visited the kitchen area and several bathrooms and toilets. We noted that these areas and the accommodation seen have not been maintained to a good state of cleanliness. Toilets and bathrooms had not been cleaned for a while. Paper towel dispensers and toilet roll holders were empty. The bed in a vacant room had yet to be assembled. The rooms seen had not been cleaned and vacuumed. It gave us an impression that the premises had been neglected. When we brought this to the attention of the registered provider’s representative, we were informed that there is no cleaning staff. It was not clear to us if this was a temporary situation and the provider will be recruiting someone in the near future. Information supplied by the registered provider confirmed that policies and procedures are in place for staff to follow to ensure the risk of cross infections is reduced. However, there was no evidence that staff have also been provided with training with regard to the prevention of infection and management of infection control. Information supplied by the registered provider confirmed they had also taken appropriate steps to ensure the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly. We noted that a maintenance person, employed by the providers was working in the building during our visit. It was not clear to us if this person works full time in The Progress Project. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 24 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, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are not competent or qualified staff to support residents. The home’s recruitment practices and procedures protect vulnerable residents. It is not clear if the staff team have met residents’ needs. EVIDENCE: During our last visit to The Progress Project we made a judgement that the registered provider needed to take appropriate steps to ensure recruitment practices and procedures protect and safeguarded vulnerable residents. During this visit we examined the recruitment records of two staff that had been appointed since our last visit. We found that appropriate information and checks were in place to ensure vulnerable residents have been protected. This included two written references and criminal record checks (CRB). However, there was no record that information regarding the proof of identity of each The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 25 member of staff had been obtained. A representative of the registered provider informed us that this is held at their head office. Residents we spoke to confirmed they were satisfied with the care provided. They also told us that the staff treat them very well. Residents also told us that staff do listen to and act on what they say. We also found evidence, during our last visit that; residents appeared to be well cared for. However, action needs to be taken to ensure all staff receive appropriate training so they are able to do the work expected of them. We spoke to all the staff who were on duty during this visit. We noted that the staff team were well motivated and were keen to ensure they provide residents with the support they needed to gain their independence. They told us that they had been employed at The Progress Project for varying lengths of time, the shortest being 3 weeks and the longest 15 months. However, they could not confirm they had received any induction training since they had been employed at this care home. They had learnt from each other how to support and work with residents. They were aware they should have had something before starting work. This would mean they would know what they are supposed to be doing and would be advised about the vulnerability of residents. We were also informed that a representative of the provider had recently issued them all with an induction training book to work through. We were also told that, to date, staff had received no other training. We spoke to a representative of the provider who confirmed this. There was no record of training provided to staff. We observed staff on duty interacting with residents. This showed us that staff treat residents with respect and ensure their dignity is upheld. When we spoke to them they were unable to demonstrate they had a good understanding of how they should work with identified residents to ensure their needs are met. The staff we spoke to could not tell us what the aims and objectives of The Progress Project are. One member of staff told us they thought the purpose of the care home was to help residents to live more independently in the community. Another person said they had been told it was a rehabilitation unit designed to help residents move onto more independent living. They also told us another manager then told them it was to provide long term care. Staff told us that they were working on a day to day basis making sure the residents are all right. Previously the home was run in a more structured way. This meant that staff knew what they were doing. Then a large number of staff left, including the manager and the more senior and qualified staff. They also told us that the management of the care home was very shabby, as they were given no guidelines to which they should work. The staff team informed us The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 26 they had not been issued with job descriptions or contracts. They were also aware that there were few permanent staff. Many of them were employed on a temporary basis via employment agencies. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 27 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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. 37, 38, 39 and 42 There is no evidence to confirm the care home is well run and in a way which benefits residents. There is no evidence which confirms residents are benefiting from the leadership and management of the care home. There is no evidence that an appropriate system has been set up for self – monitoring, review and development of the care home. There is no evidence of training provided to ensure the health, safety and welfare of residents and staff have been promoted. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 28 EVIDENCE: Mrs Kate Brady has been registered as the manager of this care home. As a result of the registration process she has demonstrated she has the necessary skills, knowledge and experience to manage the service. The registered provider has notified us of changes they have made to the management of the care home. However, they have been unable to confirm if Mrs Brady has left her post and the date, which she left. In response to recent correspondence, in which we asked them to clarify the arrangements for the day-to-day management of the care home we were informed that the registered provider has appointed a new manager. This person will be applying to be registered with us. We met the new manager during our visit. We were informed that this person had been in post approximately 4 weeks. We also spoke to staff on duty. They told us they have felt they have had no guidance and direction over recent months. This has been due to a change in the managers. They found that managers of other homes owned by the registered providers have arrived to help out. But, the overall view of the staff is that there has been no one in charge and there has been no proper management of The Progress Project. Staff have also told us they have felt very vulnerable. This is because they have no experience of working with the residents accommodated. We were told that the registered provider had not carried out regular visits to the care home to supervise the management of the care home to ensure it was being run in the best interests of residents. There was no evidence of any work that had been carried out in terms of regularly reviewing and improving the manner in which the care home has been run. We were informed of a recent investigation into allegations of abusive care practices. The investigation confirmed many of the allegations were substantiated. The registered provider has confirmed they have dismissed the members of staff and have referred their names to be entered on the Protection of Vulnerable Adults register. We were concerned to find that the registered provider was unaware that such practices which took place over a period of approximately four months. Information supplied prior to this visit confirmed the registered provider has also taken appropriate steps to ensure the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly. There was no evidence of staff being provided with training regarding health and safety issues, fire prevention, manual handling and food hygiene. Staff on duty confirmed they have not received mandatory training for some time. The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 29 The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 30 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 1 2 1 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 3 23 1 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 1 32 X 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 X 2 X LIFESTYLES Standard No Score 11 2 12 2 13 2 14 X 15 2 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 2 2 X 1 1 1 X X X 2 The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 31 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4 (a) and (b) Requirement The registered person shall keep under review and, where appropriate, revise the statement of purpose and the service user’s guide; and notify the Commission and service users of any such revision within 28 days. Previous timescale of 09/10/06 not met. Timescale for action 16/05/08 2. YA2 14 (1) (c) and (d) An appropriately trained person 16/05/08 must assess the needs of prospective residents before they are admitted. Previous timescale of 06/10/06 not met. Care plans must be drawn up for each resident that identifies their individual needs and how they should be met. A programme of training, including induction training, must be provided for each member of staff to ensure they are able meet the needs of residents. A system for monitoring, reviewing and improving the quality of care in the home must DS0000064669.V347417.R01.S.doc 3. YA6 15 (1) 31/03/08 4. YA35 18 (1) (c) 31/03/08 5. YA39 24 (1) 31/03/08 The Progress Project Version 5.2 Page 32 be set up. 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 Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 The Progress Project DS0000064669.V347417.R01.S.doc Version 5.2 Page 34 - 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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