Inspection on 06/09/06 for The Progress Project

This inspection was carried out on 6th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 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 26/02/08

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 Mr D Bannier Key Unannounced Inspection 6th September 2006 10:00 The Progress Project DS0000064669.V307883.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.V307883.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.V307883.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 233390 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 *** Post Vacant *** Care Home 7 Category(ies) of Past or present alcohol dependence (7), Past or registration, with number present drug dependence (7), Mental disorder, of places excluding learning disability or dementia (7), Mental Disorder, excluding learning disability or dementia - over 65 years of age (2) The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A total of seven (7) service users in the category MD may be accommodated of whom up to seven (7) service users may be in the categories drug dependence past/present, alcohol dependence past/present. Service users in the category MD(E) are aged between 65 and 70 years. 31st January 2006 2. Date of last inspection Brief Description of the Service: The Progress Project is a care home registered to provide accommodation and personal care for up to seven 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 property situated in a residential area of Worthing. Local shops and other amenities are within walking distance. Communal facilites currently include a lounge and dining room which are located on the ground floor . Private accommodation consists of seven single bedrooms. The service is privately owned by Hemmingrod Ltd, who have identified Mr Belisario Schiavone as the responsible individual to supervise the management of the care home. The registered manager is Mr Kenny Brady who is responsible for the day to day running of the Progress Project. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report has been written using new methods introduced on 1st April 2006. Some evidence used to assess standards has been gathered before this visit took place. For example, information has been used from the registered provider’s action plan that sets out how the requirements from the last inspection will be met. This visit was unannounced took place over two days. It started at 10am on each day and last approximately eight hours. The inspector met three of the four residents who are currently living at The Progress Project, and spoke to two of them. The other two either chose not to speak to the inspector or were not present during the inspection. This gave the inspector a picture of how it is to live at this care home. The inspector also spoke to four staff who were on duty. This helped the inspector to gain a sense of the work staff are expected to do. The inspector saw the communal areas and some of the private accommodation, with the permission of the residents living there. Some records were also examined. The inspector looked at those standards that are about how new residents are admitted to the care home; how residents are cared for; the daily life and social activities provided for residents; how the care home deals with complaints and how they protect residents from abuse; the environment in which residents live; how staff are recruited and trained; and how the care home is managed. The manager was present throughout the inspection and kindly assisted the inspector with his enquiries. What the service does well: This service has been registered since September 2005. The Progress Project had been set up to provide care and support to people with complex mental health needs and challenging behaviours who have become isolated and socially excluded. However, since it has been registered, the registered provider has encountered difficulties in providing this. At this visit the inspector has observed a service going through a period of change. A number of staff, including the registered manager, has left. Many of the original residents have also left. Discussions with the current manager has indicated that the service is The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 6 under review within the organisation to clarify and establish what the local demand for this service is and what it can realistically provide Whilst such a review is healthy and to be expected, the registered provider has a responsibility for ensuring the service continues to be run within regulatory requirements and the safety and wellbeing of residents has been safeguarded. This report identifies that residents are being well cared for and appear to benefit from the service provided. However, it is essential that the registered provider addresses the requirements made within this report, particularly those which had not been addressed from the last report. It is also essential that application is made to register the manager who has been appointed since the last inspection. It is also clear that the registered provider has much work to do to ensure this service is clear about its function and that it continues to provide a good quality service. What has improved since the last inspection? What they could do better: Clear information about how residents identified care needs should be provided for should be recorded so that staff know what is expected of them. Improvements need to made to the way medication is given to residents to ensure it is safe. Improvements need to be made to the way staff are recruited to ensure residents are protected from possible abuse. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 7 Records required by law must be maintained. This includes keeping records of complaints received about the service, and training provided to staff. This information is necessary in case the registered provider needs to demonstrate how complaints have been dealt with or the training staff have been given so they are able to care for and support residents. The Statement of Purpose needs to be reviewed and amended. This will mean that the information given to residents who may wish to be admitted provides an accurate picture of the care and services they can expect from The Progress Project. The way in which residents are admitted to the care home needs to be improved. This will ensure residents’ needs have been fully assessed and they have been assured this service can provide the care and support they need. 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 Progress Project DS0000064669.V307883.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.V307883.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 The information provided to prospective residents does not accurately reflect the services provided at The Progress Project. There was no evidence to confirm that prospective residents’ aspirations and needs are assessed. There was no evidence to confirm that prospective residents know that the home they have chosen will be able to meet their needs and their aspirations. Quality in this outcome area is adequate. EVIDENCE: According to the Statement of Purpose, the aims and objectives of this service states that “The Progress Project provides a productive and therapeutic environment for clients…” In addition the Statement of Purpose has a list of services provided to residents which includes a “comprehensive package of therapeutic activities (1:1 and group work) including relapse prevention work; concordance therapy; addressing offending behaviour; counselling and support; anger management training and assertiveness training. Following discussion with the manager it was agreed there was no evidence that such therapeutic services are provided. The inspector was informed that this is due to lack of experience and training in the staff team. In addition, the manager does not have the necessary background to successfully manage and promote such services. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 10 The inspector spoke to a Community Psychiatric Nurse (CPN) who was visiting a resident. The CPN informed the inspector that there had been some concerns regarding the resident’s placement, as the services agreed at the time of admission had not always been provided. This has now improved, but the CPN has found they must continue to monitor events closely to ensure services paid for are being delivered. The inspector noted that, on the first day of the inspection two of the four residents accommodated were still in bed by midday. This is in contradiction to the activities planned for each resident. The inspector spoke to one resident about their plans for the day. The inspector noted that, according to the resident’s weekly planner, which was on display in the resident’s room they were expecting to go out to Worthing. The resident could not confirm that this had taken place. There did not appear to be any reason why this had not taken place. The manager appeared to be very surprised on learning that two residents were in bed and the third resident had not been able to go out as planned. The Commission has received a complaint by telephone from a parent of a resident who was discharged by the care home after being accommodated for approximately one month. The parent expressed concern that the resident did not receive the support and services, which had been agreed prior to admission. The manner in which the care home dealt with this complaint will be considered under the section entitled Concerns, Complaints and Protection. The inspector advised the registered provider to review and amend the statement of purpose to ensure it reflects the service that is being provided. This will mean that new and existing residents, and their representatives, will know what service they can expect from the Progress Project. Once this document has been amended, copies should be issued to the Commission and made available to residents and their representatives within 28 days of the amendments being made. This is a regulatory matter and has therefore been made a requirement. Three residents have been admitted since the last inspection, one of whom has been discharged within a month of admission. The inspector informed the manager that he had received complaints from this resident’s social worker. The social worker expressed concern that their client had been discharged so soon. The reason given for this was that the resident had displayed aggressive and violent behaviour. The social worker expressed surprise as the resident’s behaviour, and subsequent needs had been identified in the social worker’s assessment of the client, and had been discussed with the registered manager prior to admission. Records seen confirmed that the social worker had provided the registered manager with a copy of a written assessment of the needs of the resident. The assessment clearly showed that the resident had a history of displaying violent and aggressive behaviour. There was no evidence, which confirmed that the registered manager had made an assessment of the The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 11 resident’s needs and had confirmed that The Progress Project could meet their needs. The registered provider has been advised that they are required carry out an assessment of the prospective resident’s needs. They are also required to write to the prospective resident to confirm they are able to meet the needs identified. This will mean that the resident, and their representative, will know that the care home can meet their needs before deciding to be admitted. The manager could not confirm that a written admission procedure was in place that outlined the process by which a prospective resident is admitted to the care home. It was therefore, not clear who is responsible for making an assessment of their needs, who is responsible for making the decision to admit the resident, and who is responsible for confirming in writing to the resident or their representative that the care home has the resources for meeting the resident’s assessed needs. It is recommended that such a procedure is drawn up to clarify who is responsible for admitting prospective residents to the care home. The Progress Project DS0000064669.V307883.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Care plans have not been developed as required and shared with individual residents. Residents are enabled to make decisions about their lives with assistance as needed. However, care plans and records do not support this by providing staff with guidance about the level of assistance required. Residents are supported in taking risks as part of an independent life style. However, care plans, risk assessments and records are not available to support the work of staff. Quality in this outcome area is adequate. EVIDENCE: A weekly planner has been developed for each resident. The inspector noted that one resident had a copy of this, which was pinned to a notice board in their bedroom. A copy of each resident’s planner was also on display in the front office. The planner consists of a timetable of activities which the resident will be participating in. This includes personal care, chores around the house, The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 13 individual sessions with allocated members of staff, and trips out in the community. As mentioned in the previous section, the inspector noted that two residents were in bed until midday. Their weekly planners indicated they were due to take part in an activity that morning. One resident, who was up and dressed, told the inspector they were due to go into Worthing, but had not been able to go. The resident did not seem to know why the trip had been cancelled. As the needs of all residents have not been assessed prior to admission, it was not clear how weekly planners have been developed. In addition, there was no evidence to confirm that staff have been provided with written information and guidance with regard to how residents’ needs are to be met. This is essential given the potentially complex needs of residents admitted to this care home. Staff need to have clear guidance and information to ensure residents are supported in a consistent and continuous basis. The registered provider has been advised this has been made a requirement as it is also a regulatory issue. Information provided by the manager confirmed that residents are supported in making decisions about their lives. Staff provide support and assistance as needed. One resident told the inspector that staff are helpful and understand the support and assistance they require. The inspector observed interactions between staff and residents; they were positive and supportive; staff were able to demonstrate their understanding of residents’ needs and how they should supported. Care plans and other documentation should be improved to ensure there is clear evidence to confirm staff provide support and assistance in accordance with the wishes of residents and as agreed with residents’ social workers or CPN’s. The Progress Project DS0000064669.V307883.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Whilst residents are able to take part in activities there appears to be no structure to this. Whilst there may be opportunities for residents to be part of the local community, there was little evidence of residents being encouraged to do so. The registered provider has ensured, where possible, residents have appropriate personal and family relationships. Staff do appear to treat residents with respect. However, there was no clear evidence that residents are encouraged to take responsibility for themselves in their daily lives. Residents are provided with a healthy, nutritious and balanced menu. Quality in this outcome area is adequate. EVIDENCE: There was no evidence to confirm that activities are provided as stated in the Statement of Purpose. As mentioned previously a weekly planner has been The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 15 devised for each resident. The inspector noted that one resident had gone out fishing as stated in their planner. However, two of the remaining three residents remained in bed until midday. This is despite their planners indicating each has activities planned for the morning including a trip to Worthing market and the library. The manager advised the inspector that the planners are not set in stone. However, it is of concern to note that the visiting CPN, and the parent of an ex resident has expressed concern that activities and services agreed at the time of admission are not always provided to residents. The inspector spoke to one resident who said that they were due to go out during the morning, but did not know why it had not taken place. The manager informed the inspector that, where possible, residents are encouraged to maintain contacts with family and friends. One resident was eating their lunch at the same time as the staff. The inspector noted that the resident was talking to staff about their plans for the coming weekend. This included a visit to see family members. The inspector was informed that the resident visits their family regularly. The manager informed the inspector that, in the case of another resident, maintaining relationships with their family would not be in their best interests. The inspector advised the manager that such information should be included in the resident’s care plan. This will ensure all staff are aware what is expected of them when working with each resident in this area. The inspector had lunch with residents and staff on the second day of the inspection. Residents and staff sit down together in the dining room. The lunch was prepared and served by the staff. The meal was jacket potatoes filled with prawns and salad. The inspector noted that residents are able to eat their meal where they choose. One resident sat outside in the garden whilst two others sat in the dining room. These two residents did not sit the dining room at the same time; one resident had finished their meal as the other sat down at the table. The inspector formed the impression that, as a matter of personal choice, residents do not mix together at meal times. The inspector was provided with copies of a four week menu plan. The plan indicates that the main meal is taken in the evening. It also includes an opportunity for a takeaway meal from time to time. A vegetarian option is made available at each meal time. A choice of fresh fruit or yoghurt is also available as a pudding. According to the staff rota a dedicated cook is available Monday to Friday to prepare and cook the main meal. Care staff prepare a cook meals at the weekend. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 16 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 and 20 Appropriate steps have been taken to ensure residents receive support and assistance in the way they prefer. The registered provider has ensured residents’ health care needs have been met. Work is still required to ensure the practice of administering medication ensures the safety and wellbeing of residents. Quality in this outcome area is adequate. EVIDENCE: The inspector spoke to one resident who said the staff were very helpful and supportive. The resident believed the staff knew about their individual needs and how they should be met. The inspector also observed interactions between staff and residents over a mealtime. One resident was sitting at the meal table talking to staff about plans to see their parents at the weekend. Staff were also seen talking to another resident who had chosen to eat their meal at a table in the garden. Residents appeared to appreciate discussions with staff, whose interactions were sensitive, appropriate and professional. Residents’ weekly planners included details of when they expected to receive personal The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 17 support to complete independent daily living tasks such as bathing, showering, shaving and putting on clean clothes. The inspector met the CPN of one resident who was visiting the service at the same time. He informed the inspector he visits his client frequently. The CPN confirmed the Progress Project ensures his client’s physical and mental health care needs have been met. Daily notes are kept for each resident, which includes details of visits to community services such as the GP, the dentist or optician when needed. Each resident’ weekly planner includes details of any appointments that need to be kept. One resident told the inspector they felt well cared for and the staff ensure their needs have been met. The inspector was shown the current practice of administering medication to residents by a member of staff. The inspector noted that staff continue to administer medication in the office as described at the previous inspection. The manager was advised of the dangers of such practices and was also advised of the guidance issued by the Royal Pharmaceutical Society. It was also of concern to note that this had been made a requirement at the previous visit, yet no changes had been made to ensure the administration of medication is safe. The registered person has been advised this will remain in this report as an unmet requirement. The inspector spoke to one member of staff who was able to provide evidence, which demonstrated they had received training in the safe handling, administration and recording of medication. The member of staff had been instructed by a senior member of staff in the practice of administering medication. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 18 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 and 23 Appropriate steps have been taken to ensure residents’ views are listened to. However, there was no evidence to confirm that complaints received had been fully investigated. The registered provider needs to provide all staff with appropriate training to ensure residents are protected from abuse. Quality in this outcome area is adequate. EVIDENCE: According to residents’ weekly planners a resident meeting takes place each week. This enables residents to discuss and agree upon household matters to ensure any concerns do not get out of hand. One resident told the inspector they know who to speak to if they wish to make a complaint. A written complaint procedure was on display and is also in the Statement of Purpose. The inspector had been made aware of one person who had made a complaint about the service provided. Records seen demonstrated that it had been noted. However, there was no evidence to confirm that the registered person had investigated the concerns raised and had written to complainant to confirm its outcome and any action to be taken to rectify them. The inspector had been approached by a social worker who also wished to complain about the service. The inspector advised the social worker that, in accordance with recent guidance issued by the Commission, the complaint should be taken up with the registered provider. There was no evidence to confirm that this complaint had been received or had been investigated. The registered provider The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 19 has been advised that this is a regulatory issue and has, therefore been made a requirement. The manager provided information about staff training prior to the inspection. Whilst no training has been identified over the past twelve months, the manager has stated that, in terms of future training planned, “ All staff are currently identifying training needs via supervision following new management structure.” The registered provider is advised to ensure that a training profile is set up for each member of staff and a record kept of all training undertaken. This will provide the necessary evidence to demonstrate training afforded to staff ensures they are able to do the work expected of them. It is expected this will include training in identifying different types of abuse and when allegations or incidents should be reported. The registered provider has been informed that this has been made a requirement as it is a regulatory issue. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The registered provider has ensured residents’ accommodation is comfortable and safe. Appropriate steps has been taken to ensure the premises is clean and hygienic. Quality in this outcome area is good. EVIDENCE: The inspector visited several bedrooms, toilets, bathrooms, the lounge and dining room, the utility room and the kitchen. Those areas of the home seen were presented in a homely and comfortable manner. The decoration and furnishings provided ensured residents live in a comfortable and safe environment. The inspector noted that, since last inspection, automatic door releases have been fitted to doors to the office, the lounge and to the dining room. Information supplied by the registered provider prior to the inspection confirmed that the premises and equipment had been checked and maintained regularly to ensure the safety of residents and staff. One resident showed the inspector their bedroom. The resident confirmed they were very comfortable and satisfied with the accommodation. Information supplied by the registered provider prior to the inspection confirmed that the premises and equipment The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 21 had been checked and maintained regularly to ensure the health and safety of residents and staff. The issue of transporting residents’ laundry through the kitchen was discussed with staff on duty. The inspector was informed that residents will only take their laundry through to the laundry at times when food is not being prepared and cooked. They have also been provided with a lidded laundry basket and are expected to use it when taking their laundry through the kitchen to the laundry room. The inspector noted that all areas of the premises were clean and hygienic. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 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. The registered provider needs to take appropriate steps to ensure recruitment practices and procedures protect and safeguards vulnerable residents. Quality in this outcome area is adequate. EVIDENCE: The manager provided information about staff training prior to the inspection. Whilst no training has been identified over the past twelve months, the manager has stated that, in terms of future training planned, “ All staff are currently identifying training needs via supervision following new management structure.” The registered provider is advised to ensure that a training profile is set up for each member of staff and a record kept of all training undertaken. This will provide the necessary evidence to demonstrate training afforded to staff ensures they are able to do the work expected of them. The inspector informed the manager that he had received complaints from a resident’s social worker. This was identified in YA2 of this report and highlighted concerns about the assessment of prospective residents needs and their subsequent admission to this service. The social worker also expressed concerns that staff The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 23 at the care home did not have the relevant training and qualifications to meet the complex needs of his client. The manager has informed the inspector that a review is currently taking place with regard to the future direction of the Progress Project and the service it will provide. It follows that, once this has been agreed, it will be necessary to ensure staffing levels are adequate and that all staff have the necessary training to meet residents’ needs. The registered provider has, therefore, been advised to ensure that all staff have been afforded the necessary to training to do the work which is expected of them. This is a regulatory matter and has therefore been made a requirement. The inspector was informed that one member of staff has been recruited since the last inspection. It is of concern to note that the member of staff started to work at the care home before a current criminal record check had been obtained. Records seen demonstrated that a period of four months had elapsed before this check had been obtained. This was discussed fully during the last inspection including the requirements of current legislation on the registered person to ensure vulnerable residents are protected. The registered provider has, therefore, been advised that this will appear on the inspection report as a requirement outstanding from the previous inspection. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 24 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): 37, 39, 41 and 42 The registered provider needs to clarify the aims and objectives of this care home to ensure residents are benefiting from a well run home. The registered provider has taken appropriate steps to ensure residents’ views underpin all self-monitoring, review and development by the care home. The registered provider needs to ensure all records required are being maintained to ensure the rights and best interests of residents have been safeguarded. The registered provider has ensured the health, safety and welfare of residents are being promoted and protected. Quality in this outcome area is adequate. EVIDENCE: The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 25 The registered manager has resigned, with effect from 24th July 2006. The registered provider has appointed a new manager, who has yet to be registered. As a result there has been a significant change in the service provided. According to the Statement of Purpose, the aims and objectives of this service states that “The Progress Project provides a productive and therapeutic environment for clients…” In addition the SOP has a list of services provided to residents which includes a “comprehensive package of therapeutic activities (1:1 and group work) including relapse prevention work; concordance therapy; addressing offending behaviour; counselling and support; anger management training and assertiveness training. Following discussion with the current manager it was agreed there was no evidence that such therapeutic services are provided. The manager also stated that this is due to lack of experience and training in the staff team. The manager also confirmed that they do not have the necessary background to successfully manage and promote such services. The inspector has received a complaint from the social worker of a resident who has since been discharged. The social worker has expressed concern regarding the lack of services provided. A visiting CPN also expressed some concern regarding the inability of this care home to provide services to his client that had been agreed and contracted for at the time of admission. Much of these concerns are to do with contractual issues and should be addressed by the purchasers and the providers of the service. However, whilst it is understood that time is needed for the registered provider, and the new manager, to consider and agree upon the services which the care home can realistically provided, if the registered provider wishes to provide a service that can continue to be rated as a good service it is essential that a clear statement regarding the aims and objectives is settled upon and issued within the Statement of Purpose so that residents, social workers, purchasers of the service, and the Commission know what to expect from the Progress Project. In the meantime, the inspector considered that residents who are currently accommodated are benefiting from a care home that is well run. One resident told the inspector that they are well supported by the staff and are being accommodated in a comfortable environment. The registered provider has ensured a representative visits this service regularly to monitor the service provided. Whilst they were not seen on this occasion the inspector is aware such visits are recorded and include discussions with residents in order to seek their views regarding how the service is being run. Not all records required by current legislation were available for inspection. Work is required by the registered provider to ensure care plans include sufficient information and detail so all staff know what is expected of them The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 26 when working with each resident. This will also ensure staff work to meet the needs of the residents in a manner which is provides a consistent and continuous service. The registered provider must also maintain a record of all training, including induction training, to staff employed at the Progress Project to demonstrate that they have the necessary knowledge and skills to provide the care and support required. In addition the registered provider must maintain a record of complaints received, including details of any investigation carried out and their outcomes, to demonstrate all complaints have been appropriately investigated. Information supplied by the registered provider prior to the inspection confirmed that the premises and equipment had been checked and maintained regularly to ensure the health and safety of residents and staff. The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 27 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 2 2 1 3 1 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 x 2 x LIFESTYLES Standard No Score 11 x 12 2 13 2 14 x 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x 2 3 x The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 28 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 YA20 Regulation 13(2) Requirement The registered person shall make arrangements for the safe administration of medicines received into the care home. (Previous timescale of 06/03/06 not met.) Timescale for action 06/10/06 2. YA34 19(1)(b) The registered person 06/10/06 shall not employ a person to work at the care home unless subject to paragraphs (6), (8) and (9), he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. (Previous timescale of 06/03/06 not met.) The registered person shall maintain in the care home the records specified in Schedule 4; in particular a record of all persons employed at the care home, including 06/10/06 3 YA41 17(2)Sch 4.6(g) The Progress Project DS0000064669.V307883.R01.S.doc Version 5.2 Page 29 in respect of each person employed a record of all training undertaken including induction training. (Previous timescale of 06/05/06 not met.) 4. YA1 6 (a) and (b) The registered person 09/10/06 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. The registered person 06/10/06 shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so there has been appropriate consultation regarding the assessment with the service user or a representative of the service user; the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. The registered person 09/10/06 shall ensure any complaint made under the complaints procedure is fully investigated. The registered person shall, within 28 days after the date on which the Version 5.2 Page 30 5. YA2 14 (1) (c) and (d) 6. YA22 22 (3) and (4) The Progress Project DS0000064669.V307883.R01.S.doc 7 YA41 17 (2) complaint is made, or such shorter period as may be reasonable in the circumstances, inform the person who made the complaint of the action (if any) that is to be taken. The registered person 09/10/06 shall maintain in the care home the records specified in Schedule 4 and, in particular, a record of all complaints made by service users or representatives or relatives of the service users or by persons working at the care home about the operation of the care home, and the action taken by the registered person in respect of any such complaint. 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.V307883.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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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