Inspection on 17/04/07 for The Sanctuary

This inspection was carried out on 17th April 2007.

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

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

Other inspections for this house

The Sanctuary 14/10/08

The Sanctuary 21/02/06

The Sanctuary 08/11/05

The Sanctuary 15/02/05

The Sanctuary 29/07/04

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 Sanctuary 36 Ashburnham Road Hastings East Sussex TN35 5JL Lead Inspector Jeanette Denereaz Key Unannounced Inspection 17th April 2007 03:00 The Sanctuary DS0000021263.V334601.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 Sanctuary DS0000021263.V334601.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 Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Sanctuary Address 36 Ashburnham Road Hastings East Sussex TN35 5JL 01424 200353 01424 200352 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.turning-point.co.uk Turning Point Limited Melisa Anne Richards Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is seven (7) Service users must be aged between eighteen (18) and sixty-five (65) on admission 21st February 2006 Date of last inspection Brief Description of the Service: The Sanctuary is situated within a two storey detached house in a quiet residential area of Hastings. The Sanctuary is a crisis centre and is part of the Turning Point Organisation, which has a number of mental health and drug and alcohol residential services. The home is close to the local shops and the town centre and seafront of Hastings. The home has a secluded rear garden with a patio and area of lawn. The home is registered to offer placements to up to seven service users with mental health needs, these placements act as a short term respite and are offered for periods of up to two weeks. There are no charges to service users staying at The Sanctuary. The service is block funded by Bexhill and Rother PCT, Hastings and St Leonard’s PCT and Social Services. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those staying at The Sanctuary are referred to as ‘guests’. This report reflects a key inspection based on the collation of information received since the last inspection and an unannounced site visit conducted by an Inspector on the 17th April 2007. The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the staff members and with guests that were at home during this inspection visit. Also following the inspection visit the inspector contacted other professionals who visit clients staying at The Sanctuary to ascertain their views on the service. What the service does well: The Sanctuary was found to provide good support to all the people that use this service. Prospective service users can be confident their needs will be assessed, and The Sanctuary will meet their needs during their stay. The guests spoken to said the staff were helpful and very friendly, and it was observed their were very involved in their treatment Plans and are encourage to maintain their usual routine of daily living and their independence is never restricted. One guest spoke briefly to the inspector and stated that: “This was a good place to be when feeling unwell, the staff are lovely”. Also one guest returned the CSCI “Have your say survey” in which she stated: “The place is so beautiful, so calm and pleasant. Everyone is warm and caring”. The home is well maintained, furnished and well equipped. All records seen during the inspection visit well maintained and provided clear and concise information relating the home and to the people using this service. Training is very important to the Turning Point organisation and all staff are encourage to undertake training. Training that, as been undertaken and future The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 6 training information was included in the information given to the CSCI prior and during this inspection process. A member of staff at the Crisis Resolution and House Treatment Team. (CRHT) stated that The Sanctuary is: “A much valued service, we are very lucky to have this service in this Town (Hastings)” Also a Community Psychiatric Nurse (CPN) visiting during this inspection visit praised The Sanctuary and the staff for the service it offers the local community. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Sanctuary DS0000021263.V334601.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 Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, & 5 Quality in this outcome area is excellent. All people who use this service are given a contract (Licence agreement) to which they have agreed, it give clear information about the service and the expectations the service has of the service user. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection visit there were five people in residence and another guest was expected later in the evening. The service referrals come from community mental health teams, the A&E department of the hospital, General Practitioners or from personal referrals. The Sanctuary doe not provide professional services, the individual guest use their own support team, which are in place prior to admission. On arrival all guests are given the Turning Point Hastings Sanctuary Service Licence agreement, which explains that this is a short stay residential facility for people who are experiencing mental health problems and have reached a crisis. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 10 All new comers are shown around the house, and given an induction in the Health & Safety of the building The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is excellent. The key principle of The Sanctuary is that people using the service are in control of their lives. The service offers a non-medical alternative for people who might otherwise be considered for admission to a psychiatric unit. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have an individual care plan. The care plan is formulated from the information found in the pre-admission assessment and from verbal information from the service users. On arrival to The Sanctuary the details sent by the referrer are checked with the individual to clarify the nature of their crises and assess any personal or social risks Two care plans were inspected and it was confirmed that all care plans are reviewed daily The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 12 The staff liaise with other professionals that are involved with the individual service user and this was evidenced during these inspection with the Crisis Response & Home Team (CRHT) and Community Mental Health Team (CMHT) teams visiting their clients. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good The Sanctuary assists the service users with maintaining independence in their daily living and daily routines. The guests are treated with respect and there a good rapport between the staff , other community services and the individual service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff confirmed that the guests are encouraged to maintain daily activities and are support to continue to attend college courses and employment. However. If this is detrimental to the individual’s recovery, strategies are put in place to assist them to return to such activities when they feel able. One guest during this visit had gone back to her house for the afternoon to attend her garden. Another was out with her partner and one was going out with his daughter. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 14 The guests are encouraged to maintain their own daily routine, unless it is detrimental to their recovery. The guest usually prepare their own breakfast and lunch, but the evening meal is prepared and cooked by the staff and it usually a social activity. The service has a no drugs and alcohol policy in place, and guests agree to this on admission and his is recorded n their service user contract/Licence agreement. Smoking is permitted in the lounge area only at this present time, but there is no smoking policy in all other areas of the home. The Sanctuary is a short stay residential facility for a maximum of 14 days and was describe by a staff member that this was a period of rest, time out from the day-to-day stresses and crisis in the individual’s life. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. The Sanctuary has an excellent rapport with other health care professionals and community-based services, which assists he service users with their recovery and return to the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Sanctuary does not provide personal or nursing care, however the staff do encourage the guest to maintain good levels of personal hygiene. The guests have access to the Community Mental Health Tem, psychiatrist and other health care professional that will assist them in their recovery, and this was evident during the inspection visit went professionals visiting individuals guests. At this present time the new service users are asked to hand over their medication for the first 24 hours of their safety, it is retuned if there are no inherent risks identified. There are discussions for this procedure to be The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 16 reviewed, and this has caused concerns for the staff as they feel the procedure is still appropriate and in keeping with the home objective to being a non-medical crisis centre. However, the Locality manager for the Turning Point organisation assured the CSCI that the organisation is reviewing many policies and procedures to improve the service and not to disrupt, and any changes staff will be consulted. Staff are trained in the administration of medication when they are on their induction training. Once the service user has left The Sanctuary a summary of their stay is sent to the referrer, their GP and care –co-ordinator, also a copy of their information is sent to the service user if they wish. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Turning Point’s complaints procedures are clearly stated in the contract/ Licence agreement, which is seen and signed by all service users on arrival to The Sanctuary. Posters are displayed in the home explaining how to make a complaint and who to contact. There has not been any complaints recorded since last inspection Records indicate that all Staff all trained in adult protection within their NVQ training and mandatory training from the organisation. When a guest leaves The Sanctuary they are requested to fill in a questionnaire about the service they have received, and the latest questionnaire completed stated their stay had been very beneficial and praised the staff for their hard work and support. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 18 The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27 & 30 Quality in this outcome area is good The Sanctuary provides a good quality of accommodation to service users. Communal area and bedroom are decorated to a good standard, providing a basic but pleasant accommodation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location and layout of The Sanctuary is suitable for the stated purpose of the home. The home is clean and well maintained, and all areas of the home and grounds are accessible to the guests. The home has just had an inspection carried out by the Environmental Health and the report was very positive. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 20 The building is very secure and visitors can only gain entry with the permission of staff and in accordance with the guests’ wishes. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 & 36 Quality in this outcome area is excellent. The staff at numbers to understand service and The Sanctuary are trained, skilled and in sufficient support the people who use the service. The staff and are aware of the specific nature and uniqueness of the its aims and objectives This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Sanctuary has a very stable staff team; most have worked for the organisation for over 5 years. Agency staff are employed, but the two new bank staff has been employed by Turning Point, and they are in the process of undertaking their induction training, Since the last inspection 5 staff now have NVQ3, and 3 staff in the process of completing their NVQ3. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 22 Staff interviewed during this visit all stated the training opportunities with the Turning Point organisation was excellent. Only criticism was some training is in London and not always convenient for staff to travel. Supervisions are carried out regularly and staff confirmed this, and are all recorded. 5 staff members were interviewed in private, and all expressed how much they enjoyed their work, however proposed organisational changes were making them anxious. With their permission the inspector expressed these concerns to the Locality Manager. The Locality Manager stated that policies and procedures are constantly reviewed to improve the service, but consolation and discussions with staff would always take place, and meetings at The Sanctuary have been planned. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is excellent. The management and administration of the home is based on openness and respect, has effective quality assurance systems. The records keeping within the home is of a consistently high standard and is kept securely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is on Maternity Leave and will be returning late summer 2007. There is a Temporary agency manager in post who works for 3 days per week. He is an experienced Mental Health nurse and has experience of managing services in the community. The Locality Manager is The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 24 supporting the manger on a weekly basis or as necessary and formally supervising him on a monthly basis. Unfortunately the inspector did not have the opportunity to meet with him as he was on a training course. The staff reported to the inspector that they are anxious about proposed changes to the organisation of The Sanctuary and this was relayed to the Locality Manager. The Locality Manager confirmed that the management of The Sanctuary were reviewing some of the policies and procedures and this was to reflect a more person centred approach to planning the service for the service users. She also confirmed that all staff would be involved and consulted on the outcomes. There was a full staff meeting arranged on the 19th April 2007 and the Locality Manager would be visiting the on 23rd April 2007 to discuss staff concerns. A quality Assurance system is in place, with the guests being given questionnaires on leaving the home. The Locality manager collects these results and feedback is given to the home. The health and safety documentation was very organised and is maintained and organised by a member of staff. All checks and serving of equipment is undertaken and recorded. The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 4 2 3 3 4 4 X 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 4 X X 4 X The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Sanctuary DS0000021263.V334601.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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