Inspection on 08/11/05 for The Sanctuary

This inspection was carried out on 8th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 17/04/07

The Sanctuary 21/02/06

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 Rebecca Shewan Unannounced Inspection 8th November 2005 09:45 The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 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) Turning Point Limited Vacant Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents to be accommodated is seven (7) Residents will be aged between eighteen and sixty five on admission Date of last inspection 15th February 2005 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. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon of the eighth November 2005. Before the inspection papers held by the Commission for Social Care Inspection were read. The inspection of the home took four hours. A tour of the whole home was undertaken and two support workers and two service users were spoken with. There were seven service users living at the home at the beginning of the inspection, with two service users being discharged whilst the inspection was taking place. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 The home fully assesses potential new service users. Service user contracts are in place and are appropriate to the nature of the home and the expectancy of service users whilst they are resident at the home. EVIDENCE: Records inspected showed that pre admission assessments are carried out on all new and potential service users. The home also obtains a copy of a care management assessment from a placing authority where this exists. Any issues, which are highlighted within this assessment, are addressed by the home and documented records are maintained of all correspondence with the placing authority. Therefore the previous inspection requirement has now been met. Service user contracts were viewed at the time of the inspection and were found to be detailed and specify the terms and conditions of the service users stay. Both the service user and the person in charge of the home sign the service user contract when the service user is admitted. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 The care plans are detailed and suitable for meeting service users needs. Risk assessments are satisfactory and encourage service user independence. 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 user. The promotion of independence is key to the service users recovery, therefore service users are encouraged to maintain their independence in making choices and decisions relating to their daily living and their life outside of the home. Any information relating to service user choice or decision-making is recorded in the service users care plan. Where assistance is given by a person from outside of the home (i.e. Community Mental Health Team or Community Psychiatric Nurse), this is also recorded in the care plan. Records that were viewed also included details of areas of risk or crisis relating to the service user. An action plan, which details how to assist the service user in reducing or eliminating the risk/crisis factors is formulated and reviewed daily. It was evident that the home liaises well with the multi The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 9 disciplinary should the need arise for a risk assessment to be re-evaluated, in order to prevent the service user receiving conflicting information about their recovery or steps to take towards their recovery. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 The home assists service users with maintaining independence in their daily living and daily routines. Service users are treated with respect and there is good rapport between staff of the home, other community services and service users. EVIDENCE: The Support Workers said that service users are assisted to maintain attendance to day centres, college courses and jobs whilst they are resident at the home. If this is detrimental to the service users recovery, strategies are put in place to assist them to return to such activities when the service user feels able. The home has been structured around other local community services such as Hastings Mind, Portland Place, Community Mental Health Teams, the local Primary Care Trust and Substance Misuse Services amongst others. Service users are actively encouraged to go shopping and to attend events held in the local community. The home has a means of recording when a service user is not in the home, whom the service user is with and where they are going. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 11 Where it is appropriate service users are encouraged to maintain relationships, unless it is detrimental to their recovery. Service users choose whom they and see and when. The home has open visiting time from 8 am to 10 pm, service users can entertain guests in their own bedroom or in any of the communal areas. The Support Workers said that service users are encouraged to maintain their own daily routine, unless it is detrimental to their recovery. Service users are called by their preferred name, records viewed showed that this information is documented in their care plan. The home has a no drugs and alcohol policy in place, service users agree to this on admission and this is recorded in their service user contract. Smoking is permitted in the lounge area only, there is no smoking permitted in any other area of the home. Service users and staff said that mealtimes are flexible and that service users can have food at any time of day or night. One service user who spoke to the inspector said that they eat so well at the home that put on weight when they stay there. The evening meal is cooked by the Support Workers and is then taken as a ‘family’ with both staff and service users having the meal together at the main dining table. Both staff and service users said that this is a social event and enjoyed by all. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 The home has a good rapport with other health care professionals and community based services, which assist the service user with their recovery. Appropriate measures are taken to ensure that service users are not unnecessary risk by self-medicating. EVIDENCE: The Support Workers confirmed that personal care and nursing care are not provided by the home. Staff encourage service users to maintain good levels of personal hygiene. Healthy eating and relaxation techniques are also promoted. The support Workers said that service users have open access to the Community Mental Health Team, psychiatrists, psychologists or any other health care professional that will assist them in their recovery. It is the nature of the home to operate in close contact in order to assist service users in their time of crisis. The home has a medication policy that ensures that all service users have their medication administered by the home for the first twenty-four hours of their stay. The support Workers said that after the initial twenty-four hour period, the service user is assessed and can then self medicate if there is no element of risk involved. The Support Workers said that if a service user is at risk of The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 13 under medicating or over medicating then they would be given their medication by staff for the duration of their stay. Staff are trained in the administration of medication when they are on their induction training. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has a suitable complaints procedure. The homes procedures, processes and staff training should protect service users in the event of an allegation of abuse. EVIDENCE: There is a clear and comprehensive complaints procedure in place, which is given to all service users on admission to the home. Service users also have access to the Turning Point compliments, complaints and concerns procedure. The home has had one ongoing complaint within the last twelve months, which Support Workers said had now been resolved to the satisfaction of everyone involved. There have been no complaints received by the CSCI in the last twelve months. Records viewed showed that Protection of Vulnerable Adult training is carried out by Turning Point on a yearly basis. Support Workers said that advocacy services are accessible to service users if required. Service users are protected from abuse, neglect and self-harm at all times, as this is vital in aiding their recovery. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 15 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 & 30 The home provides a good quality of accommodation to service users. Communal areas and bedrooms are decorated to a good standard, providing pleasant accommodation. EVIDENCE: The location and layout of the home is suitable for the stated purpose of the home. The home is well maintained and all areas of the home and grounds are accessible to service users. Parts of the home had been redecorated since the last inspection. There is a doorbell system in place and the entrance to the home is secure, entry can only be gained by visitors with the permission of staff and in accordance with the service users wishes. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 16 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 The home has a commitment to its staff achieving National Vocational Qualification (NVQ) level two or three. The home does not currently meet the required 50 of care staff trained to NVQ level two, however progress is being made to ensure that this will be achieved by the middle of next year. EVIDENCE: Records viewed showed that the home currently has four care staff undertaking the NVQ level three training, with a further three care staff due to commence NVQ level three training in February 2006. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 17 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 & 42 The homes manager is are competent and experienced to run the home and meet its stated purpose. Effective Quality Assurance procedures are in place and appropriate action is taken to address issues highlighted by responses received by the home. EVIDENCE: The home has recruited an existing employee into the position of Manager and an application has been made to CSCI for this person to be registered. Staff said that it was reassuring to have a permanent manager in place. A Quality Assurance system is now in place, with service users being given questionnaires on leaving the home. The Turning Point Area Manager for the home collects these results and feedback is given to home. Turning Point also has an additional form called ‘Compliments, Complaints and Concerns’, which is also used as a means of quality assurance. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 18 The home’s fire equipment was being checked on the day of the inspection. A recent Health & Safety inspection had recently been completed and areas of concern were in the process of being addressed by the home. The upstairs bedroom window with a broken restrictor had been reported for repair. The support workers said that service users are not admitted to this room if they are deemed a high risk, following risk assessment on entering the home. The Sanctuary DS0000021263.V264570.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Sanctuary Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000021263.V264570.R01.S.doc Version 5.0 Page 20 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.V264570.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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