Inspection on 16/11/05 for Trelawn House

This inspection was carried out on 16th 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Trelawn House 01/11/07

Trelawn House 30/06/05

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

CARE HOME ADULTS 18-65 Trelawn House 30 Russell Hill Purley Croydon CR8 2JA Lead Inspector Michael Williams Unannounced Inspection 16th November 2005 17:00 Trelawn House DS0000062556.V266795.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 Trelawn House DS0000062556.V266795.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. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Trelawn House Address 30 Russell Hill Purley Croydon CR8 2JA 0208 660 4586 0208 763 0979 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) Cranstoun Drug Services Mr Melvyn Higgs Care Home 15 Category(ies) of Past or present drug dependence (15) registration, with number of places Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: Trelawn is a large traditional brick built domestic style property situated near the Purley crossroads (A22/A23) and the Purley shopping centre. The property has a number of lounges including a combined lounge/dining room on the ground floor, a meeting room and a small quiet lounge on the first floor. There are 2 shared and 11 single bedrooms situated on the three floors of the house. None of the bedrooms have en-suite facilities other than wash hand basins. There are toilets and bathrooms throughout the home. The home has as its Statement of Purpose to provide rehabilitation for people with drug and alcohol problems and adults recovering from abuse. This is a rehabilitation unit, not a detoxification unit. It is expected that service users will move on after a 16 week programme of intensive support and the ethos of the service is that service users will “take responsibility for their own actions”, so they have a considerable degree of autonomy in the home. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Trelawn has changed registered owners and is now part of the organisation ‘Cranstoun Drug Services’, which, as the name infers, specialises in the rehabilitation of people drug and alcohol problems. This company specialises in the care and rehabilitation of people with drug and alcohol problems. This was the second, unannounced inspection in 2005/2006 was conducted in the evening of 16th November and was used to follow up requirements from the previous inspection, to check the health, safety and welfare of service users and to asses those key standards not previously assessed or not fully met. The helpful contribution of staff and residents is acknowledged. 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. Trelawn House DS0000062556.V266795.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 Trelawn House DS0000062556.V266795.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 Service users are being assessed prior to admission so as to assure prospective service user that needs, including their specialist needs, can be met when admitted. EVIDENCE: During the course of the two inspections this year a sample service users’ case files were examined in some detail; service users were interviewed and the manager and staff were invited to comment upon the pre-admission process. Assessments are in place for each service user and form the basis of the initial care plan and risk assessments and this includes analysis of their particular rehabilitation needs. It is made clear from the outset that service users are to participate in the rehabilitation programme and this condition forms the basis of their care contract. Also included in the pre-admission assessment are any court orders such as compulsory drug testing orders (DTO) or bail conditions. Trelawn House DS0000062556.V266795.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): The care planning process and responsible decision-making about risks are central tenets of the work in this home; service users not only know that their care plans reflect their needs but are expected to assist in drawing up the plans, this ensures their specific needs can be addressed and will assist service users achieve their potential. EVIDENCE: These standards were not reassessed on this visit but were assessed as met in the previous inspection in June 2005 and there was no indication that they cannot be met in future. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 9 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): 11 17 A range of appropriate activities is provided so as to ensure service user rehabilitation; this includes group sessions throughout the week. Service users are free to make use of the local community resources and are free to maintain personal relationships that do not affect their rehab’ programme but allows them to still have contact with the community. The staff assist service users in preparing their own meals and staff monitor their wholesomeness and in particular that they are taken in a communal setting as part of their programme of care. EVIDENCE: With the exception of standards 11 17 these standards were not reassessed on this visit but were assessed as met in the previous inspection. In respect of meals and dining arrangements, this inspection took place at supper-time and several service users where preparing the evening meal, Spaghetti Bolognaise with the support of the care worker on duty at that time. The quality of the meals is therefore dependent upon the skills of residents themselves and there opinion is that this system works and helps them build confidence in shopping cooking. The evening meal is taken en-masse as part of the programme. The dining room was being redecorated and is an agreeable area to dine in. These observations also show that the home is contributing to residents’ personal development in social and practical skills. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 10 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): 20 Service users are receiving support in the manner they require to help them rebuild their lives. Service users are supported in taking responsibility for their own medication. However there is no record made of the number of tablets at the start of the medication chart and when new medication is added during the month, this could compromise their safety. EVIDENCE: Only standard 20 was re-evaluated during this visit, the other key standards were fully met in June 2005. Whilst a stock-control of incoming drugs is recorded this is not being translated onto the administration chart and in one instance an audit of the tablets recorded as being taken did not tally with the actual number of tablets held on the day of inspection - so improvements are required in this area. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 11 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): The arrangements and effective procedures that are in place to ensure that service users and their representatives are either able to complain about or compliment the service. Service users are confident that the effective procedures that are in place to deal with any complaints will ensure that they dealt with fairly and in a timely manner. Policies, procedures and staff training that are in place regarding abuse protect the service users. EVIDENCE: These standards were not reassessed on this visit but were assessed as met in the previous inspection in June 2005 and there was no indication that they cannot be met in future. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 12 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): 30 This is a comfortable and safe environment, which will ensure the wellbeing and safety of service users. EVIDENCE: The home was in a reasonable state of cleanliness, repair and decoration and much of the outside has improved. Internally some areas needed attention when last inspected. To ensure that service users are protected from infection the kitchen was identified as an area that would benefit from a thorough deepclean. On this occasion the kitchen was found to be clean and tidy and a cleaning schedule is in place to maintain hygienic standards. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 13 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 35 Staff recruitment, staffing levels, staff qualifications and training appeared adequate to meet the needs of current service users. EVIDENCE: Staffing levels for existing care homes, including those that providing mental health or social care, must be no less than the guidance issued by the previous regulating body, the Local Authority, as at 2002. As service users in this project are mobile and independent fewer staff are needed than in homes catering for more dependent residents. During the day there are usually two or three support workers and never less than two plus the manager and an administrator. At night just one support worker is required. The new owners have established a training programme for staff including an off-site training course in therapeutic group work called ‘choosing to change’, which will then be introduced to service users. A member of staff confirmed that, under the auspices of the old organisation, she was required to undergo a thorough recruitment process including references, police checks, and other checks she also received induction training and under the auspices of the new owners ongoing support and supervision is provided. A check of staff documentation confirmed good practice. This includes supervision from an independent agency – this provides an opportunity for the whole staff team to reflect upon their practice and the tensions that arise in this intensively therapeutic regime. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 14 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 42 Service users are involved in a great many aspects of the running of this service as part of their rehabilitation. As they progress through the rehab’ programme, the service users form part of the support team for the newer residents in the early stages of the programme. No hazards were identified during this inspection, other than the medication count, and it appears to be a well managed service thus ensuring the safety and wellbeing of service users. EVIDENCE: Only key standards 37 and 42 were re-assessed on this occasion; other key standards were assessed as met in the previous inspection. Based upon a series of inspections with positive outcomes for service users it is clear they benefit from a well run home. The admission process; the rehab’ programme and the relapse programme plus the clear boundaries set for service users makes this an effective and well managed facility. No health and safety hazards were identified during the course of this inspection – which included a brief tour of the premises. Service users participate in the running of the home and in doing so receive support and guidance in the safe handling of chemicals, how to reduce hazards and how to maintain a safe environment. Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 15 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 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Trelawn House Score X X X x Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000062556.V266795.R01.S.doc Version 5.0 Page 16 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. 1 Standard YA20 Regulation 13(2) Requirement Medication: when medicines are not provided in monthly dosette pack it is required that the number of tablets held is entered on each medicine chart (in addition to the stock control record) and an audit of medication is undertaken to ensure good practice is being maintained. Timescale for action 30/12/05 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 Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. Extracts may not be used or reproduced without the express permission of CSCI Trelawn House DS0000062556.V266795.R01.S.doc Version 5.0 Page 18 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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