Inspection on 02/03/06 for Trevi House

This inspection was carried out on 2nd March 2006.

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 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

Trevi House 07/01/09

Trevi House 09/07/08

Trevi House 10/07/07

Trevi House 29/01/07

Trevi House 28/06/05

Trevi House 18/01/05

Trevi House 16/06/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Trevi House 2/6 Endsleigh Gardens Mutley Plymouth Devon PL4 6DR Lead Inspector Sheila Giblin Unannounced Inspection 2nd March 2006 13.30p Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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 Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Trevi House Address 2/6 Endsleigh Gardens Mutley Plymouth Devon PL4 6DR 01752 255758 01752 255758 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) Trevi House Project Mrs Elizabeth Angela Brooks Care Home 13 Category(ies) of Past or present alcohol dependence (13), Past or registration, with number present drug dependence (13) of places Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Female Only Age18 to 60 years Date of last inspection 28th June 2005 Brief Description of the Service: Trevi House is made up of a cul- de- sac of terraced houses. The centre has been physically enclosed for security, from the surrounding area. The unit is situated between Mutley Plain shopping precinct and the city centre of Plymouth. The centre provides second stage treatment for a maximum of 13 women, between the ages of 18 and 65, who are pursuing rehabilitation from alcohol / drug addiction, while supporting their young children who are also accommodated with them at the unit. The service has stated that no more than 16 children, under the age of 8, will also be present at any one time, with the service users retaining full parental responsibility during their stay at Trevi. An Ofsted registered nursery is provided on site and children of school age attend a local school whose teaching staff have the necessary skills to support children who may have had an unsettled childhood prior to their mother being admitted to Trevi House. Treatment is by means of counselling and mutual support. The service requires total abstinence from all service users throughout their stay except for those involved in drug reduction programmes. Restrictions on personal choice are agreed with all prospective service users in advance of their admission to the unit. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place on the afternoon of Thursday 2nd March 2006. There were 7 residents in the home. The Registered Manager, Mrs Angela Brooks was present and assisted with the inspection. Trevi House has consistently met or exceeded the National Minimum Standards, the focus of this inspection was to meet the residents and gather their views on the quality of the services and care that is provided at Trevi House. The inspector toured the centre, met counsellors and office staff, met 6 residents, met nursery staff and the children in their care. 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. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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 Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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): 1, 2, 3, 4 Thorough and comprehensive systems for admission allow service users to be confident that their needs can be met. EVIDENCE: A Service User Guide is sent to all prospective service users and provides a detailed description of the services provided at Trevi House and the restrictions placed upon service users within the first 2 weeks of rehabilitation. Preliminary assessments are obtained prior to inviting prospective service users to Trevi House where further assessments are undertaken and a care plan developed. Individual risk assessments identify specific areas of support. Service users’ are supported to identify their wishes for their future and that of their children and this forms the basis of their personal development plan. Service users confirmed that they had been provided with the Statement of Purpose and had been able to visit Trevi House to meet with the staff and other service users. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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, 8 There is a clear and consistent care planning system in place that provides staff with the information they need to satisfactorily meet the service users’ needs. EVIDENCE: Each service user is provided with a “Welcome Pack” which provides further information about living at Trevi House, including a statement about service user’s rights and responsibilities. Service users are involved in developing and reviewing their care plans and are encouraged to reflect upon their life’s events and how these have affected them. Service users keep a diary of significant events and these are shared through group work. Service users said they understood why their movements and freedoms were initially restricted and had agreed to these before entering the programme for rehabilitation. Service users said that they were involved in the running of the home and met weekly as a group to plan the following week’s menus, domestic tasks and other activities, and to discuss any issues of concerns. Service users said that they felt confident to share their experiences with staff who would respect their privacy as appropriate. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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, 12, 16, 17 Staff support service users in a professional and friendly way. The routines of the home are structured to promote personal development and independence. EVIDENCE: Therapeutic group and individual counselling supports service users to overcome their addictions and develop the necessary life skills to live independently and to care for their children. Service users said they are encouraged to make their own decisions about their future plans and a fulltime resettlement worker helps with rights to benefits and re-housing. Service users said they go out each afternoon and are encouraged to support each other to develop social and leisure interests. Service users have use of the gym and other facilities at Hamoaze day centre free of charge. A timetable of community activities is developed each week at the house meeting. Service users have a large amount of input into the meals provided and contribute toward them by cooking tea for themselves and their children as well as washing up, on a rota basis, at lunchtime. Service users are also responsible for cooking all meals at the weekend. Some residents said they’d like to do more cookery classes and to learn about nutrition so that they would be better equipped to plan wholesome meals for themselves and their children. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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): 19 Personal support promotes and respects the service users’ dignity and independence. EVIDENCE: Service users said they felt very well supported and that the staff were approachable, with Mrs Brooks, the Registered Manager always being available. Personal files showed records relating to service users’ healthcare and that of their children, as well as addressing physical and emotional wellbeing. Because of the nature of their conditions, none of the service users manage their own medication. The processes for receiving, storing, administering and returning medication are very safe and are audited weekly. Staff have received medication training from the local pharmacist. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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): 22 Complaints and suggestions from service users are treated seriously. Service users are listened to and issues resolved promptly. EVIDENCE: Service users said that the staff were very approachable and they were confident that any issues of concern would be listened to and dealt with. Service users said they are encouraged to share any concerns relating to group living within the group counselling sessions and to identify a solution together. The home has received no complaints since the last inspection: a copy of the complaints procedure is on the notice board. A copy of Plymouth City Council’s Alerter’s Guide was available and staff have received training relating to protecting service users from abuse. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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): 24, 26, 27, 28, 30 Service users live in a pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: Service users described their rooms as suitable for themselves and their children. There are adequate comfortable communal areas within the home, with specified areas for smoking. The service users share the household domestic tasks and the home was very clean. The buildings are owned and managed by Devon and Cornwall Housing Association who are responsible for maintaining the fabric of the buildings. Trevi House management team are responsible for maintaining the health and safety of the environment and records were available of maintenance and servicing contracts. A spindle on the stairs in House No 4 was missing which is a risk to young children living there when climbing the stairs. Ten staff are undertaking an NVQ qualification in Infection Control. There are 6 en suite rooms plus a bathroom and toilet on each floor in all five houses. There is one shower room available for residents. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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): 31, 32, 33, 35, 36 Staff morale was high resulting in an enthusiastic dedicated workforce that works positively with the service users to improve their whole quality of life. EVIDENCE: Staff are well trained and motivated and fully understood their roles and responsibilities. All staff have an NVQ qualification with the majority trained in dealing with people with alcohol and drug dependencies. A six-month induction programme ensures newly employed staff are competent in their role. Professionally qualified counsellors are employed to undertake therapeutic group and individual counselling. Personnel files included the required documentation. Service users confirmed that they have access to support staff 24hours a day. Due to the intense nature of the support offered, staff supervision plays an important role in the philosophy at Trevi House. Formal supervision is provided monthly, with informal supervision taking place daily at handovers and feedback meetings. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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, 38, Service users live in a well managed home. The Registered Manager and her staff team strive to provide a stimulating, safe environment that respects and protects service users’ rights and promotes their independence. EVIDENCE: The service users said that the home is well run and that they are consulted upon aspects of the day-to-day management of the home as well as the quality of the services provided. The registered manager, Mrs Angela Brooks is a qualified Drug and Alcohol counsellor and has worked at the unit for ten years. Staff have role specific job descriptions and a programme of training ensures that staff have the skills necessary to fulfil their roles. Staff confirmed that they have access to the policies and procedures. Staff have received fire safety training and the fire alarm system is tested and serviced appropriately. Previous service users are invited to stay in contact with Trevi House and continuing advice and support is offered. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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 Standard No Score 1 4 2 3 3 4 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 X X X 3 4 X X X X X Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 Page 16 N/A 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 YA24 Regulation 23 Requirement The missing spindle on the staircase in house no 4 must be replaced as it there is a risk of falling to younger children who use the stairs Timescale for action 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA11 Good Practice Recommendations Residents preparing to leave the home should be offered the opportunity to develop extra cooking skills to be able to produce healthy and nutritious food for themselves and their children. Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Trevi House DS0000003558.V273834.R01.S.doc Version 5.1 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!