Inspection on 01/02/06 for Turning Point

This inspection was carried out on 1st February 2006.

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

Turning Point 11/07/06

Turning Point 04/08/05

Turning Point 10/01/05

Turning Point 09/08/04

Similar services:

Prinsted

Elizabeth House

Kenward House

Boons Park

Winthrop Hall

Life Works Community Ltd

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

CARE HOME ADULTS 18-65 Turning Point Canterbury Alcohol Project Whitstable Road Canterbury Kent CT2 8DG Lead Inspector Mark Hemmings Unannounced Inspection 1st February 2006 12:30 Turning Point DS0000023617.V272803.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 Turning Point DS0000023617.V272803.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. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Turning Point Address Canterbury Alcohol Project Whitstable Road Canterbury Kent CT2 8DG 01227 454374 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 Ms Eleanor Harris Care Home 12 Category(ies) of Past or present alcohol dependence (12) registration, with number of places Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th August 2005 Brief Description of the Service: The Project operates a short term rehabilitative programme (the Programme). This is designed to provide a therapeutic milieu within and by means of which service users can identify and practice the skills necessary to enable them to move away from a reliance upon alcohol which is not helpful. The Programme involves service users undertaking both private work and group activities. Most service users do not stay for a period longer than six months. The premises are an older, three storey detached property which has been adapted for its present use. There is provision for six service users to have their own bedroom and there are three shared occupancy bedrooms. The property is set back a little from one of the main roads into Canterbury. The city centre is within easy walking distance. To the rear of the property, there is a large enclosed garden. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and it took about one and one half hours to complete. During this time, the Inspector spoke with four of the service users. Also, he spoke with the Registered Manager, with one of the three project workers and with the Project’s Administrator. The Inspector examined a small selection of documents and records. Also, he looked at various parts of the accommodation. The Project continues to provide the service users in residence with the specialised support and guidance they need. Service users say that they remain satisfied with the provision made for them. The Inspector did not examine all of the Standards on this occasion. Consequently, the reader is asked to read this Inspection Report in conjunction with the previous Inspection Report. This should assist the reader to obtain a more detailed account of the Inspector’s current evaluation of the adequacy of the facilities and services available in the Project. What the service does well: The service users continue to receive a suitably informed response to their individual needs for support and guidance. Service users say that the assistance received from the project workers, significantly contributes to their ability to address and to overcome their addiction. There are sound management systems in place to ensure that project workers deliver the Programme’s therapeutic interventions in a consistent and validated manner. The Project operates a sophisticated internal quality assurance system. This means that the Project is well placed to access service users’ opinions about its adequacy and to action any improvements which may be indicated. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 6 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. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 7 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 Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 8 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 and 4. Prospective service users are given the information they need to make an informed decision about living temporarily in the Project. Each service user’s needs and aspirations are assessed before admission. Service users are confident that their needs for support and guidance will be met when they enter the Project. Prospective service users are expected to visit the Project before a decision is made about moving in. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in the Project and the methods which comprise the Programme. In addition to this, the Registered Manager and the project workers speak with prospective service users to answer any remaining questions they may have. Service users say that they were confident at the point of admission to the Project, that their individual needs for support could be met reliably and consistently. The Registered Manager is aware of the responsibility placed upon her to ensure that only people whose needs for support can be met reliably, are admitted to the Project. Previously, the Inspector has established that suitable Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 9 administrative arrangements are in place to support and to validate her in reaching judgements in relation to this matter. Prospective service users are required to visit the Project before a decision is made about moving in. This is done to enable the person to get a first hand feeling of what the Project and the Programme might be able to offer to them. Service users say that this was an essential first step for them in evaluating their own commitment to address their addiction to alcohol. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 10 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 and 9. Service users are confident that their needs for support and guidance will be met in a reliable and consistent manner. They are enabled to make appropriate decisions about their lives, with assistance being given when needed. Service users are suitably consulted about the support they receive and about the running of the Project. Service users are enabled to take ordinary risks. EVIDENCE: There is a service user plan for each service user. These documents describe the support and guidance which each person has identified that they need to receive in their move away from reliance upon alcohol. The plans are written jointly by each service user and by one of the project workers who has been nominated to be their key worker. Previously, the Inspector has noted these plans to be suitably detailed given the context in which they are used. The Inspector noted that the support worker with whom he spoke, continues to have a suitably detailed knowledge of the particular needs of each service user. Also, the Inspector is satisfied that the project workers continue to use their knowledge of service users’ needs to inform appropriately their Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 11 therapeutic interventions. Service users consider that they receive all the support and guidance they need. Service users say that they are consulted about those aspects of the running of the Project which are relevant and which are of interest to them. This includes their participation in regular meetings which are used both to plan the completion of household tasks and to review how things are going in general. Service users are expected to re-establish every-day lives which are not reliant upon the use of alcohol. As part of this, they are assisted to identify, to evaluate and to manage potential risks to themselves and to others. Service users say that the guidance and support they receive in relation to this subject continues to be helpful and that it constitutes an essential part of the Programme. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 12 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, 13, 14, 15, 16 and 17. Service users have access to an appropriate range of social activities, some of which involve leaving the Home to use resources which are based in the community. They are assisted to maintain helpful contacts with family and friends. Service users are enabled to exercise a suitable degree of choice in their everyday lives. Service users are supported in following a normally healthy diet. EVIDENCE: Service users have access to an appropriate a range of social and vocational activities. Previously, the Inspector has noted these events to be chosen carefully so as to ensure that they complement the goals of the Programme. Service users consider their time to be occupied fully. Service users are assisted to maintain contacts with members of their families and with friends who do not live in the Home. Previously, service users have said that they are helped to reflect upon which contacts will be helpful to support their recovery. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 13 Service users are expected to plan for and to prepare their own meals as part of their re-establishment of ordinary living. Service users told the Inspector that this arrangement continues to work well and that they receive good quality meals. Previously, the Inspector has established that the written record of the meals served shows that a suitably varied menu is provided. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Service users receive support and guidance in a respectful and appropriate manner. Service users are assisted to maintain their physical and emotional health. Service users are helped to handle their own medication. EVIDENCE: Service users say that the project workers suitably assist them to progress through the Programme. They consider that the project workers are approachable, while at the same time being prepared to address issues with them in a straightforward manner. Previously, the Inspector has witnessed a substantial number of occasions on which project workers have interacted with service users. He has noted these events to have been characterised by a measured informality. This is consistent with the description given to him by the service users and it is indicative of good care practice. Service users who have problems with aspects of their physical health, are assisted to seek and to follow the advice of their doctor. The project workers keep a tactful eye open so that medical conditions are noted at an early point. The Commission has not received any expressions of concern in relation to the Project from partner agencies such as members of the primary health care team. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 15 Service users are expected to manage their own medication. Previously, the Inspector has examined selected aspects of the arrangements used to administer this function. He has noted the systems to work reliably. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Service users consider that their views are listened to and that as necessary they are acted upon. Service users are protected from abuse, neglect and self harm. EVIDENCE: Previously, the Inspector has confirmed that there is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Project. Service users say that they are confident that any matter they raise will receive serious attention and if possible will be addressed. The Registered Manager said that the Registered Provider has not received any complaints in relation to the Project since the time of the last inspection visit. The Commission similarly has not received any complaints about the Project in this timescale. The Inspector is confident that the project workers have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the wellbeing of a service user. Also, they are aware of how to bring such a matter to the attention of the Registered Manager and/or to external regulatory bodies. Service users told the Inspector that they feel safe living within the framework of expectations established by the Project. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 17 Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 18 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, 27, 28 and 30. Service users are provided with a comfortable setting in which to make their home temporarily. The toilets and bathrooms provided in the Project are adequate in number and in presentation. The shared-use spaces such as the lounges are adequate both in number and in presentation. The premises are presented to a normal standard of cleanliness. EVIDENCE: Service users say that they are comfortable living in the Project, with the accommodation being considered to be homely and welcoming. The Inspector noted the accommodation to be well maintained without being too fussy. There is an adequate number of toilets and bathrooms provided in the Project. They are equipped and presented suitably. There is a dining area which service users occupy when they are relaxing between Programme activities. Also, there is a large lounge in which most of Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 19 the Programme’s groups are convened. These areas are quite spacious and they are well decorated and furnished. The accommodation is maintained at a normal domestic standard of cleanliness. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 20 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 and 36. The project workers have a good understanding of their duties. There is an adequate number of staff on duty. Suitable arrangements are in place to enable staff to work together effectively as a team. The project workers have the competencies they need and the adequacy of their practice is monitored. Appropriate steps are taken to ensure that only suitable people work in the Project. EVIDENCE: The project workers are conversant with the expectations placed upon them by their roles. The Project is staffed in a manner which is designed to promote the service users’ ability to be independent and to be responsible for themselves. The service users consider the deployment of staff to be appropriate to their needs. The Inspector notes that the arrangement has worked well in the past and that it seems to continue to do so. There is a relatively stable staff team. This means that people have got used to working together and that service users know who is going to be around and what they are going to be doing. Each working day begins with a staff meeting Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 21 when the Registered Manager and the project workers who are on duty, plan and coordinate their activities for the day ahead. In addition to this, there are regular full staff meetings. Previously, the project workers have observed that they are consulted actively about how the Home is administered and that they are confident in the adequacy of the therapeutic and administrative systems used. All of the project workers have completed a formal qualification which the Registered Manager has evaluated as enabling them to provide the therapeutic services required to operate the Programme. In addition to this, the Registered Manager provides introductory training for all new project workers. Also, she appraises periodically the competencies of existing staff. The Registered Provider arranges for project workers to undertake specific courses in subjects which are relevant to the content of the Programme. Previously, the Inspector has reviewed evidence which has been consistent with the Registered Manager’s report to the effect that all of the established project workers have the competencies they need in order to work effectively within the Programme. All of the project workers meet periodically with the Registered Manager to review their work. The Registered Manager has a detailed knowledge of the work undertaken by each project worker and of how well this meets the needs of the individual service users. This is an example of good management practice. Previously, the Inspector has reviewed the way in which the Registered Provider completes a number of security checks in relation to each member of staff. These are undertaken to ensure that only suitable people are entrusted to have access to service users who may be vulnerable. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 22 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, 42 and 43. Suitable management systems are used to ensure that the Project supports service users in realising their commitment to establish sustainable lives which are free from a reliance upon alcohol. Service users’ are confident that their views and opinions about the Programme are ascertained and that they are valued by the Registered Provider. Generally suitable provision has been made to safeguard the health and safety of the service users and of members of staff. EVIDENCE: The Registered Manager is competent to manage effectively the operation of the Project. She is completing the first of the two National Vocational Awards which are required by the Standards. The Registered Provider calls to the Project about once in each month in order to check how things are going. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 23 The Registered Provider operates a well developed system by means of which service users are invited to comment about the Project in general and about the Programme in particular. This entails service users completing regular questionnaires, the results of which are then summarised in easy-to-use graphs. The Registered Manager then discusses the information received at one of the service users’ group meetings. This is done so that everyone can know what issues are current and what the Registered Provider intends to do in relation to each of them. The system is an example of good care/management practice. The Inspector noted the high level of satisfaction which has continued to be expressed in the feedback received by the Registered Provider since the last inspection visit to the Project. The Registered Manager said that all items of equipment in use in the Home remain in good working order. The Registered Manager said that the premises continue to comply with the principal requirements of the Kent Fire Service. The Inspector noted that the Registered Provider continues to ensure that suitable checks are made to ensure the operability of the fire safety equipment present in the Project. Previously, the Registered Provider has introduced a system which is designed to ensure that all of the service users are aware of how best to avoid the occurrence of a fire safety emergency and how to respond to one effectively should the need arise. This should entail monthly assessments being made to double check that each service user knows what to do in relation to these matters. The Inspector noted that the completion of these checks had become overdue. The Registered Manager said that this oversight would be corrected by 10 February 2006. Having said this, the Inspector did note that the service users with whom he spoke, did have a suitable knowledge of the fire safety issues he raised during the conversation. Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 24 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 3 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 3 N/A 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Turning Point Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 3 X DS0000023617.V272803.R01.S.doc Version 5.0 Page 25 No 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. 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 Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Turning Point DS0000023617.V272803.R01.S.doc Version 5.0 Page 27 - 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!