Inspection on 11/07/06 for Turning Point

This inspection was carried out on 11th July 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 01/02/06

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 Joseph Harris Unannounced Inspection 11th July 2006 10:00 Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 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.V301786.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 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. The current fees for the service at the time of the visit are £411. Information on the Home services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on 11th July 2006 commencing at 10am and lasted for around 6.5 hours. During the course of the inspection a tour of the premises was undertaken. Discussions were held with the registered manager and staff team. The inspector also spoke with service users in a group setting and would also like to thank the service users for allowing his participation in a group session. A range of documentation was also viewed relating to service users, staff and the day-to-day running of the home. What the service does well: What has improved since the last inspection? What they could do better: Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 6 The registered manager stated that the service and organisation are continually self-evaluating and requesting feedback to ensure that the home continues to improve. 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.V301786.R01.S.doc Version 5.2 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.V301786.R01.S.doc Version 5.2 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 and 3. The home provides satisfactory information regarding the service. Prospective service user’s needs and aspirations are assessed and the home ensures that those needs can be met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has developed both a statement of purpose and a service user guide, which detail the aims and objectives of the service and specific information regarding other aspects of the home. These documents are available for view and a service user guide and brochure is provide to all prospective service users. Prior to moving in to the home the needs and aspirations of prospective service users are assessed. As a facility that specifically works with people addressing addiction to alcohol the primary need is the focus of assessment as well as the readiness of an individual to take responsibility for their problems. However, the registered manager ensures that additional needs, risks and issues are also highlighted through the referral process. The staff in the home have a good range of experience and skill mix to ensure that the home can meet the assessed needs of service users. The rehabilitation programme is based upon validated and current treatment methods providing individual, group and peer work. There are clear expectations regarding the length and nature of the rehabilitation programme. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 9 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. A service user plan is developed for each resident. Service users are enabled to make decisions affecting their lives. Residents participate in all aspects of life within the home. There are good risk management processes in place. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home develops a service user plan for each individual. The plans focus on the primary need and are a generic in the first instance. As the treatment programme develops the needs of the service users are further assessed and the plan is added to and reviewed. Where other specific issues of need are identified the service ensures that these aspects are also addressed. However, the nature of the service is largely dependent on the fact that service users are relatively self-caring and autonomous and therefore minimal levels of personal care are required. Within the scope and purpose of the home, service users are able to make decisions affecting their day-to-day lives. The philosophy of the home is to enable service users to take control over their lives and make decisions regarding the day-to day running of the home promoting individual Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 10 responsibility through peer support. The home does not take a role in the control of individual finances other than safe keeping in some circumstances. Residents are responsible for the day-to-day running of the home including cleaning, cooking, shopping and other household chores. Meetings are held every day to organise duties and discuss issues that require addressing. The home has risk management processes in place and adequately assesses the perceived risks associated with individual service users. Risk assessments identify and provide guidance to minimise risks encouraging responsible risk taking. Risk assessments are regularly reviewed and updated as required. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 11 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, 14, 15, 16 and 17. There is a full and active rehabilitation programme. Service users have opportunities for recreational activities and to access the local community. The home works positively with service users to maintain and establish relationships. Individual rights and responsibilities are respected. An adequate, healthy, balanced diet is offered. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users enter the service on the understanding that they take an active role in the group and individual programme of rehabilitation, which is central to the success of service. A weekly timetable of group, individual and peer work has been developed and is adapted dependent on the needs of the service users in rehabilitation at any given time. These groups address process issues, anger management, social skills, self awareness and goal setting amongst other things. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 12 Service users are enabled to access the local community as they wish within periods of free time, however in the first stages of rehabilitation individuals are advised not to go out alone, but in the company of another service user. A key aspect of the service surrounds the development and maintenance of healthy relationships with both families and friends. As part of the rehabilitation programme service users generally have limited contact with external families and friends, but opportunities are made regularly available for people to visit their homes and to have visitors to the service. Service users are facilitated by staff to take responsibility within the home and are encouraged to treat the service as their home for the period of rehabilitation. There are expectations to attend all groups and service users sign an agreement to have their personal property checked and to take breathalyser tests if there is a strong suspicion of house rules being contravened. Staff respect individuals space and the service operates with an emphasis on peer pressure and support as part of the rehabilitative programme. Service users are responsible, on a rota basis, for the purchasing, preparation and service of food. The menus are collectively agreed on a weekly basis ensuring a healthy, balanced diet with choices as required. Should any individual have specific dietary needs these are catered for appropriately. Menu records demonstrate a balanced diet and a good choice of food; drinks and snacks are available at all times. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 13 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 personal support in they manner they require. Physical and emotional health needs are met. Service users are responsible for their own medication. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users admitted to the service are fully self-caring, which is assessed as part of the admission process. Where personal support is required the staff in the home facilitate this through encouragement alone. If a service user were to have significant personal support needs the placement would need to be reassessed. All service users sign on temporarily with a local GP if they are admitted from outside the local area. Individuals are responsible for managing their own healthcare needs and staff monitor any issues and ensure that appropriate actions are taken and outcomes followed up after consultation where appropriate. Additional healthcare needs are addressed as and when required due to the relatively short-term nature of the placement and rehabilitation programme. Service users are responsible for managing their own medication and have an assessment on admission to the home ensuring their competency in this Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 14 regard. All bedrooms are equipped with a lockable cupboard for storage purposes. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 15 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 views are listened to and acted upon. Suitable systems are in place to protect service users from forms of abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure in place and robust systems to address any issues of concern. There have been no complaints since the last inspection. Regular group meetings are held to enable individuals to feedback about the service and address any issues of concern. The home has policies and procedures in place regarding issues of abuse and adult protection. Staff showed good levels of awareness of how to respond and report any potential issues of abuse or concern should they arise. Such issues are also addressed through the induction programme and additional training. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 16 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 and 30. The environment is comfortable, homely and suitable for the needs of the service users. The home is clean and hygienic. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises are large, comfortable and well maintained. There is adequate living space throughout with a range of communal space. There are three double rooms and six single rooms all of which are adequately equipped and of a good size. There is a good sized garden to the rear of the home and areas of the building provide office space. The home is bright and airy. The house is situated on a main road leading into Canterbury and has good local transport links. It was reported that service meets the requirements of the local fire and environmental health departments. The home was maintained to a good standard of cleanliness and hygiene in keeping with domestic premises. There are adequate laundry facilities suitable for the needs of the home. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 17 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, 33, 34 and 35 Service users are supported by a competent and qualified staff team in sufficient numbers for the needs of the service. The home’s recruitment practices are satisfactory. Staff are provided with adequate training for the needs of the service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All staff working in the home have achieved relevant qualification in the field of addiction/counselling services, which are at least equivalent of NVQ level 2 or above. In discussion with staff and service users it was apparent that there is a very good understanding of the needs of individuals and the process of rehabilitation. The home has also achieved a good skill mix with staff favouring a variety of approaches and styles of group and individual work. The service is only staffed during daytime hours with an on-call system in place should any emergencies arise overnight. As part of the assessment process the competency of service users is defined and the home would not accept referrals for individuals requiring 24 hour care or support. A weekend meeting is held on a Friday and Monday to address any issues raised during the weekend. One staff members file was viewed during the course of the visit that contained all relevant information including CRB and POVA notifications, two written Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 18 references and proof of identity. Recruitment issues are managed from the regional office and copies of relevant information are provided to the service. Staff reported that they receive good levels of training to enable career progression in the field of substance and alcohol addictions. The organisation provides a good training package covering a range of topics including foundation training and service specific issues. The home has a positive induction programme ensuring all issues relating to the service are addressed and there is also an organisational induction programme addressing general and staff issues. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 19 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 and 42. The registered manager has sufficient experience and qualification to ensure a well run service. The home has established very good quality assurances processes. The health, safety and welfare of service users is protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has many years of experience working in the field of addiction and specifically with alcohol related problems. She has managed the service for a number of years and demonstrates a clear sense of direction and vision for the development of the service and programmes of rehabilitation. She has obtained a wealth of qualifications relating to her field of expertise and has also attained management qualifications to supplement this. Although she has not completed her Registered Manager’s Award she demonstrated her intention to complete this qualification. However, it advisable that she develops Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 20 a portfolio of her qualifications and experience for assessment by her training provider to determine equivalent qualifications for purposes of the RMA. The home has developed very good quality assurance systems at a local level and through the organisation. A range of forums and methods are available for all service users to feedback about the quality of the service. Regular questionnaires are completed, including exit questionnaires for service users and the results are collated and action points taken to address any perceived shortfalls. The home is regularly visited by a senior manager for the organisation who audits records and other relevant information. All health and safety information was well maintained and up to date including maintenance and service checks. Fire safety records were up to date and environmental risk assessments and monthly health and safety audits completed. It was reported that the home meets the requirements and legislation pertaining to health and safety issues. Adequate policies and procedures are in place to ensure safe working practices. Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 21 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 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Turning Point DS0000023617.V301786.R01.S.doc Version 5.2 Page 22 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.V301786.R01.S.doc Version 5.2 Page 23 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. 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