Inspection on 18/12/06 for Turning Point (Hoole Road)

This inspection was carried out on 18th December 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

Turning Point (Hoole Road) 12/10/09

Turning Point (Hoole Road) 26/09/07

Turning Point (Hoole Road) 03/03/06

Turning Point (Hoole Road) 18/11/05

Turning Point (Hoole Road) 21/01/05

Turning Point (Hoole Road) 08/06/04

Similar services:

Littledale Hall Therapeutic Community

Bennett House

Padgate House

Mary & Joseph

Westcliffe House

Richards House

Hamer Cottage

Stanfield House

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

CARE HOME ADULTS 18-65 Turning Point 27 Hoole Road Hoole Chester Cheshire CH2 3NH Lead Inspector Judith Morton Unannounced Inspection 18th December 2006 09:00 Turning Point DS0000006612.V324366.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 DS0000006612.V324366.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 DS0000006612.V324366.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Turning Point Address 27 Hoole Road Hoole Chester Cheshire CH2 3NH 01244 314320 01244 325875 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) www.turning-point.co.uk Turning Point Limited *** Post Vacant *** Care Home 21 Category(ies) of Past or present alcohol dependence (21), Past or registration, with number present drug dependence (21) of places Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The total number of Service Users must not exceed 21 21 of the Service Users may be A 18 of the Service Users may be D Service Users to be accommodated as follows:18 Service Users may be accommodated at 27 Hoole Road 3 Service Users may be accommodated at 38 Phillip Street 3rd March 2006 Date of last inspection Brief Description of the Service: The service, which is run by the national charity Turning Point, aims to provide a supportive substance free environment where residents can examine their lives to date, reach a greater understanding of their substance misuse and develop ways of achieving changes... The residential project comprises the main ‘first-stage’ house at 27 Hoole Road, which provides 12 places. There are also two ‘second-stage’ properties close by, one house providing 3 places and the other 4. All the houses are within a mile of Chester City Centre, and are very close to community facilities and amenities. Referrals are accepted from all areas of the United Kingdom and residents stay between 6 and 12 months. As part of the project’s philosophy, service users participate in a range of individual and group activities, including one-to-one support; relapse prevention; stress/anxiety management and relaxation. Alternative therapies such as auricular acupuncture, aromatherapy and Indian head massage are also available for service users. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit, part of the key inspection for this service, took place on 18th December 2006 and lasted four and a half hours. This visit was just one part of the inspection. Other information received by CSCI about the home was also looked at. CSCI questionnaires were given to residents, and health and social care professionals to find out their views about the home. Comments from forms that were sent back to CSCI have been included in the report. There were seven residents staying at Hoole Road on the day of the visit. The previous registered manager has left this service since the last inspection. Although the new manager was not on duty at the time of the visit, she came to the home to help the inspector. She provided documentary evidence and files requested. During the visit, various records were looked at, including minutes of meetings, staff files, service user’s files, staff rotas and training records. Two staff members and five residents were spoken with and their views about the home are also included in the report. What the service does well: There is a well-established and effective process of providing information so that prospective residents are able to make an informed choice about moving in and know that their needs can be met at the home. Care plans include a social history of the resident before they moved into the home for rehabilitation, which provides useful information for staff to identify specialist support that the residents might need. Residents have good support from staff so they receive the healthcare they need during their period of rehabilitation at Hoole Road. All of the residents spoken with said they thought that the care staff were excellent. One service user said, “it is testament to them that I did not realise that they are not trained counsellors”. The questionnaires returned from health and social professionals all spoke well of the service provided at Hoole Road. The opportunities available for residents to express their views both in private and in group situations, together with staff knowledge and awareness of the protection of vulnerable adults ensures that the residents are fully protected. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Turning Point DS0000006612.V324366.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 DS0000006612.V324366.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is sufficient information available, and opportunities to view the home, so prospective service users can make an informed decision about whether the service will meet their needs. EVIDENCE: Three of the residents spoken with all said they had been given information about Hoole Road before they decided to move in there. On the day of the site visit a new resident was just moving in and also confirmed that they had been given a brochure and colour leaflet about Hoole Road. All of the residents said they had been able to visit the home if they wished before making a decision to move in. One resident said that they had visited four other establishments across the country and had been impressed by this one and the type of support that is given. At the time of the visit, the resident had been at the home for 6 weeks they said they are really glad they chose to come to Hoole Road. There were detailed assessments on each of the two residents files checked. These also included risk assessments, which had been reviewed regularly. All the paperwork had been signed by the resident showing they had been involved in their own assessment. The aspirations of the residents were Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 9 discussed over a period of time during their 1:1 sessions and in group sessions. There was a signed licence agreement, showing that the service user agreed to the terms and conditions of the home. It identified the room they were to occupy and the resident’s own contribution to staying at Hoole Road. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff involve the residents in completing their own assessments, care plans, reviews and general running of the home so they are fully involved in making decisions about their lives. EVIDENCE: There was a detailed care plan that had been agreed and signed by the resident. This had been reviewed and adjusted where necessary as needs changed during the resident’s stay at Hoole Road. The social history included in each file varied in content and detail dependent on the resident’s willingness or ability to provide the information when they arrive at Hoole Road. Some residents write the social history themselves while others dictate it to their key worker during their 1:1 sessions. The social history helps the staff to form a picture of the resident’s life before they moved into the home for rehabilitation and could suggest specialist support that might be needed. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 11 Residents had not been consulted about, or involved in, the daily records staff write about each resident’s day. These tended to reflect the view of the member of staff rather than the resident. A more accurate picture would be gained if the residents were involved in this process. A photograph of each resident is kept on their file to help new staff identify residents, particularly if they go missing. The residents spoken with knew about their files, and were involved in completing the records. They knew the files were kept locked away and that the information in them was held confidentially. On a previous occasion a resident from Hoole Road had been found unconscious in the city centre. They had no form of evidence on them to show that they were staying in the area, or at Hoole Road. Staff time was spent looking for the resident and police time was spent trying to identify him and find out where he was staying. Further distress might have been caused if the police had contacted his family, who lived in another part of the country. It was suggested, following the previous inspection, that residents’ carrying some form of identity with Hoole Road’s details could avoid this. The current manager should consider the benefits to some of the residents in carrying this so that members of the public, police or hospital services would know to contact Hoole Road staff in an emergency. A risk assessment would determine those to be more at risk when out in the community unsupported. The residents were seen to make their own decisions and choices during their stay at Hoole Road. They were able to choose what they wanted to wear, where they spent their time, who with and to some extent, what they wanted to eat. They took it in turn to make the evening meal for all of the other residents as part of their progress towards self help skills. They decided on their individual social activities, such as college courses, voluntary work and training courses. Evidence of this was seen on their files. Residents’ meetings are held every Monday so that the household jobs rota can be discussed and any other issues that affect the residents are also discussed at this time. It was suggested that notes of these meetings should be kept to show progress being made to resolve concerns or problems the residents raised. Residents are encouraged to take certain risks in accordance with their rehabilitation programme but only after a detailed risk assessment has been completed. Residents are encouraged to take part in activities that will help them towards an independent life, including cooking, cleaning and laundry. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A range of activities, including therapeutic activities, is available for residents but only take place Monday to Friday, so residents feel they are not left with enough emotional support at weekends. . EVIDENCE: The residents are encouraged to participate in activities that are both therapeutic and occupational. When residents first move into the home, they are not always able to attend college or take on employment. The staff encourage the residents to develop at a pace that is acceptable to them depending on where they are up to with their detoxification programme. The residents have opportunities for personal development and are encouraged to help out with cooking, cleaning and, in the past, painting and DIY in Hoole Road. Some residents obtain work during their stay at Hoole Road; this may be voluntary or paid. Other residents attend college courses in order to Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 13 develop new skills for future work. One resident’s file checked showed that they were due to attend a five-day residential course on developing personal skills in the New Year. The residents spoken with said that they felt that there needed to be more activities spread throughout the whole of the week. They said they understood the financial constraints on the manager in trying to provide these activities and acknowledged that the free gym membership does help. One resident said that they were helping to raise funds for a minibus for Hoole Road to enable activities such as country walks or visits to local attractions. Another resident said, ‘a group activity, such as a long country walk, ending at a café, whenever a new resident arrives at Hoole Road, would help them to get to know each other, as it can be very difficult when you initially move in.’ The same resident said, “the staff did try but there are only so many board games you can play.” Information had been received prior to this visit, from a former resident who felt that there were not enough activities available to ‘keep you busy and keep your mind off drink or drugs’. These issues should be discussed between the manager and registered provider so that a consistent and stimulating service can be provided. The residents’ charter spells out clearly what the rights of the residents are. Each person is given a copy of the charter when they arrive at Hoole Road. It is discussed with them, together with the complaints procedure during an initial house meeting and in their 1:1 to make sure it is understood. The residents take it in turns to produce the evening meal for themselves and the rest of the group on a weekly rota. The residents spoken with said that at the moment it is not too bad as the current group have reasonable self help skills and staff do offer some support. However, one resident who had lived at Hoole Road for some time said that the meals can sometimes be really bad depending on the resident’s cooking ability. They said that sometimes not all the residents are able to take part in household chores so all the cooking can be left to just a few of the residents. A resident said that they had been at Hoole Road when there were four people with additional mental health needs and it effected him as they did not always want to communicate or spend time in other people’s company. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents get good support from staff so they receive the healthcare they need during their rehabilitation. EVIDENCE: The residents are fully involved in their assessments. Support they need for each aspect of daily living is discussed and agreed with them. This is under constant review as needs change during the process of rehabilitation. The residents have regular 1:1 sessions with their key workers but a 1:1 can also be requested if the resident feels the need. If a problem arises it is discussed and agreement reached on what level of support is needed, if any. There is a volunteer counsellor who visits Hoole Road each Thursday and those residents who wish to take up the service will meet with the counsellor for 1 hour. One resident spoken with though felt that a qualified counsellor should be employed by Turning Point so that counselling sessions can be offered more often and at a time when they are needed most. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 15 However, the same resident added that it is a testament to the support staff that he didn’t realise initially that they were not trained counsellors and he still found himself able to ‘open up’ to his support worker. The residents spoken with all felt that therapeutic, group and 1:1 sessions should take place over a seven-day period instead of five. The residents spoken with said that they found the alternative therapies, such as relaxation, Indian head massage etc, very helpful as they taught them to relax, control their feelings and deal with any anger they might feel. The residents register with a GP from one of the practices in the area. For all other healthcare needs, service users are supported by staff to use relevant community services, e.g. community nurses, dentists and opticians. Additionally, where necessary, referrals would be made by their GP for specialist medical services. Staff within the project also provide service users with information about general healthcare and specific issues relating to their lifestyles and needs. It is part of the home’s operational policy that staff administer all prescribed medicines. Residents accept this as part of their contract with the home and it is stated clearly in the resident’s handbook. The residents sign a consent form for staff to hold and administer their medicines. Where controlled drugs are used within the home, these are stored securely and are administered in strict accordance with agreed policies and procedures. All staff receive training in medicine administration as part of their induction, and regular refresher training after that. The medicines at Hoole Road are well managed in accordance with the company’s policies and procedures. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The opportunities for residents to express their views both in private and in group situations, together with staff knowledge and awareness of the protection of vulnerable adults ensures that the residents are fully protected. EVIDENCE: All of the residents spoken with said they feel that the staff do listen to them. They acknowledged that getting some of the things they ask for is outside the manager’s control but said that she does act on what they say if she can. The residents have an opportunity to voice their opinions and concerns during the Monday meeting or during their 1:1 session. Residents were also seen to call into the office to talk with staff and discuss any problems they were having. The residents are asked to complete a quality monitoring form each month. In addition to this, when residents move on from Hoole Road, they are asked to complete a questionnaire on their last day at the home to find out what they think of the service. The home has an established complaints procedure and all service users are given written information about this when they move in. The staff all receive training on the protection of vulnerable adults from abuse. This was shown in the staff files checked. Staff also receive specific training on the prevention of suicide and self harm, to ensure they recognise those Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 17 residents who are vulnerable and therefore provide them with additional protection. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although refurbishment is planned for the home, Hoole Road is sufficiently well maintained so that residents have a safe, warm and comfortable place to stay during their rehabilitation. EVIDENCE: Hoole Road is not equipped to provide a service to people who have a physical disability as there are no adaptations, stair lift or bathing aids within the house. There is an office at the front of the house which residents call into at various times during the day. Other than this, the rest of the house is in keeping with an ordinary domestic home. Outwardly the building is no different from others in that area. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 19 The residents who stay at Hoole Road generally do not have problems with mobility and are independent. They may need support to help them become more independent because of the effect their addiction has had on their ability to care for themselves. There were areas within the home, particularly the kitchen, where improvement was needed and had been identified during previous site visits. The manager explained that in the New Year, Hoole Road was due to close for a total refurbishment. For this reason, the environment was not checked in detail at this visit. However, residents spoken with all said that they were happy with their bedrooms. They said the rooms were comfortable and warm and knew that they could personalise it to their own taste during their stay. The residents also had a key to their bedroom and confirmed that they could spend time in there when they wished. One resident suggested the home really needed a therapy room as they currently had to use the lounge which was not private and meant that anyone not wishing to join in the session had to avoid using the lounge for that period. This was discussed with the manager as the building is due to close in the near future for total refurbishment and this suggestion would need to be taken into account when defining rooms for residents’ use. Hoole Road was clean and tidy. The residents themselves are largely responsible for the tidiness and cleanliness of their own room and also help with cleaning the house. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a competent, well-trained staff team to support the residents but having key workers on duty seven days a week would provide full, consistent support to residents during their rehabilitation programmes. EVIDENCE: The staff all undertake a detailed induction course and are expected to complete an induction book. Additional training specific to the service user group is provided to ensure staff are aware of the needs and risks to the residents and themselves. These include suicide and self-harm, managing stress, assertiveness, domestic violence, handling difficult people, equality and diversity, first aid, drug awareness and the protection of vulnerable adults. Three staff files were checked and showed what training the staff had completed. However, the manager might consider using a chart to show more easily which staff have completed which course and when they are due for refresher courses. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 21 Residents who were spoken with said that their key workers are never on shift over a weekend and although they try to have the same bank staff work at weekends it is not the same. One resident said, “ It is like pulling teeth here at weekends”. Another resident said, “it’s enough to make you want to leave, or at least go out and get a drink”. The manager should review way the staffing is provided, particularly key workers so that residents can have the support they feel they might need over the weekend. The staff files of two new staff were checked and showed that references had been sought. One file showed that a third reference had been asked for as there had been insufficient information provided about the member of staff on the other two. The manager explained that once the references and Criminal Record Bureau (CRB) disclosures had been provided, if they were satisfactory and she had signed them they were sent to the Turning Point head office in London for filing. The files showed that CRB disclosures had been received but there was no record in the file of the unique reference numbers of the disclosures. Although it appeared that a thorough recruitment procedure was being followed, copies of the references obtained for staff must be held on file for inspection during site visits. The residents spoken with said that all of the staff appear to be competent and well qualified. They said, “we can talk to them whenever we feel the need and even if they are due off shift they will stay with you until you feel ok.” Four staff have completed the NVQ Level 3 and are awaiting verification of their assessment. Further staff have been identified to do this training in the New Year and have started collecting evidence of their work in readiness for this. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of the residents and staff are clearly being listened to and changes are being made to make sure the service continues to be run for the benefit of the residents. EVIDENCE: The previous registered manager had left the service since the last site visit. The current manager had worked in Turning Point services for a number of years as a member of the care team before her promotion to manager. She has obtained a Professional Certificate in Management in Health and Social care and had completed NVQ Level 3 with a view to applying for the NVQ Level 4 in care in the New Year. All of the residents and staff spoken with said that she was approachable, would listen and deal with issues appropriately if they arose. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 23 The manager has not yet registered with the Commission for Social Care Inspection but was reminded by the inspector during the visit to do this as soon as possible. Staff meetings were being held weekly and all staff, regardless of whether they could attend, were given a copy of the minutes. There was evidence that the manager had carried out formal supervision with the staff and where necessary had conducted new workers’ 1 month probationary meeting. The residents were confident that they contributed to the development of the home and gave an example where one resident, who had been in rehab elsewhere before, had expressed concern about the lack of structure of their daily group meetings. The resident had been supported to devise a new structured programme for the group sessions. The residents ran these with only one member of staff present. The programme with the title of each session was printed out so that each of the residents knew in advance what the topic for discussion was to be. The residents are asked to complete a questionnaire each month to say how they feel their care and support has been. The initial responses in the questionnaires spoke of needing more topics for discussion, more group sessions, more room space and improvements in equipment. The later, more recent responses about the new group sessions have been extremely positive. There is also a weekly group meeting with an outside organisation which offers support in the community when the residents leave Hoole Road, a Cycle of Change group and Steps to Excellence group. Regular checks of the fire alarm system including smoke alarms, emergency lighting and escape routes were being made to ensure the safety of the residents. All people coming in and out of the building signed so there was a record of who was in the building in the event of a fire or other emergency. During the site visit telephone calls were received at Hoole Road that staff were not always able to answer because they were attending to residents. Messages left on the answer phone could be clearly heard by anybody in the room, which might cause a breach of confidentiality and steps need to be taken to prevent this. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 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 Standard No Score 1 4 2 3 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 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 4 X X 3 X Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 25 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 YA34 Regulation 17 Schedule 4 Requirement The manager must ensure that copies of staff recruitment documentation are available for inspection during a site visit. Timescale for action 01/04/07 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 2 Refer to Standard YA6 YA11 Good Practice Recommendations Whenever possible staff daily recording should include the view of the resident and the resident should sign the entry made. The manager should consider how therapeutic activities; other activities and support from staff known to the residents are available throughout the week, including the weekends. Notes of residents’ house meetings should be recorded to show progress being made to respond to residents’ concerns or suggestions. The manager should consider the balance of the whole group each time a new admission is considered. Consideration should be given to increasing the amount of time available for the residents to spend with a trained counsellor. DS0000006612.V324366.R01.S.doc Version 5.2 Page 26 3 4 5 YA8 YA17 YA18 Turning Point 6 7 YA28 YA42 Consideration should be given to providing a dedicated therapy room as part of the refurbishment of the home. Steps need to be taken so that messages being left on the answer phone cannot be overheard. Turning Point DS0000006612.V324366.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000006612.V324366.R01.S.doc Version 5.2 Page 28 - 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!