Inspection on 03/03/06 for Turning Point (Hoole Road)

This inspection was carried out on 3rd March 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 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) 18/12/06

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 3rd March 2006 12:00 Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Turning Point Address 27 Hoole Road Hoole Chester Cheshire CH2 3NH 01244 314320 01244 325875 jill.bell@turning-point.co.uk 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 Mrs Jillian Bell 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.V282710.R01.S.doc Version 5.1 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 18th November 2005 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 - 66 Philip Street and 38 Philip Street - each providing 3 places. All properties are located within a mile of Chester City Centre, and are very well served by community facilities and amenities. Referrals are accepted from all areas of the United Kingdom and service users’ duration of stay is usually 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 to service users. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two hours. It concentrated on requirements and recommendations made at the first inspection and key standards that had not previously been checked. It should therefore be read along with the first report. The manager was available for the inspection. Two residents and two members of staff were spoken with during the inspection. One residents’ file was viewed and a tour of the areas of the building where requirements had previously been made was undertaken. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 The residents will be fully aware of what their contribution is to staying at Hoole Road as it is now identified clearly on their contract. EVIDENCE: Each resident has a licence agreement, which they sign on their arrival, agreeing to the terms and conditions of the home. The room they are to occupy is stated on the contract and a copy is kept on their individual file. However, although the cost of the placement is stated on the contract, the residents’ own contribution to this amount was not being recorded. This has now been added to the contract so that the residents are fully aware of what their contribution is. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 The social history helps the staff to form a picture of the resident before their addiction. It might give some idea as to the cause of their addiction in the first place and any specialist support that may be required. EVIDENCE: A brief social history is now held on each file, with information being gained from the residents’ and, on at least one occasion, the resident had written his social history himself. This gives staff a greater understanding of the resident. It can also help as a starting point for staff to have discussion with the resident during their 1:1. The daily recordings made by staff had been written about the resident and not with them, so tended to reflect the view of the member of staff rather than the resident. Staff are, whenever possible, consulting with the resident and including the residents’ views on how their day has been and how well they feel care was delivered. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 9 Each file now has a photograph of the resident. This helps new staff identify the residents and is useful if a resident goes missing. The residents also carry identification when they go out so that members of the public, police or hospital services would know to contact Hoole Road staff in an emergency. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 10 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 & 16 Personal development is constantly encouraged at a pace where the staff know it will not impede the residents’ progress. EVIDENCE: The residents are encouraged to participate in activities that are both therapeutic and occupational. The residents are initially not always at a point where they can hold down a job or attend college. 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 by being encouraged to help out with cooking, cleaning and, in some instances, painting and DIY in Hoole Road. One resident spoken with said that he was attending a gym now and taking care of what he ate and drank. He praised the staff for their advice and encouragement that got him to want to care for his body and appearance. Some residents obtain work during their stay at Hoole Road, this may be voluntary or paid. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 11 Other residents attend college courses in order to develop new skills for future work. The residents’ charter spells out clearly what the rights of the residents are. Each person is given a copy of the residents charter when they advice at Hoole Road and this 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. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 12 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 The resident’s contribution to their assessment makes sure that a level of support is given that the resident needs and agrees to. EVIDENCE: The residents are fully involved in their assessment process. Support for each aspect of daily living is discussed and agreed. This is under constant review as needs change. 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. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 13 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): 23 The training given to staff on adult abuse awareness and protection will further increase the protection of the residents. EVIDENCE: All staff receive a 1 day training course on the protection of vulnerable adults during their induction training at the organisations head office. Staff who have, or are undertaking NVQ level 2 and above will also cover this during this training. Staff are observant of, and record, the service users’ activities, diet and behaviours so that they can quickly identify any self neglect or potential for self harm. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 14 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, 29 & 30 The residents benefit from the location of Hoole Road. It is very well served by community facilities and amenities. It offers the residents the opportunity for detoxification in an ordinary community setting. 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. The service users that stay at Hoole Road have all been able bodied and are independent. They may however, require support to further, or increase, their independence due to the effect their addiction has had on their ability to care for themselves. 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 tasks within the house. Jobs are allocated on a daily basis. The kitchen units had thin veneer on the doors but this had come off, particularly on the door of the unit containing the hot water dispenser. One drawer had its front missing. The requirement of the last inspection asked for Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 15 this to be repaired. The manager said that they had obtained prices to have the kitchen units replaced instead. In the meantime the walls and ceiling had been painted and were clean and bright. The microwave door was still dirty on the inside and needed cleaning. (See requirement 1) The carpet had been replaced on the stairs and landings and laminate flooring had been put down in the hall and ground floor office. There were new desks and a new computer system in the office. The office had been redecorated and rearranged to provide a front desk so that residents did not walk directly into the office as they had done in the past. This ensured greater confidentiality and also protection for the staff. The bin next to the payphone had been removed and new bins that allowed for the safe extinguishing of cigarettes and disposal of litter had been bought. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 16 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): 35 The staff have developed a good knowledge of how best to meet the needs of the residents through the training provided to them. EVIDENCE: All staff receive induction training, which includes a 1 day course on adult protection awareness. The manager should check that all existing or long-term staff have also received this training. (See recommendation 1) A copy of the local authority adult protection policy was also available for inspection. There were written policies and procedures relating to physical/verbal aggression and service users’ money. The organisation was looking at providing a rolling programme of NVQ level 3 training to all staff. An external assessor had been identified and funding was being explored. It is intended that ten staff from across all of the units would commence the training with a further five staff starting every month after. (See requirement 2) Some training was being provided that was specific to the needs of the residents. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 17 All staff were receiving twice-yearly instruction in fire prevention/action to be taken in the event of a fire. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 18 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): 39 A clearer picture of the overall satisfaction of the service delivered from Hoole Road will be obtained once the quality assurance director is appointed. EVIDENCE: The residents are asked to complete an exit questionnaire regarding their satisfaction during their stay and any suggestions they may have for improving the service. The questionnaires are kept by the home. Turning Point uses the findings from the questionnaires to further develop the service. The manager agreed that Hoole Road might benefit from finding out the views of their staff and other professionals who are involved with the service. Turning Point are appointing a new quality assurance director who will be devising questionnaires and systems for obtaining the views of all parties living, working or who are professionally involved in any of Turning Point’s properties. (See recommendation 2) Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 19 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 X 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X x X X 3 X X X X Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 16 Requirement The kitchen unit fronts must be renewed. The microwave must be thoroughly cleaned inside. Staff must undertake NVQ level 2 or above in care. Timescale for action 01/07/06 2. YA35 18 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard YA35 YA39 Good Practice Recommendations The manager should check that all long-term and existing staff have received training on the protection of vulnerable adults. Staff and professionals in contact with the home should be consulted as part of the quality assurance programme. Turning Point DS0000006612.V282710.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 DS0000006612.V282710.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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