This inspection was carried out on 16th December 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.
CARE HOME ADULTS 18-65
Vale House Stabillisation Services 43 Cowbridge Port Vale Hertford Hertfordshire SG14 1PN Lead Inspector
Alison Jessop Unannounced Inspection 16th December 2005 10:00 Vale House Stabillisation Services DS0000019600.V272933.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 Vale House Stabillisation Services DS0000019600.V272933.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. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Vale House Stabillisation Services Address 43 Cowbridge Port Vale Hertford Hertfordshire SG14 1PN 01992 553 173 01992 509 729 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) Mrs Chris Hannaby Adrian Relph Care Home 7 Category(ies) of Past or present alcohol dependence (7), Past or registration, with number present drug dependence (7) of places Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 24th June 2005 Brief Description of the Service: Vale House is a Stabilisation Unit providing short-term accommodation and therapeutic support to up to seven service users with past or present alcohol or drug dependency. The house is a listed building near the centre of Hertford. It provides seven single occupancy rooms, two bathrooms/WC, kitchen, lounge, dining room, quiet room and laundry. There is one main office and additional offices for the senior management plus a meeting room. The house is comfortably furnished and there is a garden at the rear. The home has a long waiting list and reports a high retention and success rate. A drop-in service is also available to non-residents. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two hours by one Regulatory Inspector. Most of the core standards were inspected during the previous inspection and therefore the visit was short. Time was spent talking to service users and staff over lunch. Some records were also inspected. What the service does well: What has improved since the last inspection?
Procedures relating to the storage and recording of medication has been reviewed. Stock balances are now recorded in order for audits to be carried out. Individual Risk Assessments on activities or service users are now being completed, reducing risks to staff and service users. A number of staff have started NVQ level 2 & 3 and the registered manager has begun NVQ level 4 and the NVQ assessor course. Staff have attended a number of other specialist training courses. Supervision records are now being stored on individual staff files, which are stored securely to protect confidentiality. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 6 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. Vale House Stabillisation Services DS0000019600.V272933.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 Vale House Stabillisation Services DS0000019600.V272933.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): None of these standards were inspected on this occasion. EVIDENCE: Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 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): None of these standards were inspected on this occasion. EVIDENCE: Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 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): None of these standards were inspected on this occasion. EVIDENCE: Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 11 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): 20 Service users health and wellbeing is promoted as part of the rehabilitation programme, preparing service users for when they move on. EVIDENCE: Medication procedures appear to be satisfactory. Total stock amounts are now being monitored and recorded and photo’s of service users are being added to MAR sheets. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 12 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 Access to the Hertfordshire Protection of Vulnerable Adults Procedure is required so that staff can refer to this and take the correct action should they have any concerns about abuse. EVIDENCE: A requirement was made in the previous inspection report for a copy of the Hertfordshire Protection of Vulnerable Adults Procedure to be available for staff. This standard has not been met, therefore has been carried forward. Subsequent to this inspcetion, the procedure was found on a wall but partley concealed. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 13 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): None of these standards were inspected on this occasion. EVIDENCE: Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 14 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 & 36 Staff receive regular supervision from their line manager and open discussions are held in team meetings. This is important as staff deal with difficult, emotional problems that service users have. EVIDENCE: Staff receive regular supervision, records were observed and are now being stored in staff files confidentially. Staff confirmed that they receive regular supervision from their line manager. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 15 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): 42 Manufacturers risk assessments for cleaning products are not available. Information should be made available to staff as it details what to do should a problem arise, this could reduce risks to staff and service users. EVIDENCE: Although the manager had done some work on Risk Assessments for hazardous substances, manufacturers risk assessments are not available. A requirement has been made for these to be gained as clear instructions are given about what to do if a problem arises. A gas safety certificate was not available for inspection, although staff confirmed that this has been carried out. A copy of the certificate has been requested. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 16 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 X X X X X Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Vale House Stabillisation Services Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000019600.V272933.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? YES 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 YA23 Regulation 13 (6) Requirement Timescale for action 31/01/06 2. 3. YA42 YA42 An up to date copy of the Hertfordshire Protection of Vulnerable Adults Procedure must be available to staff. 13(4)(a)&(c) Manufacturers risk assessments for cleaning products must be gained. 13(4)(c) A copy of the most recent Gas Safety Certificate must be submitted to CSCI. 31/03/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA23 Good Practice Recommendations It is recommended that staff receive training on the Protection of Vulnerable Adults Procedure. Vale House Stabillisation Services DS0000019600.V272933.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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