CARE HOME ADULTS 18-65
Vale House Stabillisation Services 43 Cowbridge Port Vale Hertford Hertfordshire SG14 1PN Lead Inspector
Alison Jessop Unannounced Inspection 22nd August 2007 10:00 Vale House Stabillisation Services DS0000019600.V349293.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 Vale House Stabillisation Services DS0000019600.V349293.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. Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 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.V349293.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 31st August 2006 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, which is not registered with the Commission for Social Care Inspection. A copy of the Service User Guide can be found in the home and is accessible at all times and a copy of the most recent inspection report can be obtained from the office. The current charges for the service range from £595 to £660 per week. Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. One Regulatory Inspector carried this unannounced inspection out over one day. At the time of the inspection the home had one vacancy. All six residents were spoken to over lunch where feedback about the service was offered. All feedback was very positive. One member of staff was interviewed and time was spent with the manager of the service and the inspector attended the weekly team meeting. Care plans and other documentation required in relation to the National Minimum Care Standards and Regulations were inspected. What the service does well: What has improved since the last inspection? Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 6 A creative writing group has been introduced where service users can express themselves within the group. Service users decide the subject and the work is displayed on the dining room wall. Staff have received training on safeguarding adults and fire safety. Procedures relating to medication have improved and staff are aware of their responsibilities in this area. 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. Vale House Stabillisation Services DS0000019600.V349293.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 Vale House Stabillisation Services DS0000019600.V349293.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Before agreeing admission the service carefully considers the needs assessment for each prospective person and the capacity of the service to meet their needs. Prospective service users are given the opportunity to spend time in the home. EVIDENCE: Referrals to Vale House can be made directly or by family members, health professionals, prisons and hospitals. Prospective service users usually visit Vale House and are interviewed by staff that are trained to do so prior to acceptance onto the programme. Consent is also gained from the prospective service user to gain further information about them. The initial assessment process is carried out within one week of the referral being made and comprehensive information is gathered. This information then forms part of the initial care planning process. The referral procedure ensures that prospective service users fully agree and feel ready to commence the rehabilitation programme. This is essential, as it could not only contribute to their success but of others completing the programme. A welcome pack is being designed which will offer in depth
Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 9 information about the various treatments that are implemented throughout the programme, which will assist to achieve recovery. Vale House Stabillisation Services DS0000019600.V349293.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although restrictions placed upon service users offer limited freedom, they are encouraged to speak openly about their needs and wishes. The home tries to accommodate these needs and wishes within the limitations of the contract. This ensures that they maintain some independence and a sense of identity. The high success rate is highly attributed to the rigid sanctions maintained throughout the programme. EVIDENCE: Care Plans are developed and agreed with service users. They are updated monthly as the service user enters different stages of the programme and the service user is able to comment on each reviewed plan. Admission onto the programme inevitably limits the service users’ freedom. Individual restrictions are also recorded. Service users confirmed that they are made aware of the rules and that they are free to leave the programme
Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 11 voluntarily at anytime. Service users also confirmed that they felt the sanctions in place were fair. A ‘buddy’ system is in place which offers new service users support from someone who may be nearing the end of the programme. Although restrictions are in place, service users are free to leave the home within limited times and with appropriate levels of supervision following the initial admission period. Action is taken to minimise identified risks to service users during these times. Each week service users can submit written requests to the staff team, staff discuss this at the weekly team meeting. Risks and progress are discussed and the decision is fed back by the key worker. All service users stated that they feel they are invited to contribute to the running of the home. House meetings are held weekly and cover items such as menu’s and household chores. Vale House Stabillisation Services DS0000019600.V349293.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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Planned intervention enables and supports service users to develop personal skills and take opportunities to engage in social and community activities. EVIDENCE: The manager stated that service users are unable to go out of the home in the initial stages of the programme, as a secure environment needs to be created which ensures that service users are emotionally stable. Once the service users are ready to go out they are actively encouraged to be involved in the community within a risk management framework. Three service users are starting further educational courses in September at the local college. Service users also participate in various activities such as swimming in order to promote a healthy lifestyle. A creative writing group is held once a
Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 13 week where service users can decide the subject. The work is then put on a notice board in the dining room. Feedback was positive about the variety, the quality and quantity of the food served. Service users shop, prepare and cook for all meals on a rota basis. Some of the service users take great pride in their achievements of providing meals to the group as this is often a new skill that has been developed. Good nutrition is an important aspect as many service users may have neglected their diet on account of their previous lifestyle. Service users are expected to sit at the dinner table for meals and are encouraged to participate in conversation. Residents are encouraged to participate in religious activities if they wish to so to meet their individual preferences. Vale House Stabillisation Services DS0000019600.V349293.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. Service users health care needs are established prior to moving in so that staff can ensure that those moving into the area have immediate access to local healthcare services. EVIDENCE: The majority of new service users will have moved from other areas of the country and will therefore not be registered with local healthcare services. Staff ensure that service users register with the local GP immediately. Various forms of complementary therapy are also offered to service users throughout the programme. Daily group and individual counselling sessions ensure that service users feel emotionally supported. Everyone said that they were aware of what was expected of them prior to moving in and understood that they are free to leave the programme at any time. Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 15 Procedures relating to medication requirements have been met. are satisfactory and all previous Vale House Stabillisation Services DS0000019600.V349293.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 good. This judgement has been made using available evidence including a visit to this service. Many safety mechanisms are in place at Vale House to ensure that service users are protected from harm. EVIDENCE: Service users confirmed that they were aware of how to make a complaint. Staff spoken to are aware of the homes Whistle Blowing Procedure and all staff have received training on adult safeguarding procedures. Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Vale House offers a homely and therapeutic environment to its service users, which encourages a positive family atmosphere helping them to complete the programme. EVIDENCE: The lounge and dining room are appropriately furnished with comfortable, domestic style furniture and furnishings. On the day of the inspection the home was clean and tidy. Vale House is a listed building and therefore development is restricted. It is a domestic style house and is not suitable for wheelchair users. There is a small lounge on the first floor with a small library, television and quiet area. There is a domestic style kitchen, and safe food hygiene procedures were observed. The hallway and stairs have been redecorated and provides a homely, welcoming atmosphere.
Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 18 Service users bedrooms offer a personal and homely feel. Service users are encouraged to bring personal possessions to the home providing they do not create risks. Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 19 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, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a very high staff retention rate, low absence rates and all staff appear to be very dedicated to their work. This contributes to the high success rate of the service. EVIDENCE: The company provide an induction and on-going training to ensure that staff fulfils the aims of the service and the changing needs of the service users. Training courses are available in relation to drug and alcohol misuse, rehabilitation and various beneficial therapies. Other compulsory training is organised and several staff are completing an NVQ qualification. All staff have a formal qualification is counselling. Procedures relating to the recruitment of staff are satisfactory. Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 20 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 manager is person centred in their approach, and leads and supports a strong staff team who have been recruited and trained to a high standard. The manager has not registered with the Commission for Social care Inspection, therefore her fitness cannot be assured. EVIDENCE: The house is managed in an open, positive and inclusive manner. In March 2006 the service was awarded Investors in People. The current manager of the home is not registered with the Commission for Social Care Inspection. This was a previous requirement, which has not been met and therefore the requirement has been carried forward. Should this not
Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 21 be met by the deadline given, the commission will consider enforcement action. The home has an effective quality assurance system in place. Records pertaining to health and safety are satisfactorily maintained. All staff have recently attended fire safety training. Several fire doors were observed being wedged open using inappropriate methods. Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 22 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 4 3 X 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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 23 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 YA37 Regulation 9 (1) Requirement A person demonstrably fit to do so must manage the home. The current manager must submit application for registration to the Commission. This requirement has been carried forward from inspection report dated 31/08/06. Fire doors must not be wedged open and methods approved by the fire safety officer must be used. Timescale for action 31/10/07 2. YA42 23 (4)(a) 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Vale House Stabillisation Services DS0000019600.V349293.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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
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