Inspection on 24/06/05 for Vale House Stabilisation Services

This inspection was carried out on 24th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Vale House Stabilisation Services 22/08/07

Vale House Stabilisation Services 31/08/06

Vale House Stabilisation Services 16/12/05

Vale House Stabilisation Services 17/01/05

Vale House Stabilisation Services 27/09/04

Similar services:

Nascent House

Hebron House

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

CARE HOME ADULTS 18-65 Vale House 43 Cowbridge Port Vale Hertford Hertfordshire SG14 1PN Lead Inspector Alison Jessop Unannounced 24.06.05 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 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 Stationary 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 I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Vale House Address 43 Cowbridge Port Vale Hertford Hertfordshire SG14 1PN 01992 553173 01992 509729 Telephone number Fax number Email 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 Care Home 7 Category(ies) of A - Alcohol depend past/present - 7 registration, with number of places D - Drug dependence past/present - 7 Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are none. Date of last inspection 17.01.05 Brief Description of the Service: Vale House is a Stabilisation Unit providing short term accommodation and therputic 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 I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive inspection, which took place over one day. Residents and staff at Vale House were very welcoming and feedback was gained from the residents in a group discussion over lunch. Due to the sensitive nature of the service individual discussions were not always appropriate, however all feedback gained from the group commended the service. No immediate requirements were made during the inspection and most standards were met. What the service does well: What has improved since the last inspection? A new Care Plan has been introduced which gives a more detailed account of service users needs. The service user signs this. Specific task Risk Assessments have been introduced which minimises or eliminates possible risks. Polices and procedures have also been reviewed. Twelve and twenty six week reports have been introduced which reviews all aspects of the service users needs, progress and preferences. This is shared with other relevant professionals so that a support network can be maintained. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 6 The new kitchen provides a bright, clean and practical area for preparation of food and drinks. New gym equipment has been purchased and on the day of the inspection a therapeutic anger bag had been delivered. 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 I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 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 standard(s) 1,2,3,4 & 5 A robust Referral and Admission procedures ensure that referrals are appropriate. This is essential for the continuation and success of the programme. 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. During the initial visit, terms and conditions of the service are explained. A welcome pack including the Statement of Purpose, Terms and Conditions and Complaints Procedure is given to the applicant. Once a decision has been made an acceptance or refusal letter is sent. Successful applicants are then placed on a waiting list. The home has a robust admission procedure where the ‘Licence to Occupy’, Statement of Terms and Conditions and disclaimer for the use of gym equipment is signed by the home and the service user. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 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 standard(s) 6,7,8,9 & 10 Although restrictions placed upon service users offer limited freedom, service users are encouraged to speak openly about their needs and wishes. The home trys to accommodate these within the limitations of the contract. This ensures that they maintain some independence and a sense of identity. EVIDENCE: Care Plans are developed and agreed with service users. They are updated monthly as the service user enters different stages of the programme. 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 voluntarily at anytime. Service users also confirmed that they felt the sanctions in place were fair. 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. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 10 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 issues regarding the running of the home. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16,17. Personal interests and hobbies are promoted and as the programme progresses they are encouraged to gradually integrate back into the community. This prepares service users for the time when the programme ends and they are ready to move-on. EVIDENCE: All service users must attend all group sessions – these cover various topics. On the day of the inspection service users read a play in the lounge. The service user’s individual care plan may contain additional skills that they may wish to develop. As part of the natural process of the programme life skills such as menu planning, cleaning and budgeting are developed. Opportunities for educational support and voluntary employment are made available depending on the service user’s needs and preferences. Voluntary work in local schools is available where drug prevention is promoted. An external educational course is compulsory in the latter stages of the programme. This is chosen by the service user and courses such as Yoga, and Gardening are undertaken. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 12 Following the initial restrictions on leaving the house, service users level of supervision is decreased as weeks of the programme are completed. On the day of the inspection some of the service users went out for short periods of time unescorted. On return to the house a search of any bags takes place to ensure they are not returning with detrimental or harmful items. Leisure programmes are limited dependent upon an individual’s progress through the programme. Visits to a local arts centre are arranged and other activities of their choice are held. Service users have access to a T.V, video and a DVD plus a small library, gym equipment and other sports equipment. The home trys to employ a varied and inclusive atmosphere, as periods of isolation can be detrimental to their recovery. However, service users confirmed that they are free, within reason, to take time on their own. Service users confirmed that they are responsible for menu planning and explained that various diets and likes/dislikes can be accommodated. 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. A Family and Friends meeting is held each week where support is offered to people involved in the lives of someone with an addiction. This is also open to non-residents families and friends. Service users can move on from the house into a flat on site once they are ready. They are welcome to visit Vale House once they have left and can use the drop in service as an on-going support network. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 & 20 This open, inclusive atmosphere offers the service users a feeling of safety and security which is essential in the recovery process as service users can gain support through difficult times. EVIDENCE: Service users are monitored very closely at Vale House and the restrictions placed on them means that independence is minimised. Service users confirmed that within those parameters they are treated with dignity and respect. The home provides a safe and supportive environment. One service user stated ‘I feel safe, secure and loved, we really are at the centre of the service’. Medication storage and records were generally satisfactory. A number of recommendations were made in relation to good practice. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 14 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 standard(s) 22&23 Many safety mechanisms are in place at Vale House to ensure that service users are protected from self-harm. EVIDENCE: One verbal complaint had been made since the last inspection. This had been recorded and dealt with within the required timescales with a satisfactory result. Service users confirmed that they were aware of how to make a complaint. Several compliments had been received from service users who have completed the programme. Although a copy of the Hertfordshire Protection of Vulnerable Adults Procedure was displayed on the office wall, this was not the most up to date version. Staff did not have access to the full procedure. Staff spoken to are aware of the homes Whistle Blowing Procedure. CRB certificates were observed on all staff files inspected. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 15 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 standard(s) 24,25,26,27,28,29 & 30 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. A new domestic style kitchen has been fitted and safe food hygiene procedures observed. Service users bedrooms observed offered a personal and homely feel. Service users are encouraged to bring personal possessions to the home providing they do not create risks. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 & 36 The staff team are enthusiastic and appear to take great pride in the service thus creating a positive atmosphere to service users. EVIDENCE: Staff confirmed that they have a job description and are aware of the homes aims and objectives. The company provide an induction and on-going training to ensure that staff fulfil the aims of the home 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 that had been attended included First Aid, Health & Safety, Fire Safety, Confidentiality and Adult Protection. The Performance and Development Manager has left recently and this position will not be replaced. Staff are due to commence NVQ training courses, which incorporates the Drug and Alcohol National Occupational Standards (DANOS). The company operates a thorough recruitment system and staff files observed included application forms, references and CRB certificates. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 17 Staff interviewed confirmed they receive formal one to one supervision with their manager and group meetings are held regularly. It is recommended that copies of one to one supervision notes should be stored on staff personal files. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 39, 42 & 43 Role specific risk assessments introduced recently has improved management’ in the home. EVIDENCE: The house is managed in an open, positive and inclusive manner. Staff join service users for dinner and participate in various activities organised. The home has an effective quality assurance system in place. This includes ‘a letter to Vale House’ which is a formal process for feedback from service users. A twenty-six week report is produced with the service user and is sent to other professionals involved. A self-assessment tool ‘the Outcomes Spider’ is used to monitor progress on the programme and includes the health and safety of the service user and any outstanding issues. New Risk assessments have been introduced for specific tasks and risk management is an integral part of the service. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 19 ‘risk A copy of the most recent gas safety test was unavailable. A copy of this must be submitted to the Commission for Social Care Inspection. Although risk assessments on the use of cleaning products were present, a recommendation was made for ‘product specific risk assessments’ to be gained from manufacturers and all risks minimised or eliminated. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 20 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Vale House Score 3 3 2 N/A Standard No 37 38 39 40 41 42 43 Score x 3 3 x x 2 x I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 23.2 Regulation 13 (6) Requirement An up to date copy of the Hertfordshire Protection of Vulnerable Adults Procedure must be available to staff. The registered person must ensure that NVQ training in line with DANOS is available to all staff. A copy of the most recent Gas Safety Certificate must be submitted to CSCI. Timescale for action 24.8.05 2. 32 18(1)(c) (i) 13(4)(c) 31.12.05 3. 42.3 (ii) 24.8.05 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. 3. Refer to Standard 20 36.4 42 Good Practice Recommendations Total stocks of medication should be recorded upon receipt of medication in order to carry out medication audits. A record of staff supervision meetings should be maintained on staffs individual files. Manufacturers risk assessments for cleaning products should be gained. Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 © 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 Vale House I52_s19600 Vale House v235024 240605 stage4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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