Care Home: Charis

Similar services:

• Herbert Street

What the care home does well As at the previous inspections, Charis continues to meet and exceed the assessed National Minimum Standards and provide an excellent residential rehabilitation service for people recovering from drug or alcohol dependency. The people who used the service described their experience to the inspectors as being as follows wonderful My life would have been over had I not come here and it has enabled me to see a difference in the way I can have a relationship with my family. This was consistent with the Project Annual Satisfaction Survey report. The majority of the people who use the service rated the various aspects of the service as 10 on the scale 1, meaning poor, to 10 meaning excellent. The average rating was 9. The management and staff at Charis are experienced and competent. Many are qualified and committed to professional development as well as further improvement of the service that would assist recovery and personal development of the people using it. In addition to having service users recovery, based on counselling and caring professional relationship at the heart of the Project, all the records required by the Care Homes Regulations are meticulously kept. The environment is simple, modern, clean, well maintained, secure and safe. Space and light are used to create a feeling of peace and tranquillity throughout the premises. What has improved since the last inspection? The Project continues to maintain a high standard of care and support, recognising the difficult challenges that a project of this nature does face. The continued highly positive feed back that the project receives is testament to the consistency and focus of the core purpose and function. What the care home could do better: No requirements or formal recommendations were made as a result of this inspection. The project has quite rightly continued to achieve an excellence rating from the Commission as a result of this inspection. This is not only because of the technical and managerial aspects of the project, but far more as a result of a history of the highly positive experience that is reported by the people who use this service. Key inspection report Care homes for adults (18-65 years) Name: Address: Charis 31 Mile End Road Mile End London E1 4TP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: James Pitts     Date: 3 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Charis 31 Mile End Road Mile End London E1 4TP 02077903040 02077028251 charis@towerhamletsmission.org www.charislondon.org Tower Hamlets Mission care home 7 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence Additional conditions: Date of last inspection Brief description of the care home Tower Hamlets Mission was established in 1870 by Frederick Charrington, heir to a brewer?s fortune. It was set up as a charity by the Charity Commission in 1938, following his death. Charis opened in 1988. The word Charis means grace in the ancient Greek language. The Registered Provider, Tower Hamlets Mission aims to enable people who suffer from alcohol and/or drug dependency to break the cycle of chronic addiction and rebuild purposeful, stable lives through the provision of high quality, comprehensive residential therapy and rehabilitation. Charis Primary Programme is registered with the Commission for Social Care Inspection for provision of care and support to up to eight males with chronic addiction problems associated with alcohol or/and drug dependency. The Programme is six months long. The fees range is #450 to #500 a week. Charis aims to assist its service users: to maintain abstinence as the foundation for a new life in recovery, to develop a more positive mental and emotional way of life, to Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 0 7 7 Brief description of the care home develop a positive spirituality, to address any outstanding practical matters that need attention and to develop recreational and social activities in recovery. The Programme uses the Twelve Steps framework embracing the spiritual as well as physical, emotional, mental and social dimensions of a person. Apart from the Primary Programme, Charis provides move on accommodation on site in The Charis Second Stage and The Charis Terrace. The premises are situated in the heart of London?s East End, in a quiet close set back from the Mile End Road. The surroundings are peaceful and contemporary. The central feature of a light well and a courtyard with a small fountain and pool give light, a sense of space and a feeling of peace to the building that houses the Primary Programme. There is a Chapel for prayer and meditation. There are good public transport links and other community facilities within walking distance. The staff team and the management are experi Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and lasted approximately four hours. The main aim of the visit was to reassess the service provision in accordance with the National Minimum Standards and the Care Homes Regulations. We spoke individually at length with one of the people who were using the service and with another two in passing. We spent most of our time talking with the registered manager, and other senior staff but did see and had short conversations with the other staff who were on duty on that day. We also viewed various records kept by the project as required. This included individual service user files, staff files, health and safety records, quality assurance documentation, etc. The inspectors saw various areas of the Project: kitchen, dining room, therapy room, Care Homes for Adults (18-65 years) Page 6 of 26 lounge, staff facilities, offices and the chapel. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 26 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Project uses comprehensive assessment tools and records the outcomes in order to make diligent placement decisions. Evidence: An inspector viewed individual files for three service users. Each of them contained records of comprehensive assessments that covered the following: alcohol and substance misuse history, psychological, social, spiritual, housing, legal, financial, nutritional, physical health, educational and other needs. Prospective service users meet with a member of the project team in order to determine their readiness to engage in such an intensive rehabilitation programme at this particular point in their lives. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The well-structured rehabilitation programme is balanced by staff respect for the autonomy, needs and choice of each person who uses the service. Evidence: Each examined individual file contained an individual personal plan. Weekly evaluation notes are also kept. Reviews are held after three months of engagement in the programme. The initial personal plan encompasses the review and more in depth information about the personal needs and their internal landscape. The Project is committed to providing the best conditions for the service users to increase their awareness of underlying issues and fully engage in recovery. This leads on to a life story. The engagement is intense and the process is fluid. It continues to be evident from speaking to the service users and the staff that individual autonomy and choice are respected at all times. This underlines the ethos of the whole service provision. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: The files also contained individual risk assessments. There have been no significant accidents or incidents at the service. Some people do leave the primary programme prior to completing it but this is expected in a service of this type. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users appreciate the opportunity to break from the alcohol or drug dependency and develop healthier lifestyles and more personal freedom. Evidence: Charis is based on a structured programme that facilitates all areas of personal development and considers leisure and recreation to be an important part of a balanced recovery. Day trips chosen by the service users are arranged by the Project on a regular basis. Charis has its own pool table, board games and a small library that includes DVDs. Visiting hours are limited because of the Programme requirements. A Visitors book is kept. A Pay phone is available, but mobile phones are not permitted. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: House Routines, Rules and Responsibilities and The Primary Programme Timetable were clearly written in the information available to the service users before committing themselves to the Programme. However, it is continually evident that the Project is committed to encouraging and developing the service users individual responsibilities and independence. The service users had regular meetings with the staff and fully contributed to the Project. The Project also holds daily group therapy meetings and recovery spiritual groups. Individual work includes counselling sessions with a Key-worker. Service users are also required to attend AA or NA (Alcoholics Anonymous, Narcotics Anonymous) meetings on a regular basis. Breaking with the past and adoption of positive and constructive attitudes toward the self, others and society are a main purposes of the Primary Programme. The Kitchen is clean and well organised. All required documentation is appropriately kept. The Project uses Safer Food-Better Business paperwork in accordance with the Food Standards Agency. The menus are displayed and indicate that a range of varied meals are on offer. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Charis provides an excellent health, emotional and psychological support to service users in accordance with their developing needs. Evidence: All of the people that use the service who met the inspectors looked well. No service users needed assistance with physical aspects of personal care at the time of the inspection. The recovery process at the Charis is focused on emotional and psychological support and therapy while maintaining and facilitating individual independence and autonomy. The people who use the service are very positive about the support provided to them at the Charis. The manager and staff emphasised the role of person led self awareness process and respect of their autonomy in recovery of dependency. Trust, confidence and ever widening of choice to enable an individual will and healing process are carefully nurtured by the Project. That is done in a structured context of a considered programme with clearly defined objectives. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: The service users are registered with a surgery and visit a local GP when it is needed. We checked the medication records, including homely remedies, and found them satisfactory. The medicines are appropriately and securely stored. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Charis has appropriate policies and processes in place to safeguard service users and their visitors. No incidents of this nature have been reported in the Project. Evidence: We viewed the Project policies and procedures for dealing with complaints and allegations of safeguarding nature. They were appropriate in their content. The safeguarding procedure is linked with the local council safeguarding board and includes safeguarding of children who might visit the service. No allegations have been made at the project in any of these regards. The Project kept a Complaints-log. No formal complaints have been made since the previous inspection either with the Project or the Care Quality Commission. Any issues or recommendations for improvement are discussed at the house meetings and these are minuted. The Charis is a listening service that responds appropriately to service user needs. The management and the staff are committed to a high standard of service provision. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is modern, clean, well maintained and peaceful. The facilities include a light well with an internal courtyard and a pool with ornamental fish, gardens and a chapel. Evidence: The premises are situated in the heart of the East End of London, in a quiet close set back from the Mile End Road. The surroundings are peaceful and contemporary. The central feature of a light well and a courtyard with a small fountain and pool give light, a sense of space and a feeling of peace to the building that houses the Primary Programme. There is a Chapel for prayer and meditation. The gardens are well maintained with service user involvement. All areas of the Project that were seen are tidy and spotlessly clean. There are good public transport links and other community facilities within walking distance. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by competent and well trained staff. Evidence: One person told us how in the previous recovery places he had experienced mistrust and constant put down by staff. Everybody the inspector spoke to at the Charis Primary Programme expressed how kind, caring and professional all staff were at this Project. The common Induction Standards were integrated with the Charis Induction Procedure and implemented with the three newer staff whose personnel records that we examined. The induction involved training days. In addition to paper-based records and certificates, the training records were linked electronically with Skills for Care data. Criminal Record Bureau disclosures for the long-standing staff have been verified and signed off by a Commission inspector. An inspector saw the originals and signed them off so that they could be destroyed in accordance with the data protection procedures. We also saw recruitment files for three new staff. The recruitment procedure is once again seen to be thorough. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The minutes of regular supervision meetings were available and indicated that the staff are appropriately supervised. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Charis Primary Programme is managed in an excellent way that enables recovery from drug or alcohol dependency and facilitates development of individual autonomy and free will in a safe therapeutic context. Evidence: The Registered Manager is competent, qualified and experienced. He has a Bachelor Degrees in Law, and Philosophy and Theology as well as Diploma in Social Work and Residential Care Manager Award. He was supported by the Charity Secretary, two administrators and the Deputy. The Deputy Manager also had Residential Care Manager award, various counselling qualifications and many years of relevant experience. The Project continues to provide an excellent service that is fully compliant with the National Minimum Standards, Care Homes Regulations and Care Standards Act. The manager has regular meetings with the Tower Hamlets Mission Management Committee as well as a service user sub-group. The members of the Committee also conduct regular visits to the Project and produce monitoring monthly reports, Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Regulation 26. All the operations are periodically reviewed and the identified actions are included in the Project Development and Business Planning processes. Satisfaction surveys that include different stakeholders are conducted on a regular basis and the reports on the outcomes are internally published. The Charis is an affiliate member of the Federation of Drug and Alcohol Professional services and also a member of the British safety Council. Health and safety risk assessments and technical checks are all within the required dates. These included: Gas and fire safety certificates, Portable Electrical Appliances Test records, Legionela test and the stair-lift service record. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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