Care Home: Somewhere House

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What the care home does well Every person who is currently staying at the home we spoke with and those who wrote to us were very positive about the care and support they receive; they benefit from regular group therapies and individual counselling sessions which are provided by suitably qualified staff. People`s needs are fully assessed and they are closely involved in the care planning and review process. They are supported to take risks as part of their agreed plan of care, are aware of the routines of the house are fully involved in all aspects of life at the home. There are many positive comments from individuals which are contained in this report. Every health professional who wrote to us has a very high regard for this service. There are many positive comments from various professionals which are contained in this report. The staff we spoke with and those who wrote to us said they enjoy working at the home, are well supported in their roles and are provided with the training they need to enable them to support people properly. Somewhere House offers a very homely environment which is clean, well maintained and comfortably furnished. The home is very well managed; the views of people who stay at the home are sought to help the service improve. There are effective procedures to ensure people are safe. What has improved since the last inspection? The registered person now ensures that all handwritten entries on medication administration records are checked and confirmed by two staff signatures. Maximum daily doses for paracetamol or similar medicines, are also recorded. This ensures people are supported with their medicines in a safe way. The registered person has obtained Somerset`s revised policy on Safeguarding Adults and this is available to staff. This helps to promote the welfare and safety of people who stay at Somewhere House. What the care home could do better: This was a very positive inspection. No areas for improvement were either required or recommended following our visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Somewhere House 68 Berrow Road Burnham on Sea Somerset TA8 2EZ     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: David Smith     Date: 2 8 0 7 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 30 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 30 Information about the care home Name of care home: Address: Somewhere House 68 Berrow Road Burnham on Sea Somerset TA8 2EZ 01278795236 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somewhere House Limited care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence Additional conditions: The home may accommodate one named service user over the age of 64 years, as detailed in the variation application received on 4th August 2006 Date of last inspection Brief description of the care home Somewhere House provides support for up to 12 adults recovering from drug and alcohol misuse; people usually stay for between three and six months. (There are also four move on houses operated by the same organisation for people who complete their programme and require less intensive support). Addiction workers, support workers and volunteers support people who stay in the home. The service is owned by Somewhere House Ltd; Mrs Angie Clarke is one of the directors of the limited company and is the Registered Manager. Somewhere House is a large Victorian style property in a residential area of Burnham on Sea. It is close to a range of local amenities, including relevant support groups. The house has been adapted to provide single, double and triple bedrooms in keeping with Care Homes for Adults (18-65 years) Page 4 of 30 12 12 Over 65 0 0 Brief description of the care home the supportive nature of this type of service. There is also a group room, provision for individual work, kitchen, laundry and indoor and outdoor communal areas. The days are well structured with time allocated to reflective learning, groupwork, meal times and social activities. Peer support is encouraged throughout the treatment programme and in the aftercare stage. The home charges 550 pounds per week. People manage their own finances and are responsible for purchasing their own person items such as toiletries, newspapers etc. Care Homes for Adults (18-65 years) Page 5 of 30 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: The last Key Inspection of this service was completed on 15/08/07. This was an unannounced visit to the home to enable us to complete a Key Inspection of this service. We spent approximately six hours in the home on the day of our visit. The inspection was carried out by one inspector, but the term we is used in this report. This is because the report, and the judgements within it, are on behalf of the Care Quality Commission (CQC). The pre-inspection planning involved reviewing the report of the last Key Inspection completed in August 2007 and the Annual Service Review carried out in August 2008. We also looked at the service history, which details all other contact with, or about, the home. Care Homes for Adults (18-65 years) Page 6 of 30 We provided a number of surveys for people who stay at the home and staff members to enable us to carry out the last Annual Service Review. We sent new surveys to the individuals who are staying at the home, health professionals and staff members as part of this Key Inspection; nineteen were completed and returned. The views of each person who wrote to us have been included in this report. This inspection was supported by an Expert By Experience who, because of their shared experience of using services, helped us to get a picture of the quality of care and support provided at Somewhere House. They spent all of their time speaking with people who are either currently staying at the home or have stayed here before and with some of the staff who support them. We gathered additional information for this report by speaking with the Manager and her Deputy. We looking at a number of records within the home such as individuals care records, risk assessments, medication administration, staff records, complaints and compliments and some health and safety procedures. We viewed all communal areas of the home, the grounds and the bedrooms used by the people who stay here. Care Homes for Adults (18-65 years) Page 7 of 30 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. 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 8 of 30 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 9 of 30 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. Individuals are given the information they need about the home to enable them to make an informed choice about whether to use this service. People are confident the home can support them as their needs are thoroughly assessed and they are encouraged to visit before they are given the opportunity to move in. Evidence: The home has an up to date Statement of Purpose and a handbook which contains detailed information including house guidelines and routines, cleaning, cooking and laundry arrangements: it also contains a copy of the homes complaints procedure. There is also an informative website which clearly explains the range of services provided at Somewhere House. Each person who is staying in the home who wrote to us, and those we spoke with, said they were able to choose to stay at the home and that they did receive enough information to decide if this service was suitable for them. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: We looked at the records of two people who have recently begun their stays. These contain lots of information about each person and show that thorough assessments were carried out to help decide if the home would be a suitable service for them and to ensure all of their needs could be met. If any assessments have been completed by other health professionals, copies are obtained and used as part of the assessment process. Wherever possible, people are encouraged to visit Somewhere House so that they can get an insight into the facilities and programmes offered, meet some of the people who are currently staying at the home and some of the staff who would be supporting them. On the day of our visit one person was visiting and having their assessment completed. Each person signs a contract and an agreement when they begin their stay. These clearly explain the philosophy of the service, boundaries which people are expected to adhere to, expectations and how people can complain if they are unhappy with any aspect of the service. Care Homes for Adults (18-65 years) Page 11 of 30 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. Individuals needs and goals are met and each person has a plan that they have been involved in making. Each person is supported to make decisions about their lives and to take risks to enable them to live as independently as possible. People staying at the home are confident that information about them is handled appropriately. Evidence: We looked at the care records for two of the people who are staying at the home. When people begin their stay they are supported to complete a plan of care where their own needs, aspirations and goals are recorded; they re-write their care plan each month with the support of their counsellor or addiction worker. Every person who spoke with the Expert said they work to a care plan and they felt that they had good input to their care plan. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: The staff members we spoke with or who wrote to us said they are always provided with up to date information about the support needs of the people who stay in the home. Comments from staff include the home caters for every individuals needs and clients needs come first. People remain fully involved in all aspects of decision making about their care and how their identified goals will be met; they sign up to an agreement where they are expected to gain further support by attending outside groups such as alcoholics anonymous and narcotics anonymous. Staff support people to attend these groups and help them gain and attend voluntary work placements. The people who stay at Somewhere House are encouraged to run the home. They have weekly house meetings where they are free to discuss any issues relating to the house or the staff who support them. People have chosen to stay here and they are regularly asked about any changes they wish for themselves as well as within the home. As part of their programme to recovery, people may have certain restrictions placed on them; these are individual to each persons needs and are agreed with them as part of their plan of care. Any risks to people are assessed and care records contain written assessments. People staying at the home are confident that information about them is handled appropriately and that confidentiality is maintained. The home has strict policies in place relating to confidentiality; individuals and staff sign a confidentiality agreement. On arrival at the home, we were asked to read the homes confidentiality policy, as are all visitors to the home. Care Homes for Adults (18-65 years) Page 13 of 30 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. Each person is treated as a individual and has opportunities and appropriate support for personal and emotional development. People have access to a range of leisure activities and maintain links with the local community. Each persons rights are respected. Individuals are able to keep in touch with families and friends. People have healthy, well presented meals which they choose. Evidence: As part of their agreed treatment and recovery programme, people benefit from regular group therapies and individual counselling sessions which are provided by suitably trained and qualified staff. They are also supported to attend groups outside of the home and to access appropriate employment or education placements. Each Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: person is able to discuss which college courses or work placements may suit them; there is also a supported work system should people not wish to volunteer in shops so that they still gain experience and work within a small team to help build their confidence. One person staying at the home said the counselling is personal and I am made to feel that I matter and another told us we do really constructive group work and all the counsellors are really good at their jobs. Another person told the Expert after three months I started to tell the truth. I came in [very difficult to support] and they never ever gave up. After two weeks they started using TA (Transactional Analysis), which was really good, and CBT (Cognitive Behavioural Therapy). People have free time and, in line with any agreed restrictions, can choose how they spend it. Each person who stays at the home has access to a wide range of leisure facilities. They make use of the local library and use the Internet there to keep in touch with family and friends; they are members of the local gym and use the towns swimming pool. People told us they often go out for walks and trips to the beach and one person said it is the first time in my life that I have been to the gym. Peer support is encouraged throughout the treatment programme; people said they find this type of support very valuable. An example given is when people have suffered from sleep disorders, other people staying in the home had helped and supported them through this difficult time. The general running out the house is led by a group leader, supported by staff. They allocate jobs to other people staying in the home, which are agreed at the house meetings. The purpose of this group leader role is to provide a feeling of independence and ownership which is valuable when people leave the home. People staying at the home who wrote to us said they make decisions about how to spend their day, the feel they are able to do what they wish in their free time and that staff do listen to them and act on what they say. This is what people told us about the support they receive and what it means to them: it gives me the support and encouragement to be a healthy independent person, they support me and give me the tools necessary to function in normal life so I can recover from my addiction, they care about us and give us the knowledge to live clean healthy lives, they are very caring and treat me as an individual and they look at why you have a problem and they do everything and more to fix you. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The health professionals who wrote to us said the home supports people to live the life they choose wherever possible, responds well to their different needs and respects each persons privacy and dignity. One professional told us the home work well with a complex client group; they engage well with them with very good outcomes. Excellent therapy, training opportunities and resettlement. People are very well supported to maintain family links and relationships. Visits are encouraged and these generally happen on Sundays although other days can be arranged in Sundays are problematic. People are allocated six phone calls every week; these are phone calls to family or friends and maybe incoming or outgoing. Many of the people staying at the home are working towards improving relationships with their families; the home has been successful in reuniting some people with their children. Home visits are also encouraged if people wish and feel able to do this. Menus are decided by the people who are staying at the home. People get together to decide what meals they wish to cook, they then write the shopping list and decide who they would like to cook with. The food is of a good standard and portions are large; people have a light lunch and dinner in the evening. Fruit, tea and coffee are constantly available; if supplies of food run short in the week, people will do a quick shop. People who spoke with our Expert said that any special diets, such as following certain particular religious beliefs or people who are vegetarians, are catered for. One person said the food is good quality. When I came here I was underweight and I have put on four stone. Care Homes for Adults (18-65 years) Page 16 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples physical and emotional needs are well met. The home supports each person with their medicines in a safe way. Evidence: (Standard 18 does not apply; people who stay at the home do not require any staff assistance to meet their personal care needs). People staying at the home write their own care plan, which includes how to support their health and well being. These plans are reviewed each month. When people begin their stay, the home ensures that individuals are registered with a local GP and dentist; the home may also contact the previous GP and psychiatric team if they need to. They have excellent links with the local mental health team and they can make direct referrals should they need to. Support is offered to attend appointments in line with the individuals agreed plan of care. Regular drug tests are carried out by suitably trained staff; people agree and Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: sign consent forms when they move to the home. The healthcare professionals who wrote to us said the home does meet each persons health care needs, seeks their advice and acts upon this to manage and improve individuals health care. During the last Annual Service Review one local GP wrote to us; they described this service as excellent. Each person has their own addiction worker who helps them explore their experiences, identify areas which require change and help develop their life skills. People also discuss mental or physical health issues during group therapy. We looked at how peoples medication is stored and administered. Risk assessments are completed when people begin their stay to see if people are able to manage their own medicines or to identify any support they may need. People are also asked to review their current medication with the GP; should they wish to change their medicines this is supported by the GP and the staff team. People are responsible for some of their medicines, such as antibiotics or vitamins; other medicines are stored securely and can only be accessed and administered by trained staff. Daily records are kept of the medicines people take; to reduce the risk of errors, we recommended following our last visit that all entries are checked and signed by two staff and this is now being done. The home have their own medication policy and an excellent system in place for checking stock levels of medicines. Every time medicines are dispensed by staff they have to check the stock level is correct before they start and then record the level of stock left; for example, if a person takes medicine three times a day the stock levels are checked and recorded each time. There is also another weekly check completed to ensure these daily stock takes are accurate. Clear records are kept of all medicines entering or leaving the home. Care Homes for Adults (18-65 years) Page 18 of 30 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. If individuals who live in the home, or people close to them, have concerns about their care they know how to complain; their views are listened to and acted on. People are safeguarded from abuse, neglect and self harm and the home would take action to follow up any allegations. Evidence: The home has a formal Complaints Policy, a Safeguarding and a Whistle Blowing Policy, which staff can use in confidence to raise any issue or concern they have regarding poor practice. The home has policies in place to reduce the risk of harm or abuse to people; following our last visit we recommended that the home obtains a copy of Somersets revised policy (May 2007) on Safeguarding Adults and this was sought immediately. The people who are staying in the home we spoke with, and those who wrote to us, said they know they are able to complain if they are unhappy about any aspect of the home and they would be confident in doing this. People told the Expert on entry to the programme people are explained the complaints procedure. Every person they spoke with said that they would be comfortable in making a complaint and are actively encouraged to do so by staff. Staff members and health professionals told us they do know who to speak to if they Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: have any concerns regarding the care and support provided at the home; they feel their views would be listened to and taken seriously. There is a complaints book kept in the hall where complaints and the outcomes are recorded; in the three and a half years the home has been open they have only had three complaints; each has been addressed appropriately in line with the homes policy. There are very many complimentary cards and letters displayed in the home; some from people who have stayed at the home and others from their relatives. Regular meetings are held with the people staying at the home which help monitor staff interventions and their standard of work. These meetings can be used to address issues as well as discussing positive aspects of the support they receive. There are clear guidelines in place in relation to supporting people with their finances. People are encouraged to take responsibility for their finances including benefit claims, how they manage their money and banking. Staff are always available if people require extra support. Staff are provided with training in relation to Safeguarding Vulnerable Adults and are subject to enhanced Criminal Record Bureau disclosures (CRBs), before they start work in the home. The home maintains thorough records of each accident, incident or other significant event which occurs. We are always notified of significant events together with any other concerns regarding individuals who are staying in the home. Care Homes for Adults (18-65 years) Page 20 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Somewhere House provides a very homely and comfortable environment for people during their stay. Evidence: Somewhere House is a large Victorian style property situated in a convenient location in Burnham-on-Sea, close to the sea, town and local leisure facilities. There are car parking spaces at the front of the home and there is a large patio style garden at the rear. The home is not designed for people who have mobility difficulties. No specialised equipment is available and people need to be able to manage stairs to access the upper floors. The communal areas consist of a large lounge, dining room, kitchen and laundry. There is also a group room and smaller quiet room which is used for individual relaxation or counselling sessions; people are able to use the group and quiet rooms in the evenings if they wish. There is an office on the ground floor and a bedroom used by staff who sleep-in. The majority of bedrooms are shared, in keeping with the supportive nature of this type of service. Some bedrooms have en-suite facilities; there are adequate facilities for people who need to share bathrooms or toilets. People told the Expert they are Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: able to smoke in designated areas and in the garden, where there is a comfortable area set aside. Staff do encourage people not to smoke and will let them know if they believe that they are smoking too much. We did view all of the communal areas of the home; these are very well kept and suitably furnished. Somewhere House feels very much like a large family home; people who have stayed at the home have some of their artwork displayed and this helps with the homely feel. We also saw each of the bedrooms which people use; these are all very clean and tidy. The home has a large rear patio style garden. People who stay at the home have asked for the garden to be improved; this now has been done with a herb garden and rockery added and some vegetables are also being grown. There is a large garage where people can store items such as their bikes, weights and where they can play table tennis if they wish to. The people staying at the home told us they help with all of the housework and do their own laundry. People said the house is always fresh, clean and tidy. Care Homes for Adults (18-65 years) Page 22 of 30 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. Each persons needs are met and they are provided with safe and appropriate support by a competent and well trained staff team. Thorough checks are carried out on new staff to ensure they are suitable to work in the home. Evidence: Staff are provided with job descriptions which clearly identify their roles and responsibilities. Staff we spoke with and those who wrote to us said they are clear about their own and others responsibilities. The home also has a student support scheme which gives local trainee counsellors, social workers and psychologists the opportunity to work with experienced staff. The people who spoke with the Expert said relationships between them and the staff were positive and highly regarded; people believe every member of staff to be considerate of their wishes. One person said that staff members have different qualities; some read body language, some are blunt and forthright for example. The staff the Expert observed supporting people clearly had good relationships with each person, explaining things clearly and in a nice manner. One person staying at the Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: home said not one staff member is here for the money, it is the love of the job. The staff we spoke with and those who wrote to us said they are happy working in the home and told us they are always given up to date information about the people they support. They feel there is a relaxed atmosphere in the home, they feel listened to and that their views are taken seriously and acted upon wherever possible. Comments from staff include: Somewhere House is an extremely supportive environment. It is a pleasure to work with such an employer and I am very happy and supported working at Somewhere House. The health professionals who wrote to us said the staff team have the right skills and experience to support peoples needs. The home operates a robust recruitment process. The personnel records of staff who have recently joined the team contain their photograph, copies of their application form, documents proving their identity and eligibility to work in the UK, a health declaration, two satisfactory references and an Enhanced Criminal Record Bureau Disclosure (CRB). New staff are only appointed after a three stage process is completed. Firstly they attend a formal interview; they then take part in a group activity with people staying at the home and finally work one shadow shift. The last two stages allow time for people staying at the home to meet prospective staff and to give feedback to the Manager. New staff complete a thorough induction training programme; all staff are then provided with ongoing training such as first aid, fire safety and food hygiene. Staff are also given training in specific areas such as care planning, medication administration, abuse (currently known as safeguarding vulnerable adults), drug awareness, mental health, equality and diversity and assessing risks. The staff we spoke with and those who wrote to us are happy with the level of training they receive. They are provided with training they feel helps them understand and meet peoples needs, keeps them up to date on new ways of working and gives them enough knowledge about healthcare and medication. One member of staff said training, supervision and supporting staff are all done well. The staff team continue to meet regularly; they are also given time to discuss and reflect after group sessions. Each member of the team is provided with regular supervision sessions. Care Homes for Adults (18-65 years) Page 24 of 30 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 home is very well run and each individual benefits from how it is managed. The views of the people who stay at the home are sought to help the home review their practice. Each person is safeguarded as the home keeps clear records, staff understand the ways things should be done and health and safety practices are carried out. Evidence: The registered manager is Mrs Angie Clarke; she is also one of the company directors. Mrs Clarke has over 22 years experience in this field and is suitably qualified. She is supervised every month and attends training courses, meetings and workshops which help to ensure she is able to share good practice and keeps up to date with new ways of working. The Manager told us they opened this home to offer a different kind of rehabilitation service. The aim to create a family type of support network, not only for the people Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: staying at the home, but also for those who have moved into less supported homes. During our visit people who have moved on were able to call in and spend time with staff and the people who are currently staying. Peer support is really encouraged and people told us they find this extremely valuable. The people staying at the home we spoke with and those who wrote to us and discussions with staff members, the Manager and her Deputy show that there is an open and inclusive management style. People said they are happy to discuss any issues with the manager and they feel they are always listened to; one person said this is the most professionally run home I have been part of. The home actively encourages and supports people to put forward their views on the quality of care and support provided by Somewhere House. They carry out an annual audit where feedback is sought from people who have stayed at the home and from others with an interest in the service, such as peoples care managers. Their views are taken into account and any changes or improvements which are required are made. People can also express their views during house meetings, when reviewing their care plans or in more informal discussions with staff. This is what people who have stayed at Somewhere House told us about the home: This is the best rehab in England, great house, great staff and great treatment, I am very grateful to be in Somewhere House, although it is a real struggle sometimes. They are saving our lives, this place is just amazing and I would recommend this home to all addicts seeking help. Health professionals told us they rate this service very highly. One said I have been thoroughly impressed by the service all clients have received and another told us they go way beyond the usual rehab remit for their clients. I wish there were more rehabs like them. The management systems and structures are efficient; the record keeping is of a good standard. Files and other documents are very well organised, easy to access and stored securely when not in use. This is in line with the homes policy on confidentiality. The home has a number of policies and procedures, which are designed to ensure that both the people who stay in the home and the staff team are safe, the service complies with the law and remains aware of best practice or new ways of working. Each member of staff read these policies as part of their induction so that they understand them. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: There are recording systems in place to support health and safety in the home, which are used consistently. The is an up to date Fire Risk Assessment in place; the Fire Officer visited recently and told us the home have a very good fire warden and all fire procedures and records are very good. They feel it is a well run home, has no fire safety problems and commented the homes alarm system is above the standard required for this type of home. Regular tests are carried out on the homes electrical wiring, central heating system and on portable electrical appliances; adequate insurance cover is in place. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 29 of 30 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. 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