Care Home: Vale House Stabilisation Services

Similar services:

• Nascent House
• Hebron House

What the care home does well The service provides a diverse range of support and care to people who have a drug and or alcohol addiction. There are various systems in place which reflect both professionalism and expertise in working practices. These were observed as appropriate to the needs of the people using this service. The service has produced detailed service plans, which give a comprehensive insight into to the needs of the individual. The service has a good assessment system in place, which is both detailed and comprehensive in its approach to identifying all the needs of new and existing users of the service. Vale House provides detailed information about the operation of the service to prospective and current residents in a detailed and comprehensive statement of purpose and service user guide. This includes the rules of remaining within the service and the right to leave the service at anytime, if they choose to do so. The staff team are both committed and enthusiastic in their approach to people living within this service. The people living at Vale House confirmed that they are actively involved in their care planning. The ex by ex confirmed that "Residents have input to their care plan and these are reviewed on a regular basis". The staff spoken with during the inspection appeared to have a clear understanding of their individual roles and responsibilities . The service appointed a new manager in May 2009, who was previously a care manager within the same service and therefore offering both knowledge and consistency to the people using the service users. The staff team and service users were very complimentary about the current manager and their consultative style of management and felt both supported and valued. One of the reasons why this service is so valued by the people who use it is because they feel that the staff team are "firm but fair", approach that is essential when working with this particular service user group. Several positive comments were received from speaking to both the ex by ex and the inspector, "One person stated that they were struggled for the first few weeks of the programme but they were there to support and encouraged me to talk and interact". "Its good here. I`m so grateful for this place. It is hard work but worth it in the end." What has improved since the last inspection? There is currently improvements to the building taking place in order to improve and further develop the existing facilities, which include an additional bedroom, staff sleeping in room plus en-suite, a refurbished kitchen and an additional games room on the ground floor. The manager has improved the regularity of supervision to all staff. The two requirements made at the last key inspection have also been met, with the manager currently applying to become registered manager with the Commission. What the care home could do better: The manager must ensure that staff receive the mandatory training that they require in order to carry out their role effectively and to ensure the best possible service is provided to people living at Vale House. On the day of this inspection there was no evidence to confirm that staff had received fire or food hygiene taring, within the required time frame. All records and documentation relating to the running of this service must be kept up to date, with a particular focus on the health and safety records (fire records) which ensures people`s health and safety is maintained at all times. The manager and staff should continually review the routines and restrictions imposed upon the service users to ensure that people`s rights, dignity and choices are respected and upheld at all times, with a particular focus on specific activities and the appropriateness of these and also the restrictions on receiving phone calls. The ex by ex stated that "The resident did not like having any privacy when talking on the telephone (as staff are always present through all stages of the treatment programme). The ex by ex suggested to the manager that at the half way stage of the programme (3 months) residents are allowed out in the community so maybe did not need staff supervising their telephone calls". Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Vale House Stabillisation Services 43 Cowbridge Port Vale Hertford Hertfordshire SG14 1PN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Greaves     Date: 1 8 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 29 Information about the care home Name of care home: Address: Vale House Stabillisation Services 43 Cowbridge Port Vale Hertford Hertfordshire SG14 1PN 01992553173 01992509729 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Chris Hannaby care home 7 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 maximum number of service users who can be accommodated is 7 The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Past or Present Drug Dependance - Code D, Past or Present Alcohol Dependance - Code A, of the following age range: 18 to 65 years Date of last inspection Brief description of the care home Vale House is a Stabilisation Unit providing short-term accommodation and therapeutic support to up to seven service users with past or present alcohol or drug dependency. The house is a listed building near the centre of Hertford. It provides seven single 7 7 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home 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 dropin service is also available to non-residents, which is not registered with the Care Quality Commission. A copy of both the Statement of Purpose and Service User Guide can be found in the home and is accessible at all times. A copy of the most recent inspection report can also be obtained from the office. The current charges for the service is £710 per week. Care Homes for Adults (18-65 years) Page 5 of 29 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: two star good 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 Vale House was carried out on the 22nd August 2007 and an Annual Service Review was completed on the 7th August 2008. This key inspection report draws on information obtained from the recent Annual Quality Assurance Assessment completed on the 23rd June 2009 (AQQA) and from a full inspection visit carried out on the 18th August 2009. The Care Quality Commission is trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently using a method of working where experts by experience are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. Therefore as part of this inspection process an expert by experience was invited to take part in collating the views of the people using the service at Vale House. Their findings and comments are Care Homes for Adults (18-65 years) Page 6 of 29 contained throughout this report. The term ex by ex will be used in this report to describe peoples whose knowledge about social care services comes directly from using them. The inspection process also included speaking to people using the service, staff on duty and a full inspection of records relating to care planning, medication, health and safety, staff records and training and the general management of the service What the care home does well: What has improved since the last inspection? What they could do better: The manager must ensure that staff receive the mandatory training that they require in order to carry out their role effectively and to ensure the best possible service is provided to people living at Vale House. On the day of this inspection there was no evidence to confirm that staff had received fire or food hygiene taring, within the required time frame. All records and documentation relating to the running of this service must be kept up to date, with a particular focus on the health and safety records (fire records) which ensures peoples health and safety is maintained at all times. Care Homes for Adults (18-65 years) Page 8 of 29 The manager and staff should continually review the routines and restrictions imposed upon the service users to ensure that peoples rights, dignity and choices are respected and upheld at all times, with a particular focus on specific activities and the appropriateness of these and also the restrictions on receiving phone calls. The ex by ex stated that The resident did not like having any privacy when talking on the telephone (as staff are always present through all stages of the treatment programme). The ex by ex suggested to the manager that at the half way stage of the programme (3 months) residents are allowed out in the community so maybe did not need staff supervising their telephone calls. 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 set out 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 9 of 29 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 29 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 admission process considers carefully the needs assessment for each prospective person and therefore ensuring the capacity of the service to meet their needs. Evidence: Referrals to Vale House can be made directly or by family members, health professionals, prisons and hospitals. Prospective service users usually visit Vale House and are interviewed by staff that are trained to do so prior to acceptance onto the programme. Consent is also gained from the prospective service user to gain further information about them. The initial assessment process is carried out within one week of the referral being made and comprehensive information is gathered. This information then forms part of the initial care planning process. The AQAA states At the point of admission the service user and member of staff completes our admission pack and this includes documents such as Data Disclosure forms, which allow the service user decisions on who we can pass information onto etc. They are also informed that a folder will be created and this will contain their personal information which is kept in a locked cabinet. Service users are aware that their personal Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: counselling sessions are confidential between themselves and their counsellor and notes of sessions are recorded only to evidence the session date. Three people spoken to during this inspection confirmed that they had been fully involved and consulted throughout the admission and transition process. I did feel involved when I came to Vale House and people were respectful. The referral procedure ensures that prospective service users fully agree and feel ready to commence the rehabilitation programme. This is essential, as it could not only contribute to their success but of others completing the programme. A welcome pack has been compiled and offers in depth information about the various treatments that are implemented throughout the programme, which will assist to achieve recovery. Care Homes for Adults (18-65 years) Page 12 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be very confident that the care plans reflect a detailed and comprehensive record of peoples needs, which ensures that service users are assessed, reviewed and safe from risk. Evidence: Two service plans were inspected in detail and were found to provide a detailed and comprehensive insight into each individuals needs. Individual notes and guidelines for people were observed within the service. Everyone living at Vale house is supported within both the internal review framework of one to one support and also through regular community meetings to ensure changing needs are continuously assessed and reviewed. Three monthly reviews occur with the placing authority for the individual service user. People confirmed that they been involved in the development of their support plans and consulted in the way that care is received in terms of preserving peoples rights and dignity. Ranges of risk assessments are completed within the service and actions points recorded. These risk assessments are very detailed and contain all the required information. Service users are restricted in many ways by their Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: admission agreement. However all service users spoken during this inspection confirmed that they had been fully consulted about these restriction. Several people commented that they felt these rules were necessary in achieving the aims and objectives of their placement and contributed to their rehabilitation. Rules and restrictions also provide a safe and supportive environment in which people can live and assist people in developing and maintaining the self help and life skills required for a more positive and more meaningful life, beyond the placement at Vale House. Care Plans are developed and agreed with service users. They are updated monthly as the service user enters different stages of the programme and the service user is able to comment on each reviewed plan. Admission onto the programme inevitably limits the service users freedom. Individual restrictions are also recorded. Service users confirmed that they are made aware of the rules and that they are free to leave the programme 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. Action is taken to minimise identified risks to service users during these times. Risks and progress are discussed and the decision is fed back by the key worker. The expert by experience found that Residents have input to their care plan and these are reviewed on a regular basis. One residents external Care Co-ordinates (drug workers who arranged the placement) visited on 3 occasions in 6 months. Residents seemed to have positive relationships with their key workers. They are able to see their key workers at any time. One resident was seeing an external counsellor on a weekly basis. Harm reduction advice and information is often lacking from abstinent based services, however both staff and service users stated that harm reduction ran throughout the programme. Overdose prevention and response advice was displayed on posters in reception. All service users stated that they feel they are invited to contribute to the running of the home. House meetings are held weekly and cover items such as menus and household chores. Care Homes for Adults (18-65 years) Page 14 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service at Vale House can feel assured that they will have a diverse range of daily and life skill opportunities offered as part of their rehabilitation programme in order to support their recovery and enhance their life skills. Evidence: Vale house provides a variety of opportunities for people which are a combination of in house therapeutic groups i.e. Art therapy, life story sessions and some holistic therapies are also provided. People are encouraged and supported to embark on a period of voluntary work within the local community which includes helping out and assisting in local charity shops based in Hertford. One person stated After 3 months I was asked what voluntary work I wanted to do, I was then found a placement within a garden centre. There is no communal phone, although there is one in the office. Telephone calls are Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: applied for use through the staff. There is no Internet access although there is a printer and computer that may be used at any time. There is a rota for day to day responsibilities i.e. cooking and shopping, clearing the tables and washing and drying up. This is a regime that people are supported to adhere to as part of their placement and their recovery programme. Service users decide on a weekly menu, taking into account peoples likes and dislikes. Each day a different person has the responsibility of choosing and preparing the meal for the whole group. The ex by ex found The menu is ordered and prepared by residents. Religious needs are catered for as are alternative diets. The residents decide on the menu and go on one main shop per week and two smaller top up shops. Residents can have drinks at any time. A kettle is supplied in all rooms. Residents cannot leave their rooms before 7.am. Residents in the move on accommodation generally have dinner on Sundays in the main building with the current residents. On the day of this inspection the service users were using a mobile kitchen housed in the garden area as the service was being redeveloped and extended. However this did not appear to cause any major inconvenience to the people living or working at Vale House. Several people spoken to stated that they had a variety of opportunities to take part in both in-house activity sessions and also the opportunity to commence on vocational courses at local colleges. The ex by ex found that The programme was based on 8 week group work programmes. The programmes include exploration of feelings, theories of addiction and complementary therapies including Reiki and massage. User involvement is encouraged as the residents are able to input to the group content and subjects. Group rules are strictly adhered to. Once in the abstinence based move on accommodation residents are permitted to stay out until 11pm. Residents are able to see their key workers at any time. Move on accommodation includes a 3 bedroom flat and a bedsit. Aftercare drop-in times were advertised on the door. If residents do not want to stay for the full programme (residents stated that this rarely happens) the staff do all they can to persuade them to stay. If the resident leaves the staff will ensure that they have somewhere to go. There was a concern that people were expected to attend certain sessions even though they preferred not to or did not posses the skills to carry out that particular activity i.e. swimming. This activity should be considered carefully in order to ensure that a persons dignity and respect is not compromised, even within the strict regime of this service. The ex by ex found The resident did not like having their privacy compromised when talking on the telephone, as staff are always present through all stages of the treatment Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: programme. The ex by ex suggested to the Manager that at the half way stage of the programme (3 months) residents are allowed out in the community so maybe did not need staff supervising their telephone calls. Another person stated that They had to attend swimming but was not able to swim. The resident stated that they would be happy to have swimming lessons but did not like sitting and watching the group swim. This activity should be considered on an individual basis in order to ensure that a persons dignity, respect and choices are not compromised, even within the strict regime of this service. Care Homes for Adults (18-65 years) Page 17 of 29 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. Service users health care needs are established prior to moving in ensuring that those moving into the area have immediate access to local health care services. Evidence: Each person at Vale House has a care plan which is devised upon entry into the service. This is reviewed in conjunction with the person using the service, the staff team at Vale House and with the placing authority. The manager and staff team work hard to ensure all the mechanisms are in place to support the service user through their rehabilitation placement and also to prepare them for moving on. This was further evidenced by speaking to people during this inspection who stated I feel almost glad that I had a problem as it has made me learn about life and myself. Every staff member has different expertise, so you can learn from them all. The ex by ex found The resident had health problems on arrival. They stated that they had a GP allocated at the outset and their medication was sorted out quickly. Random drug and alcohol testing is carried out and consented to as part of the programme that people sign up to upon admission into the service. Procedures relating to medication are satisfactory and all previous requirements have Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: been met. Care Homes for Adults (18-65 years) Page 19 of 29 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. People living in this service can be assured that they will be protected from abuse and that they will be listened to if they raise any concerns or make a complaint about any aspect of their care. Evidence: The service has a detailed complaints procedure in place. A record is maintained within the service of any complaints made detailing actions and outcomes as necessary. People using the service have been informed about the complaints procedure. The AQAA stated that We provide opportunities for service users to express their concerns in a safe and confidential way through house group, one to one, group therapy sessions, and where the staff ratio is high this allows us to offer an intense level of one to one support outside of the structured program. Our quality assurance forms evidence this, and we currently have received no formal complaints that have required us to implement the complaints procedure over the last twelve months. The ex by ex found One person stated that the complaints procedure was explained on entry to the programme. A detailed procedure is in place to ensure that people using the service are protected from abuse and harm. Staff employed within the home are all subject to enhanced Criminal Records Bureau disclosure. Care Homes for Adults (18-65 years) Page 20 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Vale House offers a homely and therapeutic environment to its service users, providing a positive group living style atmosphere, encouraging people to complete their programme. However inadequate fire monitoring practices could place people at risk Evidence: Vale house provides a welcoming and homely environment which is respected and valued by the people who use this service. On the day of this inspection the service was undergoing some re-development including the creation of an additional bedroom and staff sleeping in room facilities extended and improved. There will also be a games room created on the ground floor and a new kitchen and dining room. This work is due to be completed by the end of the summer. There was an up to date risk assessment in place for these building works in relation to the health and welfare of service users, staff and visitors. The inspector was shown around the accessible areas of the service but not in the bedrooms of the service users as permission had not been obtained prior to the inspection taking place. However the ex by ex had the opportunity to talk to several people about the facilities at Vale house and found The building was noticeably bright and clean and reception staff courteous and friendly to residents. People are responsible for keeping their rooms tidy. People confirmed that they have their own televisions in their bedroom. Residents can also watch television Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: or DVDs in the main lounge after 5pm. The ex by ex stated that There is a sign warning that residents may be searched on entry to the building. Smoking is permitted solely in the lounge after 5pm. At the time of the inspection a games room was being built which will be a non-smoking area. All areas of the home were maintained to a good level of cleanliness, considering the building work being carried out that was causing some element of disruption and thus creating additional cleaning. All health and safety documentation was seen and completed to a satisfactory standard, with the exception of the weekly and monthly fire checks. This was pointed out to the manager immediately and the inspector was informed that this had been an oversight and would be rectified prior to the inspection being completed. This is particularly important considering that the current building work being carried out could place people at additional risk from malfunctioning equipment. The service is in the process of applying to increase the occupancy of the service by extending the existing building to accommodate an extra bedroom and also extending the staff sleeping in accommodation. Care Homes for Adults (18-65 years) Page 22 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that a loyal and experienced staff team support them and who have been recruited using the Companies policies and procedures to ensure their safety and protection. However staff training is currently inadequate and incomplete and therefore which could place people at risk. Evidence: The manager and staff work hard to provide a safe, supportive, therapeutic and non judgemental environment for people using this service. Recording systems, support plans, and supervisions are all provided to a good standard. During this inspection there were several examples observed where staff clearly demonstrated their commitment to their work in caring for the people who use the service. The ex by ex found Residents seemed to have positive relationships with their key workers and one person stated that Staff are brilliant, Staff are always here to help you. Another person stated that I respect the staff. They stated that they struggled for the first few weeks of the programme but they were there to support and encouraged me to talk and interact. The rota was checked on the day of this inspection and the service demonstrated that adequate staffing is provided on both day and night time. This cover provides two staff on each shift plus a voluntary worker. The manager is supernumerary to these staffing Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: levels. The staff cover over the weekend is one person on each day and the sleep in duty. Staff meeting are held weekly, with the most recent meeting being held on the 12/08/09. The manager provides supervisions on monthly basis and staff confirmed that they felt supported and valued by the current manager. The staff training records were incomplete and therefore could not confirm that all staff had received the mandatory training required to carry out their role effectively. There was no evidence to confirm that staff had been provided with either fire or food hygiene training. The staff recruitment records were not examined at this inspection as previous inspections had identified no issues. Therefore information taken from the recently completed Annual Quality Assurance Assessment states that staff are recruited and appointed and in line with the companies policies and procedures in relation to the protection of the service users. The AQAA states We provide a thorough recruitment and selection procedure, and on commencement of employment we provide a thorough induction procedure. All staff are CRB checked. Care Homes for Adults (18-65 years) Page 24 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Vale house can feel confident that they are living within a service that is generally well managed and that offers an environment that is structured and assists in their recovery and rehabilitation. Evidence: People living within Vale House are provided with detailed information that has been produced in a format that is both explanatory and comprehensive. Both the Statement of Purpose and Service User Guide have been updated since the last inspection was carried out. The current manager was appointed in May 2009 and had previously been a care manager within the same service. They are currently in the process of applying to be registered with the Commission. Supervisions and staff meetings are held regularly and two staff spoken to on the day of this inspection staff confirmed that they feel very supported and respected by the manager. The manager and staff are working to wards further developing the quality assurance system to cover all aspects of the service in order to ensure there is regular monitoring and reviewing to improve areas of development, with a particular focus on service user involvement and the monitoring of medication. All records inspected were secure and were up to date and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: held in accordance with the Data Protection Act 1998 ensuring that peoples rights and best interests are safe guarded by the homes polices and procedures. Individual and generic risk assessments have greatly improved and have been further developed to ensure people living at Vale House are safe and protected. The general standard of fire checks/recording is good with the exception of the fire records as on the day of the inspection these records were incomplete. There are systems in place in order to ensure that everyone living, working or visiting this service are protected from cross infection and hygiene standards throughout the home were good. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 1 24 17 There must be up to date and accurate fire records held within the service to ensure people are protected and their health and welfare is maintained. To keep people safe. 18/09/2009 2 35 18 All staff must receive the appropriate training in order to carry out their role effectively and to provide the best service possible to the people living at Vale House. People had not been provided with either fire or food hygiene training. To protect the welfare of the people using this service. 30/10/2009 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 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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. 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