Teen Challenge UK - Whitchester House Housing Support Service Whitchester House Duns TD11 3SF Telephone: 01361 890271 Inspected by: Howard Armstrong Type of inspection: Unannounced Inspection completed on: 13 October 2011
Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 10 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: Teen Challenge UK Service provider number: SP2003003478 Care service number: CS2004062669 Contact details for the inspector who inspected this service: Howard Armstrong Telephone 01896 664400 Email enquiries@scswis.com Teen Challenge UK - Whitchester House, page 2 of 21
Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership N/A What the service does well Whitchester House provided very good standards of care and support for residents. It was clear from discussion with residents and staff that consultation and choice were important aspects of the programme. Residents and staff were observed to treat each other with respect. Residents told us that they found staff to be very supportive, and always available to talk. What the service could do better The service needed to devise a volunteer placement policy and should try to involve more residents in the recruitment and selection process for new staff. It should put staff supervision contracts in place and review its recruitment and selection procedure to bring it in line with best practice and current legislation and regulations. What the service has done since the last inspection The service has continued to maintain high standards, and had implemented areas for improvement noted at the last inspection. Conclusion Residents were very happy with the care and support that they received. They confirmed that staff were sensitive to their needs. Residents appreciated the structure and variety of the programme offered as well as the regular trips out of the centre. Teen Challenge UK - Whitchester House, page 3 of 21
Who did this inspection Howard Armstrong Teen Challenge UK - Whitchester House, page 4 of 21
1 About the service we inspected Before 1 April 2011, Teen Challenge UK - Whitchester House was registered by the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (known as the Care Inspectorate), took over the work of the Care Commission, including the registration of care services. This means that from 1 April 2011 this service continued its registration under the new body, the Care Inspectorate. Teen Challenge, Whitchester House provides a service from a converted building near Duns in the Scottish Borders. The service is provided for people who have had a history with problematic substance abuse. The brochure for Whitchester House states that: "At Whitchester House we offer up to 18 months of support and accommodation for men aged 18 to around 35. The comprehensive timetables of programmed activities are underpinned by Christian principles and are designed to help the resident acquire and practice the skills necessary to lead a successful drug free lifestyle. They are finely balanced between classroom/group work and practical vocational activities, personal development and general housekeeping skills." The range of activities available to the residents included classroom activities, groupwork, gardening, cookery, joinery, house decoration and general maintenance. Also, residents went on regular walks and trips, particularly at weekends. Service users were mainly self referred or referred through the Teen Challenge outreach work in the community. Many residents heard about the service through 'word of mouth' and came from across Scotland. Funding was made available through the Teen Challenge charity and residents' benefits entitlement. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - N/A This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.scswis.com or by calling us on 0845 600 9527 or visiting one of our offices. Teen Challenge UK - Whitchester House, page 5 of 21
2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report following an unannounced inspection carried out during the morning and early afternoon of 13 October 2011. The inspection was undertaken by Howie Armstrong, Care Inspectorate Inspector. During the inspection, we spoke with the Manager and two other members of staff. Four members of staff were on duty. Thirteen service users were interviewed in a group setting. Evidence was obtained from a variety of sources including: Certificate of registration Service annual return and self assessment Support Plans and files of four service users Four staff files Service policies and procedures Teen Challenge UK - Whitchester House, page 6 of 21
Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Teen Challenge UK - Whitchester House, page 7 of 21
The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The service gave us a self assessment that outlined what it did well. Some areas for improvement were noted. We discussed with the manager that the Care Inspectorate will be putting more emphasis on thorough completion of self assessments. The service should expand on its strengths and identify areas for improvement in all statements. Taking the views of people using the care service into account We sent 15 Care Service Questionnaires to the service for distribution to residents so that they could give their views about the service. We received 11 completed forms. These confirmed that three residents agreed strongly that they had been asked their opinion about how the service could improve, and eight agreed. Eight residents agreed strongly that they were happy overall with the service provided, and three agreed. Three residents provided specific written comments: "I like the mix of staff, some have been through the program themselves and I can talk to them about situations they may have been through themselves - and staff members that haven't been through addiction problems but have had a good knowledge of life are equally good to talk to about situations that come up..." "I am very happy with the service I receive here. I've been here six months and would not change anything about the services I receive." "Throughout my stay at Whitchester I have been supported very well. I have felt that the level of support offered is ample for my needs and that if I require any additional support the centre would go out of their way to gain this facility." Teen Challenge UK - Whitchester House, page 8 of 21
During the inspection visit we talked with 13 residents in a group setting. They all confirmed that they were very happy with the service they received. In particular, they thought that the phased approach used by the staff was an effective way of working, and that the structure of the programme was good. They stressed that staff (as well as phase 4 residents) were always available for support. They said that both the accommodation and the food was good. Residents mentioned one or two issues: They said that it was quite cold in the mornings. We discussed this with the manager who said that this had already been noticed and was due to the recent drop in outside temperatures. He had already adjusted the heating to take account of this. Residents understood why they could not use computers to access the internet or social networking sites. However, some said that they would like to use a computer for other purposes, for example writing letters or playing computer games. The manager said that residents were able to use the office computer to write letters, and that the service had a specialist games console for computer games. Some residents pointed out that they were not allowed to take baths until they had reached phase 4 of the programme. Until then, they were restricted to showers. The manager said that this issue had never been raised with him and he would be happy to look at it. However, there would always need to be some restriction on baths because of the limits of the water heating system and the costs involved if everyone wanted to take regular baths. Also, new residents were allowed to have baths to assist with substance withdrawal. We think that the service policy in relation to baths could be usefully reviewed, and have made a recommendation about this in Quality Theme 1, Quality Statement 1.2. Another resident wondered why his skills as a hairdresser could not be used, as he would have been happy to provide regular haircuts for residents. The manager explained that there were health and safety issues involved, and there could be obvious tensions if someone didn't like their haircut. Taking carers' views into account We did not contact any carers during this inspection. Teen Challenge UK - Whitchester House, page 9 of 21
3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Overall grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths This section includes evidence from Quality Theme 1, Quality Statements 1.1 and 1.2. We found that the service was performing very well in the areas covered by this statement. There was a 'service user consultation and participation policy' in place. This committed the organisation to: Make sure that residents could make comments and suggest improvements Consult residents about changes to the programme Consider residents' views and provide feedback to them about how their views had been taken into account, and Provide opportunities to be involved in decision-making. The service used a programme that was split into four 'phases', and a review was carried out with the residents at the end of each phase. The review process included a questionnaire about what the residents thought about the service. We noted that the feedback in the four files that we examined was very good. Teen Challenge UK - Whitchester House, page 10 of 21
The Residents' Handbook included a commitment to: "listen, respect and respond to your views," and "to ask you for feedback about the service." Residents had a number of other ways of feeding back about the service, for example House Meetings, Review Meetings and a Suggestion Box. In discussion the manager said that he adopted an 'open door' policy and encouraged residents to talk to him about any issues they had. He confirmed that residents did use this option quite frequently. All the residents who completed questionnaires for us agreed, or agreed strongly, that the service asked for their opinions about how it could improve. Areas for improvement The self assessment stated that the service would develop its support plans so that residents were more involved in devising them. This aimed to encourage residents to take more 'ownership' of support plans. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Teen Challenge UK - Whitchester House, page 11 of 21
Statement 2 We enable service users to make individual choices and ensure that every service user can be supported to achieve their potential. Service strengths Inspection report continued We found that the service was performing very well in the areas covered by this statement. Residents were involved in making choices on a regular basis in relation to their support plan. The plans were highly personalised and included information about lifestyle, social, cultural and religious/faith beliefs. We noted that the Index/checklist for the support plan was very thorough, and that residents had clearly contributed to devising their own plan. There was a wide range of educational options available to residents, including: Dealing with other agencies and organisations Financial issues Household skills Health & hygiene Life skills Lifestyle choices, and Basic English & maths, delivered by Borders College Residents had one-to-one support from a key worker. They were able to attend various training courses and gain certificates and accreditation. One of the four modules was about planning for leaving the service, and making arrangements for returning gradually to the community. We noted that residents had opportunities to visit their home community with a trusted adult, for example for a weekend visit home. All the residents who completed questionnaires for us agreed, or agreed strongly, that the service checked with them regularly that their needs were being met. Teen Challenge UK - Whitchester House, page 12 of 21
Areas for improvement The self assessment stated that the service wanted to build a greater network of support agencies and accommodation for residents once they had completed the programme. Some residents told us that they would like to be able to have a bath occasionally, rather than a shower. See recommendation 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service should review its policy in relation to baths in consultation with residents, and take their views into account. National Care Standards, Housing Support Services, Standard 6 - Choice and communication. Teen Challenge UK - Whitchester House, page 13 of 21
Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths This section includes evidence from Quality Theme 3, Quality Statements 3.1 and 3.3. We found that the service was performing very well in the areas covered by this statement. The manager said that they usually involved a senior resident in part of the interviews for new staff. Residents were also asked to comment on new staff via a questionnaire at the end of their trial period. Residents were able to comment on staff and the support they received via the reviews that were held at the end of each phase of the programme. The service had an appropriate recruitment and selection policy and procedure in place. The procedure allowed them to recruit people who had been through the programme as a resident. This factor seemed to help residents gain confidence in the staff team and their way of working. All the residents who completed questionnaires for us agreed, or agreed strongly, that staff treated them with respect. See Quality Theme 1, Quality Statement 1.1 for information about participation and involvement that also applies to this statement. Areas for improvement The service should consider giving more residents the opportunity of contributing to the recruitment and selection process. For example, they could be asked about the kind of skills they thought were necessary to complement existing team members, or they could be asked to suggest possible interview questions. See recommendation 1. Although the service used volunteers, there was no volunteer placement policy. See recommendation 2. Teen Challenge UK - Whitchester House, page 14 of 21
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 2 Recommendations Inspection report continued 1. The service should try to involve more residents in the overall recruitment and selection process. National Care Standards, Housing Support Services, Standard 8 - Expressing your views. 2. The service should develop a volunteer placement policy to support its work with volunteers. National Care Standards, Housing Support Services, Standard 3.1 - Management & staffing arrangements. Teen Challenge UK - Whitchester House, page 15 of 21
Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We found that the service was performing very well in the areas covered by this statement. Feedback from staff that we talked to, and who sent us questionnaires, confirmed that they felt well trained and motivated by the organisation. Staff turnover was low. All staff received core training that included health & safety, whistleblowing, confidentiality and equal opportunities. We noted that there was a very good staff induction process that was supported by a comprehensive checklist. We found very good evidence that staff were supported to train and gain qualifications. We noted that staff were supervised regularly and notes kept of these meetings. Annual appraisals were carried out and recorded. Recruitment & selection, whistleblowing and supervision policies were in place. All the residents who completed questionnaires for us agreed, or agreed strongly, that staff had the skills to support them. Areas for improvement Inspection report continued Although the service policies said that supervision contracts were used, we noted that these did not seem to have been put in place. Particularly as staff could be supervised at different intervals it would be good practice to record this as part of a staff contract. See recommendation 1. The recruitment and selection policy and procedure had not been reviewed for some time. It stated that only one written reference was required. However, we noted that in the staff files we examined current best practice was used, that is two written references, one of which is from the most recent employer. See recommendation 2. Teen Challenge UK - Whitchester House, page 16 of 21
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 2 Recommendations 1. The service should put in place staff supervision contracts, consistent with its own policy statement. National Care Standards, Housing Support Services, Standard 3 - Management & staffing arrangements. 2. The recruitment and selection policy and procedure should be revised to take account of current best practice, Care Inspectorate regulations and the Equality Act 2010. National Care Standards, Housing Support Services, Standard 3 - Management & staffing arrangements. Teen Challenge UK - Whitchester House, page 17 of 21
Quality Theme 4: Quality of Management and Leadership - NOT ASSESSED Teen Challenge UK - Whitchester House, page 18 of 21
4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information No requirements or recommendations were made at the last inspection. Public liability insurance was in place until 21 December 2011. We talked with two members of staff. They confirmed that they felt well supported and enjoyed their work. The six staff who completed questionnaires for us provided very good feedback. All confirmed that they had been able to undertake training and qualifications while employed by Teen Challenge. Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Teen Challenge UK - Whitchester House, page 19 of 21
5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 2 5 - Very Good 5 - Very Good Quality of Staffing - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - Not Assessed 6 Inspection and grading history Date Type Gradings 18 Jan 2011 Announced Care and support 5 - Very Good Staffing Not Assessed Management and Leadership Not Assessed 4 Aug 2009 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 4 - Good 26 Jun 2008 Announced Care and support 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Teen Challenge UK - Whitchester House, page 20 of 21
To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527. This inspection report is published by SCSWIS. You can get more copies of this report and others by downloading it from our website: www.scswis.com or by telephoning 0845 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0845 600 9527 Email: enquiries@scswis.com Web: www.scswis.com Teen Challenge UK - Whitchester House, page 21 of 21