CARE HOME ADULTS 18-65
Chy Colom Chy Colom Agar Road Truro Cornwall TR1 1JU Lead Inspector
Diana Penrose Announced Inspection 3rd March 2006 09:30 Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Chy Colom Address Chy Colom Agar Road Truro Cornwall TR1 1JU 01872 262414 01872 262414 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Addaction Ltd Mr Roland George Bence Care Home 12 Category(ies) of Past or present alcohol dependence (12), Past or registration, with number present drug dependence (12) of places Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th August 2005 Brief Description of the Service: Chy Colom is a detached property positioned in a residential area of Truro, close to the City Centre. There is a large garden at the front of the building and limited car parking space. Chy Colom was built over a hundred years ago as a vicarage. It still has many of the original ecclesiastical fittings throughout the home, which add character. A substantial refurbishment was completed in January 2004, which significantly improved the accommodation. The home has three floors; on the ground floor there is a large lounge, a dining room and a counselling room. Another communal room has been converted into a study room with computers. The home is non-smoking but there is a facility at the back of the home for those who wish to smoke. The bedrooms are on the first and second floors; four of them are shared rooms. Access to these floors is by stairs only, wheelchair users or residents unable to climb stairs cannot be accommodated at the home. The home operates a twelve-week rehabilitation programme. Residents are only accepted onto the programme following a very comprehensive assessment. Appropriately qualified and experienced staff work in the home. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited Chy Colom on the 03 March 2006 and spent three and a half hours at the home. This was an announced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 25.08.05. In addition the inspector focused on the following key areas of care: assessment and care planning, health care, risk taking, links with the community, family and friends, complaints, adult protection, some of the environment, staffing and training. On the day of inspection 6 residents were living in the home. The methods used to undertake the inspection were to meet with the registered manager and staff to gain their views on the services that Chy Colom offer. The residents declined the offer to talk to the Inspector. Chy Colom’s records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. What the service does well:
The home provides a twelve week structured substance abuse secondary rehabilitation programme. A thorough assessment and an interview are undertaken prior to any residents being accepted onto the programme. An individual care plan is compiled from the assessment. The care plan includes resident centred goals and comprehensive notes are maintained. The whole ethos of the home is centred on the residents. Independence and empowerment is very much promoted in the home and forms part of the therapeutic process. Residents are encouraged to taks responsible risks and go out into the local community according to the programme and their individual risk assessment. They help with the cooking and undertake household duties on a daily basis. Each resident is allocated a key worker to work closely with them throughout their stay at the home. There are strict house rules and the residents are informed of these at the outset. Representatives from Alcoholics Anonymous and Narcotics Anonymous, for example, visit the home to talk to the residents and a great deal of creative work takes place with the staff. There is a system for dealing with complaints and recording the action taken. There is also a policy and system in place to safeguard residents from abuse. The home is set in tidy grounds it is well furbished and well maintained. It was warm and clean on the day of inspection and there were no unpleasant odours. There are adequate laundry facilities and residents deal with their own laundry. The Registered Manager has worked at the home for several years and is competent to run the home. He has now completed the Registered Managers’ Award. He is supported in his role by a team of counselling and care staff; there were sufficient staff on duty during the inspection. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 6 There is a commitment to staff training and development and core competency training is provided for all staff. There are excellent training records maintained. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Residents are only admitted to the home following an assessment of their needs to ensure they are suitable for the programme and that home can provide adequate care. EVIDENCE: Admission of new residents to the home is only offered on the basis of a thorough assessment. The registered manager prefers the prospective resident to visit the home for the assessment. A qualified counsellor undertakes the assessment. Any restrictions on choice and the treatment programme are discussed at this time and there is an application form for the resident to complete. Assessment documents are obtained from other agencies if applicable. An individual care plan is drawn up from the initial assessment. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Individual care plans are generated for each resident that inform and direct the staff in their care provision. Residents make decisions about their lives in accordance with the programme; assistance and support is given where necessary. Risks are assessed and appropriate support is given to enable residents to lead an independent lifestyle. EVIDENCE: Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 10 There is a very good process for admission to the home, which is resident, centred. An individual care plan is compiled from the initial assessment. The plans include client centred goals and are signed as agreed by the residents. Care plan reviews take place on a monthly basis or at other times if required. Resident reviews also take place regularly and there is a review of the induction period and the therapeutic process. There are relevant risk assessments and these are reviewed and signed. Comprehensive notes are maintained. Independence and empowerment is very much promoted in the home and forms part of the therapeutic process. The registered manager said that lots of encouragement is given, the whole programme is geared aropund the residents as they have to ‘own’ their recovery. Confidence and assertiveness training takes place. The residents are encouraged to be open about their needs and feelings. They can make decisions about their lives and this was evidenced in the records. Daily meetings take place with the residents and they can air their views and make decisions about the running of the home. The house rules are discussed in group meetings.They are able to go out in line with the programme and the house rules. They can attend Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) group meetings if they wish. There are clear parameters for the residents in the home and there is an openess with the staff. Evidence of individual choices and preferrences are recorded. Residents are enabled to take responsible risks according to their individual risk assessments. Residents gradually go out into the community according to the programme and their individual risk assessment. There is a form for visits/overnight stays away from the home. This includes safeguards, plans and contingencies in case there is a problem. There is a procedure in place for unexplained absences, and absences have been appropriately dealt with and reported. Representatives come into the home to talk to residents and help them make decisions, these included Social Services, Alcoholics Anonymous and Narcotics Anonymous. The domestic superviser undertakes hygiene training with the residents and they participate in the cooking and other domestic activities in the home. There is a rota for these duties. Safety training takes place and there is a monthly fire drill that includes the residents. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 15 Links with the local community are good and allow residents the opportunity to socialise in accordance with the programme. Residents have appropriate contact with family and friends in accordance with the programme EVIDENCE: Residents can socialise within the boundaries of the programme and are encouraged to be part of the local community. The registered manager said that the first two weeks are spent in house then residents can go out in the evenings. Later in the programme residents can request a weekend away from the home. The registered manager said that residents go to the local swimming pool and sports centre, cinema, walking, shopping and bowling, for example. The first two weeks is a time for settling and disconnecting from outside stresses, visitors and telephone calls are discouraged at this time. After this period visitors are limited and residents consult the group as to who will be visiting. There is a telephone for residents use after 17:00 hours and an e-mail connection. A record is maintained of visitors to the home. There are guidelines for overnight stays away from the home and a formal request has to be approved. Completed forms were seen within the resident’s files.
Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Residents receive advice and support as required but are encouraged to be independent. Residents have access to health care services and are encouraged to exercise and eat healthily to ensure their physical and emotional needs are taken care of. EVIDENCE: Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 13 There is a routine in the home with ‘house rules’ however bedtimes and some activities can be negotiated. The registered manager said that residents are encouraged to control their own lives but support and advice is given when necessary. Advice on personal hygiene has been given on occassions. Privacy was respected during the inspection. Residents have a key to their room. A keyworker is asigned to each resident. All residents register with a GP in Truro and attend appointments when needed independently. The registered manager said exercise is encouraged, a regular Pilate’s class takes place in the home and there are two bicycles and weights available for residents use. He said that nutrition is important and wholesome meals are provided. There is access to an eating disorder consultant if required. The home also invites visits from other specialist healthcare professionals when needed. Residents receive talks from various agencies during their stay at the home, for example the benefits agency. There is an appropriate system for recording and reporting accidents. There have been no accidents since the last inspection. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a satisfactory complaints procedure that ensures complaints will be listened to and acted upon. Arrangements are in place for the protection of residents safeguarding them from harm or abuse. EVIDENCE: The home has a suitable complaints procedure and a method for recording complaints and the action taken. There have been no complaints to the home or the Commission. There is an appropriate adult protection policy in place that includes the reporting of incidents or allegations to the Commission for Social Care Inspection. A copy of the local multi agency procedures is in the office. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 and 30 The home and grounds are well maintained providing a safe environment for residents, staff and visitors. There is sufficient indoor and outdoor communal space for residents to be comfortable and choose where they would like to be. The home is clean and free from offensive odours making it a pleasant hygienic place to live in. EVIDENCE: Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 16 The home provides a comfortable, homely environment and is clean with no offensive odours. The grounds are kept tidy and attractive and are easily accessible. The residents participate in the gardening. The home is not accessible to wheel chair users. There is suitable heating, lighting and ventilation. The home is well maintained and there is a programme for redecoration. The home has a large lounge with comfortable sofas; the television has been moved back into the lounge from the quiet lounge at the request of the residents. This seems to be working well. The smaller lounge is now a quieter room that has access to the garden. Another communal room is used as a study room with computers for use by residents. The dining room is spacious and offers facilities for residents to make their own drinks during the course of the day. The home is non-smoking throughout but a facility is provided at the back of the home for those wishing to smoke. The laundry facilities are adequate for the size of the home and are situated off the garage at the back of the home. There are good hand-washing facilities for staff and protective clothing is provided. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 Staffing levels meet the needs of residents and staff morale is good. Staff receive training relevant to their roles to ensure that residents need EVIDENCE: The registered manager said the staff employed have the knowledge and skills necessary to care for the client group. Qualified counselling staff are employed as keyworkers for residents. The registered manager stated that two bank staff are employed to cover annual leave and sickness and he also works as part of the team. There were sufficient staff on duty on the day of inspection. The working day is from 08:30 to 22:00 and a member of staff sleeps in overnight. The registered manager said the company are committed to staff training. Each member of staff has an individual training profile and training plans that are excellent. Core competency training is provided for all staff. All care staff are partway through the NVQ level 3 training in care but have not progressed due to problems with the programme provided by Truro College. The home is looking to move to another course provider. Fire training takes place each month and the residents are included in this. Four staff are booked on a 4 day first aid course and a course on dealing with violence and aggression is iminent. The registered manager has completed the Registered Managers’ Award and has undertaken a fire warden’s course, which he found useful. Two staff have undertaken training in auricular acupuncture.
Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not inspected on this occasion. Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X X X X X X Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 4. 6. Standard YA39 YA43 Regulation 24 25 Requirement The annual development plan for the home must be sent to the Commission There must be a business and financial plan for the home that is available for inspection Timescale for action 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chy Colom DS0000063547.V281369.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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