Inspection on 28/11/07 for Chy Keres

This inspection was carried out on 28th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chy Keres 19/10/06

Chy Keres 09/03/06

Chy Keres 29/11/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Chy Keres Tregadillett Launceston Cornwall PL15 7EU Lead Inspector Alan Pitts Unannounced Inspection 28th November 2007 10:00 Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 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 Keres DS0000064743.V350383.R01.S.doc Version 5.2 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 Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chy Keres Address Tregadillett Launceston Cornwall PL15 7EU 01566 779805 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) www.hft.org.uk Home Farm Trust Geraldine Mary Rawbone Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2006 Brief Description of the Service: This home was registered to provide services from 3/10/05. The building is designed to a high specification, providing level access, good furnishings, fittings and equipment. The detached property is situated in the small rural village of Tregadillett, close to the A30 and the facilities of Launceston. The home is designed to offer a flexible short break for adults with a learning disability who are 18-65 years. A maximum of 6 guests can be accommodated in ground floor bedrooms that have en suite bathrooms. One bedroom also has overhead tracking provision for the use of a hoist between the bedroom and bathroom. The facility has been designed to operate as a 6 bedded unit or 2 self-contained wings, each with kitchen, lounge and 3 bedrooms. There are no ‘permanent’ residents, and the home offers respite care only to the people of Cornwall. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of approximately 4.5 hours, during which time the inspector met with the registered manager, three staff, a residents, and the parent of a regular resident. Records were inspected and a tour of the premises undertaken. This purpose-built site offers facilities to a very high standard for respite care. The building is only about 2.5 years old. There is a large regular client group who know the home and the staff, and vica versa. The home makes good use of other facilities in Cornwall, such as day centres, most residents being occupied during the week. This is a well run and well thought out service offering a valuable break to carers and residents alike. What the service does well: What has improved since the last inspection? What they could do better: The registered manager could ensure that any specific instruction regarding medication is supported by evidence from the relevant GP. More could be done in respect of quality assurance and publishing the findings from feedback received. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 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 Keres DS0000064743.V350383.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective residents that are not known to the service will receive a thorough assessment to ensure their individual aspirations and needs can be met. EVIDENCE: A referral system is organised by the Department for Adult Social Care and reports are supplied to the homes registered manager. The registered manager completes an assessment process to ensure the home can provide services for the person referred and is involved in decisions regarding appropriate placement decisions. The assessment process includes visits to the home and other visits are used to facilitate a gradual introduction for an evening meal and an overnight stay to prepare for longer visits. The Department for Adult Social Care complete the financial assessment and the contractual arrangements with residents’ representatives. The Department for Adult Social Care have a contractual arrangement for £162.70 fee per night and service users representatives contribute £8.00 to £11.00 per night. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The registered manager is experienced in assessment procedures and organising short stay care breaks. The records inspected were organised to provide information and instruction for staff regarding the welfare of guests. The staff communicate well with guests and their representatives. EVIDENCE: There is detailed information available and records showed appropriate organisation and admission plans. The detailed assessment process is used to create a care plan for each guest. This records all areas of preferences and risk assessment, involving the guest and key staff. Support staff complete the daily recording of relevant events on contact sheets to ensure appropriate communication occurs at the home. The emphasis is on short stay breaks so the recording of information regarding health needs, dependency levels, various preferences for personal care, social activities, known behaviours and routines are necessary for care staff to Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 10 provide appropriate care. This information is being transferred to the new Home Farm Trust electronic system. A visiting parent confirmed how good the communication was, and was very positive about the informal, friendly approach of the staff, and how much their relative enjoyed staying at Chy Keres. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A range of social and recreational opportunity is provided with regard to assessed preferences. EVIDENCE: Support services are provided by Chy Keres during the evening and in the morning to prepare for daily activities. Guests are expected to attend a range of external facilities provided on weekdays. At the weekend a full support service is offered and care staff organise a range of activities. A minibus is available to assist with trips to places of local interest or community facilities. Guests come to Chy Keres for respite care, and all have external relationships with family and friends. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 12 The home uses digital photography to include relatives in the communication of events and activities enjoyed at the home. The staff were observed to exhibit appropriate skills and attitudes in their interactions with guests. There is a variety of nutritious meals provided. A record of these meals is kept. A visiting parent confirmed how much their relative enjoyed coming to Chy Keres. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The personal and health care needs of guests are met with evidence of promoting privacy, dignity and good multi disciplinary working taking place. EVIDENCE: Guest accommodation includes an en suite bathroom and toilet that offers privacy and comfort. The registered manager assesses dependency levels and the needs of guests to determine staffing levels and the support required for individual preferences, behaviours and health needs. The staff are proactive in maintaining links with guests representatives to establish if there have been any changes in care needs since their last visit. The administration of medication is maintained with appropriate audit procedures and records that require staff to sign as witness to the appropriate procedures. Medicine Administration Records were seen to be in order, and medicines are appropriately stored. Discussion took place with the registered manager about ensuring that specific instructions from guests’ representatives in respect of medicine administration are supported by written instruction from Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 14 the relevant GP. A temporary residency agreement is completed for guests with the local medical centre in Launceston and for ‘out of hours’ services. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Support staff have a clear understanding of ‘Adult Protection’ issues and procedures that will protect guests from abuse. EVIDENCE: There is a policy and procedure regarding the protection of vulnerable adults, complaints and concerns that is part of the staff training and induction process. The homes’ complaints procedure is available in the service users guide and in the home. There is an active and ongoing training programme for staff. The guests have access to other agencies whilst staying at Chy Keres. One parent confirmed that they would feel able to voice any concerns and were confident that they would be listened to. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 - Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The Home Farm Trust provides an excellent standard of décor, equipment and maintenance at this purpose-built home to ensure guests enjoy short stays in a safe and comfortable environment. EVIDENCE: The home was seen to be warm, clean and organised to provide for the welfare of guests. Communal areas are light, comfortable and spacious. There are two lounge areas. All bedrooms are fully furnished with colour coordinated decoration and furnishings. The rooms are lockable and a secure storage facility in the rooms is also provided for valuables. Specialist assisted bathing, toilet and other aids and adaptations are provided to assist guests with a physical disability. The home meets all health and safety requirements regarding fire precautions and detection, call alarms, window restrictors, low surface temperature radiator covers and hot water regulators. There is level access inside and out with wide doors for wheelchair access. The building was designed with the guests in mind. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 17 There is a patio area with seating for guests to enjoy in more clement weather. Parking for approximately 7-8 vehicles is provided. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Home Farm Trust is providing skilled support staff, in appropriate numbers to provide for the welfare of guests. EVIDENCE: Discussion with the registered manager and personnel files show job descriptions and a National Training Organisation compliant induction process. Personnel files in conjunction with the Home Farm Trust electronic system showed relevant application forms, references, and Criminal Records Bureau checks. Staff training has been completed and is ongoing, including First Aid, Fire Precautions, Medication, Food Hygiene, Autism, Moving and Handling, communication skills and Health and Safety. The registered manager and training records confirm that the majority of staff are registered on NVQ level 2 training and others are progressing to level 3. The registered manager maintains records of structured staff supervision meetings and individual staff training profiles. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 19 There is an established staff team with a low turnover, so guests benefit from continuity of care. Staffing is provided in relation to the dependency levels of guests; a guest presenting behaviours that challenge may require staffing on a 1:1 basis. One waking and one sleeper (on call) are provided for guests that may require attention at night. A third member of staff is provided from 7.30am until 10.30am to assist with the peak period of activity. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Home Farm Trust management and staff continue to meet the various standards, resulting in guests receiving good standard of service. EVIDENCE: The registered manager has appropriate experience and has completed the Registered Managers Award. The registered manager continues to develop professional skills and has attended an ‘International Respite Care Conference’ in France. A quality assurance questionnaire was last used in late 2005, and the results were posted to all the representatives of guests. The registered manager is looking to undertake a new quality assurance questionnaire in early 2008, and is planning to publish a summary of the findings in the home’s Service User Guide. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 21 The registered manager has developed this new service from the start. The health and safety of guests is promoted and protected through maintenance contracts and risk assessment procedures used at the home. An office team support the registered manager with administrative and financial tasks. This was the inspectors’ first visit to the home and the registered manager provided an informative overview of the service, demonstrating a good understanding of relevant issues. Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 22 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 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Chy Keres DS0000064743.V350383.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!