Inspection on 09/03/06 for Chy Keres

This inspection was carried out on 9th March 2006.

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 28/11/07

Chy Keres 19/10/06

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 Mike Stokes Unannounced Inspection 9th March 2006 03:00 Chy Keres DS0000064743.V277432.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 Keres DS0000064743.V277432.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 Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chy Keres Address Tregadillett Launceston Cornwall PL15 7EU 01179 273746 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) Home Farm Trust Geraldine Mary Rawbone Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: A site visit was completed on 23/9/05 and the home was registered to provide services from 3/10/05. Appropriate consultation has occurred with building control, environmental health and fire safety, the home meets the required standards. 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. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was organised to review the care provided at the home when the staff were unaware it would happen. I arrived at 3.00 pm and stayed until 5.00pm. During the visit I met 2 members of staff and looked at various records that are maintained regarding the welfare of service users. I was able to meet a service user and observe the use of the homes facilities as required, the communication and interaction with staff and the organisation and preparation of the evening meal. What the service does well: 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 Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 6 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.V277432.R01.S.doc Version 5.1 Page 7 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): 1, 2, 3 and 4. The home has a statement of purpose and service users guide that provides information about the home in an appropriate format for service users and their representatives. Prospective service users will receive a thorough assessment to record their individual aspirations and needs. EVIDENCE: The home has completed a statement of purpose and service user guide. The service user guide is supplied to each service user and their representative during a pre admission meeting and a guide is also left in each room as part of the information pack about the home. A referral system is organised by the social services and reports are supplied to the homes registered manager. The registered manager completes an assessment process to ensure the home can provide appropriate services for the person referred. The assessment process includes visits to the home; other visits are used to facilitate a gradual introduction for an evening meal and an overnight stay to prepare for longer visits. The social services complete the financial assessment and complete the contractual arrangements with the service users representatives. The registered manager completes the ‘Principles of Agreement’ document with the service user and representatives to clarify the terms and conditions regarding breaks at Chy Keres. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 8 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, 8 and 9. 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 service users. EVIDENCE: A discussion occurred with the staff on duty regarding the communication and planning required to provide for the welfare of the service users being admitted for a short stay. The staff expressed approval of the detailed information available and records showed appropriate organisation and admission plans. The detailed assessment process is used to create a care plan for each service user. This records all areas of preferences and risk assessment, involving the service user 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 provide appropriate care. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 9 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): 12, 14, 16 and 17. The emphasis of the short stay break is to provide leisure activities and relaxation rather than educational activity and development of skills. EVIDENCE: Support services are provided by Chy Keres during the evening and in the morning to prepare for day care. Service users are expected to attend day care or other opportunities normally 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. The registered manger is developing a newsletter that will provide a diary of events using digital photography to include relatives in the communication of events and activities enjoyed at the home. The staff on duty discussed the catering arrangements and a variety of nutritious meals are provided. A record of these meals is kept on a daily basis in the handover procedure. I observed the care staff consulting with the service user regarding his preferences and the organisation of the evening meal. A discussion also occurred regarding the plans for the evening and weekend ahead. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 10 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, 19 and 20. The personal and health care needs of service users are met with evidence of promoting privacy, dignity and good multi disciplinary working taking place. EVIDENCE: The service users accommodation includes an en suite bathroom and toilet that offers privacy and comfort. The registered manager has noted dependency levels and the needs of service users to determine staffing levels and the support required for individual preferences, behaviours and health needs. The administration of medication is maintained with appropriate audit procedures and records that require staff to sign as witness to the appropriate procedures. A temporary residency agreement is completed for service users with the local medical centre in Launceston and Kernow Doc services for ‘out of hours’ services. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 11 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. Carers will have a clear understanding of ‘Adult Protection’ issues and procedures that will protect service users from abuse. EVIDENCE: The care staff on duty discussed the 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. The registered manager is aware of the need to continue the development and reinforcement of appropriate communication strategies and awareness, involving service users, advocates and through discussion with staff in supervision. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 12 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, 25, 26, 27, 28, 29 and 30. The Home Farm Trust are providing a good standard of décor, equipment and maintenance at the home to ensure service users live in a safe and comfortable environment. EVIDENCE: The home was subject to a site visit in September 2005 and a complete review of the facility was completed as part of the registration process. A tour of the premises occurred on this inspection. The support staff on duty confirmed approval of the operational procedures and equipment available and used in the first 4 months of service provision. 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 service users 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. The Home Farm Trust have consulted appropriately with Building Control (Means of Escape) regarding the removal of the Kitchen door self closure mechanisms. The removal has improved access to these areas for service users. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 13 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): 31, 32, 33 and 36. The Home Farm Trust is providing competent support staff, in appropriate numbers to provide for the welfare of service users. EVIDENCE: Support staff confirmed that they are provided with job descriptions and an induction process. Training completed by this new staff team includes First Aid, Fire Precautions, Medication, Food Hygiene, Autism, Moving and Handling, communication skills and Health and Safety. The previous inspection confirmed that the majority of staff are registered on NVQ level 2 training. The registered manager maintains records of structured staff supervision meetings and individual staff training profiles. There is a minimum of 2 carers on duty and staffing is provided in relation to the dependency levels of service users, a service user presenting behaviours that challenge may require staffing on a 1:1 basis. 1 waking and 1 sleeper (on call) are provided for service users that may require attention at night. A third member of staff is provided from 7.30 am until 10.30 am to assist with the peak period of activity. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 14 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): 37, 38 42 and 43. The Home Farm Trust management and staff continue to meet the various standards, resulting in service users receiving good services as stated in the homes aims and objectives. EVIDENCE: The registered manager has appropriate experience and has completed the Registered Managers Award. The registered manager has developed this new service in an organised and efficient manner. The staff expressed their approval of communication systems, the organisation and the various procedures and routines used at the home. The Home Farm Trust has 3 other separately registered care homes in St. Austell and another 3 in the Wadebridge area. The health and safety of service users are promoted and protected through maintenance contracts and risk assessment procedures used at the home. An assistant service manager supports the registered manager and other administrative and financial support functions are provided locally. An assistant service manager completes a monthly report on the conduct of the home and a copy is sent to this Commission. Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 15 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 3 2 3 3 3 4 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 X X X 3 3 Chy Keres DS0000064743.V277432.R01.S.doc Version 5.1 Page 16 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.V277432.R01.S.doc Version 5.1 Page 17 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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