Inspection on 20/03/06 for Chy Koes

This inspection was carried out on 20th 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 Koes 31/07/07

Chy Koes 08/08/06

Chy Koes 26/01/06

Chy Koes 08/12/04

Chy Koes 22/06/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

Honeybourne House

12 Orchard Mews

Stallcombe House

Stepping Stones

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

CARE HOME ADULTS 18-65 Chy Koes Chy Koes Woodland Road St Austell Cornwall PL25 4RA Lead Inspector Elaine Bruce Unannounced Inspection 20th March 2006 09:00 Chy Koes DS0000039607.V271602.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 Koes DS0000039607.V271602.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 Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chy Koes Address Chy Koes Woodland Road St Austell Cornwall PL25 4RA 01872 322000 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) Cornwall County Council Mrs Anne Davies Care Home 5 Category(ies) of Physical disability (5), Physical disability over 65 registration, with number years of age (5), Sensory impairment (5), of places Sensory Impairment over 65 years of age (5) Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users to include up to 5 adults with a physical disability (PD) Service users to include up to 5 adults aged over 65 with a physical disability (PD{E}) Service users to include up to 5 adults with a sensory impairment (SI) Service users to include up to 5 adults aged over 65 with a sensory impairment (SI{E}) Total number of service users not to exceed a maximum of 5 Date of last inspection 26th January 2006 Brief Description of the Service: Chy Koes is situated on the outskirts of St Austell. The home occupies the ground floor of a building that incorporates a separate care home for older people on the first floor. There is a large garden with lawns to the rear of the building with garden tables and bench seating. Ramps are provided for easy access. There is limited car parking space at the front of the home. The home provides respite care for up to five adults with a physical or sensory disability. Accommodation is provided on one floor and service users can access all areas. There is a spacious lounge with a dining area and a well equipped kitchen. There is a large shed in the garden for smokers that is heated and has furniture and a television. Assisted bathing and showering facilities are provided and all rooms have accessible call bells. Building work has just taken place to improve the facilities of the home to include two new bedrooms which have en suite facilities. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection at Chy Koes was an announced inspection. It took place on the 20th March 2006 between the hours of 0900 and 1445. The registered manager was present during the course of the inspection as was one of her deputy assistant managers. Chy Koes has recently been closed for improvements to be made to the environment. This improvements have been delivered to a high standard but two of the bedrooms are not presently being used until the staffing levels at the home have been increased. What the service does well: What has improved since the last inspection? What they could do better: As a priority Cornwall County Council should review the staffing levels at Chy Koes. Two new refurbished bedrooms with excellent facilities for service users with high physical care needs are presently unable to be used due to the poor staffing levels. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 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. Chy Koes DS0000039607.V271602.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 Koes DS0000039607.V271602.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): 2,3,4 and 5 Service users access the resource of Chy Koes via social services. Social services and the Chy Koes management team assess all service users prior to admission to the home to ensure that they can meet assessed care needs. EVIDENCE: All service users access the home by the care management process that involves a social care and financial assessment. The assessment is requested at the time of the referral and is then discussed to ensure that the home can meet the needs of the service users. In addition an assessment by the manager or a deputy takes place again to establish that the home will be able to meet the care needs of all prospective service users. Prospective service users and their families can visit the home before deciding to stay. It is recommended that the pre admission assessment document is dated and signed by the assessor. The service users are involved in a financial assessment and the social services department provide a contract to the home and the service user. Chy Koes DS0000039607.V271602.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): 6,7,8,9 and 10 Care plans evidence that individual care needs are being met in a way which respects the rights and choices of the service users. EVIDENCE: Each service user has a comprehensive individual care plan in place which has been agreed with the service user and family if appropriate. The care plans include all aspects of health and social care including a life history. There are relevant risk assessments in place and evidence of individual preferences and choices. A copy of the plan is given to the service user. There is evidence in place that the care plans are reviewed on an ongoing basis and always when the service user is re-admitted to the home. Relevant daily information for each service user is recorded on a contact sheet held in the individual service users file. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 10 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): 11,12,13,14,15 and 16 The service users are encouraged to pursue their interests and hobbies when they are staying at Chy Koes. Service users do though need to be aware that there are times when the staffing levels may not allow them to pursue their interests fully. EVIDENCE: The assessment process and discussions with the service users and their representatives identifies the agreed plan of activity or appointments that the service user would wish to continue with during their stay at the home. It is though noted that although the home has a mini bus there is no driver available to use this facility unless the carer on duty takes all the service users out. This is not always appropriate and in line with individual assessed needs. It is recommended that this situation be reviewed as a priority. Service users are encouraged to go out to the shops, churches, library, pubs and cinema as they wish. This can though be limited depending on the staffing levels at the time. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 11 The service users are encouraged to pursue their interests and hobbies. The service users can telephone their family and friends at any time and they can visit at any reasonable time. Chy Koes DS0000039607.V271602.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): 18,19 and 20 Care planning documentation evidences that the health and personal care needs of the service users are being met. EVIDENCE: Mealtimes, bedtimes and other activities can be flexible to respect the wishes of the service users. Support and assistance with personal care is given as required and recorded in the care plans. Equipment is provided according to individual needs. Individual preferences are taken into account and recorded. Specialist support from occupational therapists and physiotherapists is given as required. Service users maintain their contact with their general practitioners and community nursing staff provide support as required. The home does not maintain stocks of medication as service users bring the medicines they require for their stay and any surplus is returned home when they leave. Medication administration records were found to be completed appropriately on the day of the inspection. Any service user who is assessed as able to self-medicate is provided with a lockable facility. All staff who have medication administration responsibilities have received accredited medication training. The medication policy and procedure that guides staff on good practice is up to date. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 13 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 in place a satisfactory complaints policy and procedure. Staff should read the updated adult protection policy and procedure as soon as is possible. EVIDENCE: The home has in place a satisfactory complaints policy and procedure. There is also a leaflet in the home detailing “How to make a comment, compliment or complaint”. There is a system in place for recording all complaints including details, investigations and outcomes. All the staff employed at the home have received adult protection policy and procedure training. The Cornwall County Council policy and procedure on adult protection has recently been considerably updated but staff at Chy Koes have not read this. It is recommended that all the staff read as soon as is possible this important policy and procedure. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 14 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): These standards were not assessed at this inspection. EVIDENCE: Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 15 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): 31,32,33,34,35 and 36 It is recommended that serious consideration be given to improving the staffing levels at Chy Koes to allow the recently improved bedrooms to be used for service users with high physical disabilities. EVIDENCE: All the staff are issued with job descriptions that are specific to Chy Koes. The care staff fulfil all the kitchen, domestic and laundry duties in addition to their care responsibilities. During the day there are two care staff members on duty to undertake these duties. A large number of the service users at Chy Koes have complicated care needs requiring one to one support. This places high demands on staff hours and has resulted in a situation where two of the newly registered rooms for service users with high physical disability needs are not being used. The staffing levels should be reviewed by Cornwall County Council as a priority. Cornwall County Council have a comprehensive recruitment policy and procedure that is adopted within the home. Training needs are identified through the annual appraisal and supervision process. Each staff file has in place a good selection of training evidence to Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 16 include fire drill, moving and handling, basic food hygiene certificate and first aid for example. All staff members except one have obtained their NVQ level 3 in care. It is recommended that where staff training is cascaded to the team this is documented in staff meetings. Staff are receiving regular support and guidance through the supervision process. All supervision is recorded. All those staff who have supervision responsibilities have received training to allow them to undertake these duties. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 17 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): 37,38,39,40,41,42 and 43 The registered manger is committed to providing a good service for the service users at Chy Koes. To enable her to do this task she requires additional staffing hours to be provided by Cornwall County Council. EVIDENCE: The registered manager is a level one registered nurse. She keeps her nursing qualification up to date and regularly attends statutory and good practice training. The manager works full time hours over a four day week and is on call when not at the home. She is supported in her duties by assistant managers and her manager has a statutory to visit and report on Chy Koes to the CSCI (at a minimum monthly). It is noted that there are some “gaps” in these reports which must be addressed. The manager attends monthly Cornwall County Council managers’ meetings and holds regular meetings for her own team. Good practice training often takes place in group sessions and includes a variety of topics related to the care needs of the service users. Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 18 The social services department has a comprehensive range of regularly reviewed policies and procedures in place that are adopted within the home. Evidence is in place of a service user survey that has been completed well by the participants and the results analysed. This quality assurance task has been completed well. The management and safety representative have a commitment to the health and safety of the service users. There are health and safety risk assessments in place and staff sign these records to verify that regular checks are taking place. Chy Koes DS0000039607.V271602.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 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 2 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 2 12 2 13 3 14 2 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 N/A 3 3 3 3 3 3 3 Chy Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 20 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. 1 2 3 4 5 Refer to Standard YA3 YA11 YA23 YA31 YA37 Good Practice Recommendations To sign and date the pre admission assessment document. To give consideration to employing a driver for the mini bus as soon as possible. For staff to read as soon as is possible the updated adult protection policy and procedure. To give consideration as a priority to increasing the staffing levels at the home. To consistently provide to the CSCI monthly statutory reports to meet with the requirements of Regulation 26 Chy Koes DS0000039607.V271602.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 © 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 Koes DS0000039607.V271602.R01.S.doc Version 5.1 Page 22 - 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. 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