Inspection on 08/08/06 for Chy Koes

This inspection was carried out on 8th August 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chy Koes 31/07/07

Chy Koes 20/03/06

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 Key Unannounced Inspection 8th August 2006 08:00 Chy Koes DS0000039607.V298294.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 Koes DS0000039607.V298294.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 Koes DS0000039607.V298294.R01.S.doc Version 5.2 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.V298294.R01.S.doc Version 5.2 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 20th March 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.V298294.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection at Chy Koes was an unannounced inspection. The registered manager was on duty during the course of the inspection. She was busy interviewing for a clerical post at the home and communicated with the inspector prior and after the interviews. The inspector spent time with the two service users at the home for their respite stays. They gave very positive comments on the standard of the care that they are receiving at the home. Two bedrooms have recently been refurbished to a very high standard at Chy Koes, but at this time are not being occupied due to staffing levels which are not adequate to meet care needs (of the service users) when the home is full. This situation appears to be very unsatisfactory. For example one of the service users spoken to during the course of the inspection was unable to have his full respite stay at Chy Koes, having to transfer to another resource. This would not be the situation if the home was staffed appropriately. What the service does well: What has improved since the last inspection? Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 6 There have been improvements to the staff having more of an understanding and knowledge base of adult protection policies and procedures following training. All staff have received this training. 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 Koes DS0000039607.V298294.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 Koes DS0000039607.V298294.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 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 resources of Chy Koes via the Adult Social Care Department of Cornwall County Council. They and the management team at Chy Koes assess all service users prior to admission to the home to ensure that they can meet assessed care needs. Quality in this outcome area is adequate. 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 met 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. This may not happen routinely every time with someone who is well known to the respite resource of Chy Koes, but would always take place where there had been a change in care needs. Prospective service users and their families can visit the home before deciding to stay. A pre admission documentation has been developed and is being used by management who carry out the assessment. The service users are involved in a financial assessment and the adult social care department provide a contract to the home and service user as well as Chy Koes. Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 9 It is noted that service users with high physical care needs are being admitted to two of the bedrooms at this time. The home is running at 2/3 service user occupancy instead of 5. Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 10 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. Conversations with the service users during the course of the inspection confirmed that this is the case. Quality in this outcome area is good. 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 appropriate 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 user file. Chy Koes DS0000039607.V298294.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17 Each service user is 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. Quality in this outcome area is poor. Meals are individually catered for with likes/dislikes fully catered for. EVIDENCE: The assessment process and discussion with the service users and their representatives identifies the agreed plan of activity/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 and cinema as they wish. This can though be limited depending on the staffing levels at the time. It was noted during the course of the inspection that the Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 12 two service users at Chy Koes (for respite) were enjoying the company of each other during their stay and that they had met each other at the home on previous stays. The service users are encouraged to pursue their interests and hobbies and during the course of the inspections staff were noted to be spending time establishing how they wished to spend the day. The service users can telephone their family and friends at any time and they can visit at any reasonable time. All the staff have responsibility for meal preparation at the home and staff have been trained to the basic food hygiene certificate level. A menu is in place and a record of all meals provided. Each service user is asked at every meal what they wish to eat and drinks are also regularly provided during the course of the day. The kitchen is well stocked, tidy and clean and was found to meet a good standard at the last environmental health officer inspection from the District Council. Chy Koes DS0000039607.V298294.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 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. Quality in this outcome area is good. Service users are encouraged to administer their own medication and satisfactory arrangements are in place to support this process. EVIDENCE: Mealtimes, bedtimes and other activities are flexible to support and 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 Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 14 as able to self-medicate is provided with a lockable facility in their bedroom. 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.V298294.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 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 have recently read the updated adult protection policy and procedure and have received training in adult protection awareness. Quality in this outcome area is adequate. 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 and all staff have read this new guidance. Chy Koes DS0000039607.V298294.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 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 environment at Chy Koes is comfortable, clean and suitable for service users with high physical care needs but at this time only three out of the five bedrooms are being used due to staffing levels. Quality in this outcome area is good. EVIDENCE: Chy Koes provides a respite care service for service users with a physical disability with care needs ranging from low to high levels of dependency. At this time admissions to the home include service users with high physical care needs to two of the rooms and lower care needs to the other room that is being used. There is a large communal lounge/dining room and a smaller communal room with a computer. Patio doors from the lounge lead into the private garden. In the garden is a smoking shed (smoking is not permitted inside the home). Access to the garden from the lounge is on the level. At the front of the home car parking is available although this is limited. The home has five single bedrooms each with their own hand basin and a call bell system. Each bedroom has an adjustable height bed and a lockable space Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 17 is provided for the storage of money and valuables. The two recently registered bedrooms have en-suite facilities, adjustable height wash basins and overhead tracking hoists. Radiators are noted to be of low surface temperature. Within the home is a large shower room with a w.c., an adjustable height wash hand basin and grab rails. The shower can be used whilst sitting, standing, or in a shower wheelchair. There is also a large bathroom with adjustable height bath and wash hand basin and electric ambulift to offer maximum independence. Good risk assessments are in place for the environment. The home was found to be very clean on the day of the inspection. All the staff have cleaning responsibilities/duties. Chy Koes DS0000039607.V298294.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 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 Staffing levels were found to be appropriate to meet the needs of the two service users at the home on the day of the inspection. It is recommended that serious consideration be given to improving the staffing levels at the home to allow the recently improved bedrooms to be used for service users with high physical disabilities. Quality in this outcome area is poor. EVIDENCE: All the staff are issued with job descriptions that are specific to Chy Koes. The care staff fulfil all the kitchen and laundry duties in addition to their care responsibilities. During the day there are two care staff members on duty to undertake these tasks. 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 are not being used. The staffing levels should be reviewed by Cornwall County Council as a priority. On the day of the inspection one service user was having to transfer to another home to continue his respite care which was not in his best interests. Cornwall County Council have a comprehensive recruitment policy and procedure that is adopted within the home. Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 19 Training needs are identified through the annual appraisal and supervision process. Each staff file has in place a good selection of training evidence to 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. 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.V298294.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 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 manager is committed to providing a good service for the service users at Chy Koes. Conversations with the two service users at the home during the inspection confirmed that a good service is being delivered. Additional staffing hours must though be provided by Cornwall County Council to enable service users to stay longer at the home when requested. In addition it is very unsatisfactory that two bedrooms for service users with high physical care needs are unable to be used due to staffing levels. Quality in this outcome area is poor. 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 who have all been given specific responsibilities. One of the assistant managers on duty on the day of the inspection presented as knowledgeable and capable around her specific tasks and responsibilities. Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 21 Monthly statutory visiting record reports are being received by the CSCI as required by legislation. 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. The adult social care department has a comprehensive range of regularly reviewed policies and procedures in place that are adopted within the home. 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, including detailed fire risk assessments. Chy Koes DS0000039607.V298294.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 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 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 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 3 3 Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 23 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. 1. Standard YA31 Regulation 18(1)(a) Requirement The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of the service users. Timescale for action 31/10/06 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. Refer to Standard YA11 Good Practice Recommendations To give consideration to employing a driver for the mini bus as soon as possible. Chy Koes DS0000039607.V298294.R01.S.doc Version 5.2 Page 24 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.V298294.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. 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