Inspection on 20/04/10 for Chypons

This inspection was carried out on 20th April 2010.

CQC found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chypons 28/04/09

Chypons 06/05/08

Chypons 05/12/07

Chypons 15/06/07

Chypons 21/03/07

Chypons 31/05/06

Chypons 21/03/06

Chypons 16/06/05

Chypons 09/11/04

Chypons 13/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Key inspection report Care homes for older people Name: Address: Chypons Clifton Hill Newlyn Penzance Cornwall TR18 5BU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ian Wright     Date: 2 1 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Chypons Clifton Hill Newlyn Penzance Cornwall TR18 5BU 01736362492 01736360399 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Geoffrey Walden Knights Name of registered manager (if applicable) Miss Donna Louise Norton Type of registration: Number of places registered: care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 27. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care neds on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) maximum 27 places Dementia aged 65 years and over on admission (Code DE(E)) maximum 3 places Mental disorder, excluding learning disability or dementia, aged 65 years and over (Code MD(E)) maximum 3 places Date of last inspection Care Homes for Older People 2 8 0 4 2 0 0 9 0 0 0 Over 65 3 3 27 Page 4 of 30 Brief description of the care home Chypons provides accommodation and personal care for up to 27 older people, three of who may have dementia and a further three who may have a mental illness upon admission. The home is situated in the village of Newlyn, near to Penzance and is easily accessible by road. All the amenities of the village and town of Penzance are close by, although there is quite a steep hill leading up to the home. There is ample car parking space for visitors in the homes grounds. The home consists of two inter-linked wings. Most of the bedrooms are for single occupancy and have en suite bathrooms. The main lounge and several of the bedrooms have spectacular sea views. There is a large lounge/ dining room and hairdressing/beauty salon. There is a small, paved terrace area on the upper floor to enable people who use the service to sit outside if they wish. The home has a lift to enable people who use the service to access the upper floor. The entrance to the building has suitable access for people with physical disabilities. The home has equipment and grab rails at strategic points to assist people with physical disabilities. The home is privately owned. A registered manager is employed to manage the home on a day to day basis. A team of care staff, including senior carers and ancillary staff provide care and support to people who use the service. At the time of the inspection fees range from £395-£575 per week. Additional charges are made for hairdressing, newspapers and personal items. A copy of this inspection report is available via the homes management or free of charge from the Care Quality Commission (see back of the report for contact details). Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection took place by one inspector, in fourteen and three quarter hours over two days. All the key standards were inspected. The methodology used for this inspection was: (1)To case track four people using the service. This included, where possible, meeting and discussing with the people their experiences, and inspecting their records. (2) Discussing care practices with management, staff, relatives and people who use the service. (3) Inspecting records and the care environment. (4) Carrying out a postal survey of the views of people who use the service, staff who work in the service, and the relatives of people who use the service. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), were used to help form the judgements made in the report. Care Homes for Older People Page 6 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 7 of 30 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information provided to people who use the service (e.g. regarding services offered) is satisfactory. For example people who use the service receive a statement of terms and conditions of residency or contract, containing satisfactory information. Pre assessment procedures are satisfactory and should ensure the registered persons appropriately check they can meet a persons needs before admission is arranged. Evidence: The home has a satisfactory statement of purpose and service user guide. A copy of the service user guide is available in each bedroom. These documents require amendment to give contact details of the Care Quality Commission rather than the preceding regulatory bodies. We inspected the pre admission assessments for three people. There is a satisfactory pre admission assessment policy and pre admission assessment format. Completed assessments contained satisfactory information regarding the people who moved to Care Homes for Older People Page 10 of 30 Evidence: the home. The registered manager told us a full pre admission assessment is completed with the prospective resident before admission is arranged.Where necessary copies of social services and health assessments-if they have been completed- should be obtained before admission is arranged. We viewed the contracts / statement of terms and conditions of residency for some people using the service and these were satisfactory. Care Homes for Older People Page 11 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are happy with the personal and health care support they receive. Care staff are viewed as caring and supportive. Some improvement is required regarding record keeping and care planning.The medication system, is managed to a generally satisfactory standard, although there are some minor improvements required. Evidence: The majority of people the home caters for are there because they are elderly and frail. A minority of people may also have dementia (3) or mental health needs (3). We met with many of the people who live in the home. People looked well cared for and were happy with their care. Everyone the inspector spoke to said they were happy living at the home. The inspector also was able to speak to several relatives. All said they were happy with their relatives care. People said staff were very good, caring and attentive. However we did receive comments in our postal survey, that some relatives felt that communication could be improved, between the homes staff and relatives. Care Homes for Older People Page 12 of 30 Evidence: We inspected the files of four people who use the service. A care plan was available on all files inspected. Care plans are stored in the staff room. Care plans are generally satisfactory, although some are not fully completed and this needs to be prioritised. There is evidence that care plans are reviewed regularly. We raised a concern that daily records were often duplicated in the handover book and the persons file. Some information in the handover book should have only been documented in peoples individual records (e.g. in respect of ensuring data protection regulations are complied with). The registered manager said she would change the system. From the postal survey we can conclude that the perception of many stakeholders is that people using the service are well cared for. In regard to health records kept, these are generally satisfactory. For example it is possible to track when a person using the service last saw a GP and / or a district nurse. For people who have lived in the home for some time it is possible to ascertain when they saw an optician, dentist, chiropodist, although this was not possible for people who have recently been admitted to the service. It would be useful to obtain-if possible- this information at the pre admission assessment stage, so staff can then arrange these appointments (as necessary and if wanted) for the person once they have moved in. A concern was raised by a health care professional regarding the care of one person when they were admitted to hospital. This was investigated under the Cornwall Council Adult Safeguarding procedures. It was concluded that some aspects of record keeping could be improved, but it was decided there was no evidence to pursue the matter further. We have referred the matter to Cornwall Council who fund the persons care. The matter is currently being investigated under the authorities safeguarding procedure. We inspected the medication system. Medication is stored in a dedicated medicines room. Medication is supplied in a monitored dosage system supplied from a local pharmacist.The medicines room was clean and tidy. Storage of general prescribed medication is satisfactory. Some controlled drugs are kept in the home, and administration and recording of these is satisfactory. The operation of the system is generally well managed. We did note that a couple of dosages of medication were not signed for, although these seemed to be administered. Similarly there was a minority of types of medication which were over stocked, and greater care of ordering needs to occur so to minimise the cost to the NHS and also to avoid waste through medication Care Homes for Older People Page 13 of 30 Evidence: having to be returned for disposal. There is a record that staff have received appropriate training regarding the administration of medication. Care Homes for Older People Page 14 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines,food and opportunities meet the needs of the people living in the home, although further development of the activities programme is recommended. Evidence: We observed a relaxed and friendly atmosphere in the home. People said they could get up and go to bed when they wished. Some activities are available to people, although some people said they would like more activities organised including trips out. The registered persons said they had tried to arrange trips in the past but it had proved difficult to motivate people on the day of the activity to participate. The registered persons however said they would arrange further trips in the future but people would have to prepay for these-which seems reasonable. Other people said they would like more bingo sessions and exercises sessions. There were also several comments in the postal survey from relatives, external professionals and people using the service which said there should be more activities available for people in the home. One professional also commented that at times there should be more engagement between staff and people using the service. Care Homes for Older People Page 15 of 30 Evidence: People living in the home said they could receive visitors when they wanted, and we met several people visiting their friends and relatives during the inspection.People tend to receive visitors in the main lounge or in their bedrooms if they wish for more privacy. People are positive about the food provided. The main meal is served at lunch time. There is a choice of cooked tea or sandwiches at tea time. Regular drinks were served to people throughout the days of the inspection. The inspector had lunch with the people living in the home. The main meal on the day of the inspection was served in the dining room, and the majority of people were assisted through to that area, or people can have their meals in their bedrooms. Staff assisted people with eating when this was necessary. Assistance was to a good standard. The meal was unrushed and a pleasant occasion. The kitchen was inspected. It is clean and well equipped. There was generally a satisfactory supply of stock. Suitable records of meals are kept. The Food Standards Agency Better Food, Better Guidelines hygiene system is in place. Care Homes for Older People Page 16 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is satisfactory, although development is required to the homes adult safeguarding procedure. People should feel that if they have a concern or a complaint that it will be responded to appropriately. Evidence: The registered persons have a satisfactory complaints procedure. A summary of this is contained in the homes statement of purpose and service user guide. The contact details of the Care Quality Commission needs to be amended in some of the documentation. The inspector observed some complaints policies-within the service user guide in some peoples bedrooms, which only gave details of the preceding regulatory body. The registered persons have received some complaints, but these seemed to be responded to satisfactorily by the registered persons. The Care Quality Commission have not received any complaints about the home since the last inspection. The inspector spoke to many of the people in the home and nobody reported any concerns or complaints. All people said that all staff were very nice and had no concerns about staff attitudes or behaviour. Our survey responses stated people knew what to do if they had concerns about the home. The registered persons adult safeguarding procedure needs some amendment. Any safeguarding matters should be referred to Cornwall Council who has a responsibility Care Homes for Older People Page 17 of 30 Evidence: for co-ordinating any safeguarding investigations. The registered persons should not initially investigate matters, although they should instigate certain actions, such as suspending staff if they are accused of abusive practice, if this is appropriate. We believe the registered persons are aware of what to do, but the policy needs to reflect correct procedures. There was one safeguarding referral, just prior to the inspection. CQC and Cornwall Council have made some recommendations regarding improving care planning and record keeping, but based on the evidence available we could not conclude there had been any neglectful or poor care practices. Most staff have attended adult safeguarding training, although there are some staff that need to attend this. Similarly some staff also need to attend training regarding Deprivation of Liberty and the Mental Capacity Act. Care Homes for Older People Page 18 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building is suitable for the purpose of being a care home. Chypons seems to be a pleasant environment for the people who live there. However it is essential action is taken to fit window restrictors, where these are absent, on first floor windows to prevent the risk of falls. Evidence: The building was inspected. Chypons provides suitable space for the people accommodated. There is a large lounge /dining room. There is a TV in the lounge, but this is in one area so it is possible to sit elsewhere without being disturbed by it. The room has spectacular views of Mounts Bay from Marazion (St Michaels Mount) to Newlyn Harbour. There is also another area in the hallway where people can sit, and a balcony is situated nearby, where people can sit out side. The lounge and other communal areas are all reasonably decorated and have suitable furnishings. However some of the carpets e.g. in some of the hall ways are beginning to look worn and will in time need to be replaced. There is a suitable number of toilets and bathrooms. The bathrooms have suitable assisted bathing facilities e.g. a Parker style bath-appropriate for people who are frail / have a physical disability. Bathrooms and toilets have locks on the doors. There is a large kitchen, and laundry room. The home has a sluice facility. The home Care Homes for Older People Page 19 of 30 Evidence: has a lift and a stair lift to assist people with a physical disability to move between floors within the home. Bedrooms were inspected. Decorations and furnishings are to a good standard. Many of the bedroom doors do not have a lock. People using the service should at least have a lockable facility e.g. for personal possessions or valuables, if it is not appropriate for them to have a lockable bedroom door. It should however be the default position that all bedrooms have a lockable bedroom door, and people are issued with a key unless they lack capacity. We noted two bedrooms on the first floor did not have window restrictors. The registered provider must ensure they take urgent action to ensure this situation is rectified, and also to check other rooms have a restrictor fitted to windows, where this is necessary. We require written confirmation that this work has been completed within the timescale given. The fitting of restrictors is important to prevent intruders being able to enter the building from the outside, and also to minimise the risk of falls. The Health and Safety Executive provides a guidance leaflet regarding where window restrictors are necessary, and the Environmental Health Department (Health and Safety) can also provide guidance regarding this matter. There are two shaft lifts which connect the ground and first floors of the home. One of these has been replaced since the last inspection. There is also a stair lift on one of the stair cases. There is a suitable supply of hot water throughout the building. Heating is sufficient and people did not report being cold at any time. The home was clean on during the inspection and there were no unpleasant odours in the home. Care Homes for Older People Page 20 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are viewed positively by people who use the service. Staffing levels are currently satisfactory to meet the needs of people using the service. Personnel and recruitment records need some improvement for example regarding pre employment checks. Training provision needs some improvement so staff have sufficient knowledge and skills to carry out their jobs and meets legal standards. Improvement in these areas will ensure staff are recruited and trained appropriately to work with the people in the home. Evidence: On the day of the inspection there were four care staff on duty from 07:30 to 14:00 (one of whom was working until 15:00). Three staff on duty until 17:30, and two staff on duty until 21:00. Two staff were on duty from 21:00 to 08:00 (i.e. on a waking night shift). The registered manager was also on duty during the day. There were also ancillary staff such as kitchen and cleaning staff, and the homes accountant. People using the service, who the inspector spoke to, all said they were positive about care staff. When we spoke to staff members individually, they were positive about their experiences about working in the home. We also observed staff working with people using the service and the input provided was person centred, and staff were polite, and worked with people in a respectful manner. Care Homes for Older People Page 21 of 30 Evidence: We understand that the registered persons are currently reviewing staff levels. As part of any review they must ensure people using the service have sufficient staff on duty at all times to meet peoples care needs particularly considering the diagnoses of people living in the home, their personal and health care needs, and the size and layout of the building. Personnel records were inspected for eleven staff (i.e. care staff on duty during the 24 hour period on the day of the inspection). Personnel records needed some improvement so suitable information is obtained as required by regulation. All people had a copy of an application form. The application form however needs to include a declaration whether the person has any criminal convictions so staff employed in future provide this information. Most staff had provided a full work history, evidence of their identity and a self declaration of medical fitness, as required by the regulations. It is essential that where foreign nationals are employed (who are from outside the European Economic Area) full checks are carried out regarding whether these people have a right to work in the EEA area. The UK Borders Agency can provide advice regarding this matter. Such evidence must be maintained on individual staff files as it is an offence to employ anybody who does not have a right to work in the European Economic Area. In regard to obtaining references one member of staff who commenced employment since the last inspection only had one reference. This reference said they would not reemploy the person. The registered manager however said the person had proved to be a satisfactory member of staff. It is essential that two references are always obtained for all staff. One reference should always be from the persons previous employer, and preferably (where necessary and possible) where they have worked in a caring capacity. Staff have a Protection of Vulnerable Adults First/ Independent Safeguarding Authority check (POVA First/ ISA First) and a Criminal Records Bureau check (CRB). These checks ensure people employed are not on a list which states they are deemed not fit to work with vulnerable people (POVA/ISA), or have a criminal record (CRB) which may deem them unsuitable to work in an environment with vulnerable people. On one persons CRB it was listed that they had some criminal convictions. It is essential that there is documentary evidence that any person employed declared the conviction when they applied for the job, and that the registered persons have concluded that the convictions do not put people using the service at risk. In regard to staff induction the staff we spoke to were positive about their Care Homes for Older People Page 22 of 30 Evidence: experiences. However for records we assessed for three staff employed since January 2010, there were no records of induction on file. We were told this process had been completed, although records had not been filed. It is essential these records are always maintained on peoples personnel files. We looked at whether staff had a National Vocational Qualification in care. According to the homes records just under 50 of care staff employed (8 out of 20) have an NVQ 2 or above in care. We checked records of training received by eleven of the staff employed. By law staff require the following training: (1) Regular fire training in accordance with the requirements of the fire authority. (2) There must always be at least one first aider on duty (at appointed person level). (3) All staff must have manual handling training and regular updates of this (e.g. annually). (4) All staff must have basic training in infection control. (5) Staff who handle food receive food hygiene training. (6) All staff must have an induction and there needs to be a record of this. Staff also need to have suitable training to meet the needs of people who use the service such as dementia and mental health. The eleven records assessed demonstrated that all staff have received training to generally a good standard. There are some gaps in the training delivered but the registered manager appears to have a good system of checking this and arranging the training where this is necessary. We do have a concern regarding the provision of first aid training. The training some staff have received does not determine they are deemed as an appointed first aider, but trains them only to have an awareness of first aid. It is essential that at all timesincluding nights- there is at least one person on duty who has received first aid training to an appointed person level. The registered persons need to clarify what training staff have received, and ensure there are appropriate levels of first aid training delivered to staff as a priority. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered persons are deemed by the commission as suitable persons to carry on and manage the home. The monies of people who use the service are managed appropriately. Health and safety standards are satisfactory, although the fire system must be tested at intervals prescribed by the fire officer. Evidence: The registered provider is Mr Geoffrey Knights. The registered manager is Ms Donna Norton. The registered persons have been deemed by the commission as having suitable knowledge, skills and experience to carry on and manage the home. Ms Norton has completed the Registered Managers Award (RMA). Staff we spoke to said they felt supported by management, and felt the team worked well together. People living in the home said they were happy with the service and said the management of the home was approachable. We received some comments from staff members stating that there should be more staff meetings and management should do the best to ensure regular meetings do occur to ensure appropriate consultation with staff takes Care Homes for Older People Page 24 of 30 Evidence: place. We inspected the registered providers Quality Management Policy. This had been partially implemented i.e. a survey had been completed of stakeholder views. People using the service and their relatives stated they were happy with the service. It would be beneficial if other aspects of the policy were implemented; for example development of an annual improvement plan. We assessed arrangements regarding the management of the finances of people who use the service. Records kept for the management of individual monies were satisfactory, and monies kept tallied with the records maintained. The registered manager said staff and the registered provider does not act as appointee for any monies or benefits of people using the service. Relevant policies and procedures are in place, although we have stated the homes safeguarding procedure needs to be improved. Other policies were reviewed in July 2008 and therefore should be reviewed again. The registered provider has a health and safety policy. There is also a fire risk assessment. Internal checks of the fire system are generally satisfactory, although records do show one week was missed. Testing of fire extinguishers and the fire system appears to have been completed appropriately by external contractors.The homes records show staff have received suitable training regarding fire prevention. Portable electrical appliances were last tested in September 2009. There is a certificate to state the electrical circuit has been tested and is deemed safe (10/12/2008-required every 5 years). The gas cooker and boiler were serviced in February 2010. The hoists, stair lift and passenger lift have been serviced in the last year. Health and safety risk assessments have been completed including in regard to the prevention of legionella. In the environment section of the report we have issued a requirement regarding window restrictors being fitted to windows, where this is necessary, to minimise the risk of falls. A current certificate of insurance was displayed in the home. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 19 23 Window restrictors need to be fitted where this is necessary. This will help to minimise the risk of falls and/or intruders entering the building. 01/07/2009 2 29 19 Obtain two written references for all staff. This will help to ensure that people employed to work with the residents at Chypons are deemed suitable to work with vulnerable elderly people. 01/06/2009 Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 17 Ensure care plans and daily records are completed fully This will ensure records to deliver care are maintained to a higher standard which should improve consistency of the delivery of care. 01/07/2010 2 18 13 The adult safeguarding procedure needs to be amended to reflect agreed multi disciplinary safeguarding procedures People using the service will subsequently be more assured that correct procedures are followed if they have an allegation of neglect or abuse. 01/08/2010 3 19 23 Window restrictors must be fitted to all windows where this is necessary. The registered persons should seek advice from the Environmental Health Department about this 01/07/2010 Care Homes for Older People Page 27 of 30 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action matter. The Commission requires the registered persons to confirm in writing when this work is completed. (Timescale of 01/07/2009 not met. Second Notification) This will help to minimise the risk of falls 4 29 19 Satisfactory pre employment 01/06/2010 checks must be completed on all care staff employed from the date of this report. The issues outlined in this report must be appropriately addressed. (Previous timescale of 01/06/2009 not met Second Notification) Action regarding the matters of concern will ensure people using the service, and other stakeholders will be more assured that staff employed are deemed as fit to work with vulnerable people and within a care setting 5 30 18 Staff must have satisfactory training as is required by law. The registered persons must: (a) Complete the current 01/09/2010 Care Homes for Older People Page 28 of 30 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action training programme being undertaken. (b) Ensure there are satisfactory levels of first aid cover, to an appropriate level, at all times. This will give people using the service assurance that staff are trained to meet their needs and deal appropriately with any incident where first aid is required. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 Continue to develop the activity programme taking into consideration views of people who use the service. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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