Inspection on 28/04/09 for Chypons

This inspection was carried out on 28th April 2009.

CQC found this care home to be providing an Adequate 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chypons 20/04/10

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 09/07/2009.

Inspecting for better lives 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:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ian Wright     Date: 2 8 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 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): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Geoffrey Walden Knights care home 27 Number of places (if applicable): Under 65 Over 65 3 3 27 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 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 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 Care Homes for Older People Page 4 of 32 Brief description of the care home 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 and the registered provider employs a manager to assist him to run the home. 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 the CQC website. Care Homes for Older People Page 5 of 32 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: one star adequate 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 six hours in one day. All the key standards were inspected. The methodology used for this inspection was: (1)To case track three people using the service. This included, where possible, meeting and discussing with the people their experiences, and inspecting their records. (2) Discussion with staff about their experiences working in the home. (3) Discussion with other people using the service, and their representatives. (4) Observing care practices. (5) Discussing care practices with management. (6) Inspecting records and the care environment. (7) Completed a postal survey to ascertain the views of people who use the service, and staff who work in the home. Other evidence gathered since the previous inspection, such as notifications received Care Homes for Older People Page 6 of 32 from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. What the care home does well: What has improved since the last inspection? What they could do better: Some improvement is required to pre admission assessment procedures and care planning. For example it is important there is evidence that the registered persons are assessing people before they move to the home. Thorough assessment procedures ensure the registered persons can be confident they can meet peoples needs before people move in to the home. Subsequently, it is important for the care planning system to be able to track whether people using the service are receiving external health care support such as regular visits from a dentist, optician etc. This will give us more assurance people are receiving appropriate access and support from external health professionals. There needs to be a satisfactory supply of hot water to all bedrooms. We are aware this is still not the case with one of the bedrooms. Our previous requirement regarding this matter is renotified. Staff personnel records and the system of pre-employment checks have improved. However, two staff employed since the last inspection each only had one written reference. Improvement is still required regarding other employment checks-as required by the regulations. It is essential such checks are completed to assist in ascertaining fitness of people employed to work with the vulnerable. We were concerned that the fire system was not being regularly checked by the registered persons. We have re notified the registered persons regarding the testing of emergency lighting on a number of occasions. The gas cooker also had not been serviced yet this year. It is essential these checks are performed so we can be confident the home is safe, and risks of fire are minimised. Care Homes for Older People Page 8 of 32 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 set out on page 4. 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 9 of 32 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 10 of 32 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 adequate 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 generally satisfactory. For example people who use the service receive information regarding the service and individual fees. This should help people to be more aware of their rights and responsibilities. It was not clear if people were always assessed, by the registered persons, prior to admission. More information needs to be available on peoples files regarding this process. This will give more assurance that a rigorous pre admission process is in place, and that people moving into the home can subsequently be more certain the service will be able to meet their needs if admission is agreed. Evidence: The home has a statement of purpose and service user guide. A copy of the service user guide is available in the hallway of the home. The registered manager said a copy of the service user guide is available in each persons bedroom. A copy of the homes brochure is given to prospective clients when an initial enquiry is made. Care Homes for Older People Page 11 of 32 Evidence: We inspected the pre admission assessments for three people. There is a satisfactory pre admission assessment policy. The registered manager said a copy of the social services assessment (for people who are publicly funded) is obtained before admission arranged. The registered manager said she or other senior staff will try to visit the person at home or at hospital before admission is arranged. Copies of pre admission assessments were either dated prior to the date of admission or on the date of admission. It is essential that the registered manager and senior staff always go out to assess the person before admission is arranged. This is so they can meet the person, check the home is registered to meet the persons care needs and complete a pre admission assessment to check the home can meet the persons holistic needs. Notes of this meeting should be maintained and should be signed and dated. It is also important that where possible the person moving to the service has the opportunity to visit the home, so they can check it meets their needs and expectations. We viewed the contracts / statement of terms and conditions of residency for two of the same group of people. People either receive a copy of the social services contract (if publicly funded) or a copy of the homes contract (if privately funded). Care Homes for Older People Page 12 of 32 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. Care planning is generally satisfactory, although records of external medical appointments need some improvement so people can be more assured there is more effective monitoring of peoples health care needs. People said to us they were happy with the support given to meet their health and personal care needs. Medication is managed to a satisfactory standard so people can be assured their medication will be looked after appropriately. Evidence: We inspected the files of four people who use the service. A care plan was available on all files inspected. Care plans are accessible to staff. There is evidence care plans are reviewed. Care plans contained a manual handling assessment. Some care plans needed to be completed more thoroughly. For example it was evident that the documentation, in some cases, was not fully completed. However, people who use the service, who we spoke to, were positive about the care they received. We also spoke to some relatives of people using the service and they were also very complementary about the service provided. Care Homes for Older People Page 13 of 32 Evidence: People who use the service said they were satisfied with the health care support they receive. There is evidence on file that GPs and district nurses visit, but it was difficult to determine when people last saw other professionals such as a chiropodist, dentist or an optician. The registered manager said a chiropodist visits monthly and a book is maintained regarding these visits. This information should be in individual care files. The care planning system needs to be developed to ensure staff can ascertain when support from external professionals (such as a dentist, optician etc. was last received [e.g. at a glance] ). Subsequently it can then be easily determined when the person next needs to have support and treatment from these professionals. We inspected the medication system. Medication is stored in a dedicated clinical room. Medication is supplied in a monitored dosage system supplied from a local pharmacist. Storage of general prescribed medication is satisfactory. Some controlled drugs are kept in the home, and administration and recording of these are satisfactory. Training regarding medication appears satisfactory. Care Homes for Older People Page 14 of 32 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 seem to meet the needs of the people living in the home Evidence: People using the service, who the inspector spoke to, said they could get up and go to bed when they wished, and said routines in the home are relaxed. We observed a friendly, relaxed atmosphere in the home. Some activities are arranged for example external entertainers visit the home, and staff also facilitate some group activities such as quizzes. There is a weekly Christian service of worship held in the home. Some people receive regular visitors, and some people go out with relatives. People we spoke to said they were happy to occupy their time either in the lounge or their bedrooms. People said they enjoyed the activities provided. People can have a daily newspaper delivered. The library will not visit the home, which is disappointing. However, staff will go to the library on peoples behalf, and borrow a selection of books for them. People are positive about the food provided. The main meal is served at lunch time. Care Homes for Older People Page 15 of 32 Evidence: There is a choice of cooked tea or sandwiches at tea time. Regular drinks were served to people throughout the days of the inspection. Suitable records are maintained regarding food provided. Care Homes for Older People Page 16 of 32 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. Complaints and adult safeguarding policies are satisfactory. This should give more assurance that if people living in the home have a concern, the registered persons will deal with the matter 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 registered persons have not received any complaints regarding the home. The Commission for Social Care Inspection, and subsequently the Care Quality Commission have also not received any complaints about the home. Some amendment should occur to the policy, for example, details of the Care Quality Commission should be included within this documentation. This should include details of the commissions national call centre. Details of Cornwall Councils complaints department (or other authority if the person is funded by another body) should be included in the service user guide of the person using the service. If the person is funded by a public authority they have a right to use the statutory complaints procedure of the funding authority, and subsequently people should be made aware of their rights. The registered persons have a satisfactory Adult Safeguarding procedure. The Care Homes for Older People Page 17 of 32 Evidence: Commission for Social Care Inspection and subsequently the Care Quality Commission have not received any safeguarding referrals. The registered persons also have not referred any safeguarding concerns to Cornwall County Council. People who live in the home, and work in the home, who we spoke to, said they did not have any concerns or complaints. They said there are no concerns regarding staff attitudes or how staff worked with people living in the home. The registered persons said they had not had to refer any ex staff for inclusion to the Protection of Vulnerable Adults register. (A list of people deemed unsuitable to work with vulnerable adults). Care Homes for Older People Page 18 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Chypons provides a suitable facility for the people living there. However improvement is still required to the water supply to ensure there is hot water in all areas of the building. It is also essential that window restrictors are fitted where this is necessary. 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. Redecoration was occurring in the main lounge at the time of the inspection. 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. Care Homes for Older People Page 19 of 32 Evidence: There is a large kitchen, and laundry room. The home has a sluice facility. The home 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 one bedroom on the first floor did not have a window restrictor. The registered persons need to arrange for one to be fitted, and also to check other rooms have a restrictor fitted to windows, where this is necessary. The edge of a carpet in one bedroom was loose, however the maintenance man repaired this during the inspection. We issued a requirement at the last inspection that there needed to be a satisfactory supply of hot water in all parts of the home.The registered manager said there are plans to fit an additional boiler at the home which will improve supply. She said there is a satisfactory supply of hot water to most bedrooms except for one. For this bedroom it is necessary to transport hot water by jugs for the person accommodated in it. Although it is appreciated the registered persons intend to rectify the situation, the current situation is not acceptable-particularly as the commission reported on the matter in April 2008. We are subsequently repeating the statutory requirement issued in the last inspection report. If suitable action does not occur within the timescale we will consider taking enforcement action. This could include stating that any bedroom without hot water cannot be occupied until the matter is resolved. 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 32 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 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 benefit from receiving support from suitably skilled and knowledgeable staff in sufficient numbers to meet their needs. However, it is essential two references, and other information required by regulation is always obtained for new staff. This will help to ensure the registered persons can be assured staff employed are fit to work with vulnerable people in a care setting. Evidence: On the day of the inspection there were three care staff on duty from 07:30 to 17:00, two staff on duty from 17:00 to 21:00, and two staff on duty from 21:00 to 08:00 (i.e. on a waking night shift). The registered manager was also on duty from 08:00 to 18:00. There were also numerous ancillary staff such as kitchen and cleaning staff, a maintenance man and the homes accountant. Personnel records were inspected for six care staff (i.e. staff on duty during the 24 hour period on the day of the inspection), plus a sample of some of the ancillary staff working on the day of the inspection. Personnel records inspected were generally satisfactory, although two of the care staff employed since September 2008, each only had one reference on file. It is essential that verbal references are chased and recorded. These then need to be confirmed in Care Homes for Older People Page 21 of 32 Evidence: writing. A reference from the last employer needs to be obtained, and if possible a reference from when the person last worked in a caring capacity. There was evidence the registered persons had obtained a Protection of Vulnerable Adults First check (POVA First) and a Criminal Records Bureau check (CRB) for staff employed since the last inspection. These checks ensure people employed are not on a list which states they are deemed not fit to work with vulnerable people (POVA), or have a criminal record (CRB) which may deem them unsuitable to work in an environment with vulnerable people. Staff had an application form, containing work history. Some staff had evidence of their identity , and a self declaration of medical fitness. However, this information was not evident for other staff employed since the last inspection, as required by the regulations. A requirement was issued at our last key inspection and is subsequently renotified. Staff working in the home have suitable opportunity to obtain a National Vocational Qualification in care. We checked records of training staff have received. 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 awareness. Training records assessed demonstrated that all staff have received appropriate training in these areas. The registered manager has made an excellent effort to ensure training standards have improved and now meet regulatory requirements. The registered manager has developed a chart outlining training received by all staff. This should assist in maintaining the current standard. Induction procedures appear satisfactory. For example new staff shadow more experienced staff when they commence employment. An induction checklist is completed to state staff have been made aware of the homes procedures. In regard to people who commenced employment since the last inspection, there were some gaps in the completion of checklists. It is important such checklists are always completed thoroughly with new staff, and the new person signs /dates the form to state they have understood instructions given. Care Homes for Older People Page 22 of 32 Care Homes for Older People Page 23 of 32 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 adequate 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 need some improvement. For example the registered persons must ensure the gas cooker is serviced annually, and the fire system is tested at intervals prescribed by the fire officer. Improvement in these areas will ensure there are improved health and safety precautions in the home, and people living there can be more assured they are kept safe. 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). It is clear to us Mr Care Homes for Older People Page 24 of 32 Evidence: Knights and Ms Norton have worked very hard to improve standards at the home, supported by their management and staff team. 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 inspected the registered providers Quality Management Policy. A survey of stakeholder views e.g. people using the service and their relatives, was completed in February 2009. Management also audit various records in the home to ensure standards are maintained, and where necessary improved. This system may however need some further development to ensure for example regulatory breaches outlined in this report are addressed. The registered provider Mr Knights, regularly visits the home several times a week, talks to people using the service about their experiences and checks the quality of the service provided. 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 do not act as appointee for any monies or benefits of people using the service. The registered provider has a health and safety policy. There is also a fire risk assessment. Internal checks on the fire system were not being completed at appropriate intervals. According to records emergency call points and emergency lighting had not been tested since 17th February 2009. An immediate requirement was issued regarding these matters. We are concerned that we have notified the registered persons several times regarding the testing of emergency lighting. The registered manager has since confirmed a procedure to check the system has been reintroduced. Testing of fire extinguishers and the fire system appears to have been completed appropriately by external contractors, and a maintenance agreement is in place. Staff records demonstrate they have received suitable training regarding fire prevention. Portable electrical appliances were last tested in August 2008. There is a certificate to state the electrical circuit has been tested and is deemed safe (10/12/2008). The gas cooker was last serviced in January 2008. This now needs to be re-serviced. Other gas appliances have been serviced.The hoists, stair lift and passenger lift have been serviced in the last year. The boiler was serviced in February 2009. There is a risk assessment regarding the prevention of legionella. The environmental health officer inspected the food premises in December 2008, and in regard to health and safety in December 2007. Both visits deemed arrangements to be satisfactory. Care Homes for Older People Page 25 of 32 Evidence: As stated in the staffing section, training regarding health and safety issues is to a very good standard. A current certificate of insurance was displayed in the home. Care Homes for Older People Page 26 of 32 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 29 19 Recruitment records for care 01/06/2008 staff employed from the date of this report must: Have evidence on file to confirm the persons identity. Have a statement by the person as to his/her mental and physical health (e.g. as part of their application form.) These measures will assist in providing appropriate evidence individual staff are fit persons to work in a care home. 2 38 12, 13(4), 23 Health and safety 01/09/2008 precautions need improvement: Emergency lighting must be tested at intervals recommended by the fire authority. Provide evidence to CSCI that this is being completed regularly by the deadline. Care Homes for Older People Page 27 of 32 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 3 15 Ensure there is clearer evidence that the registered persons complete pre admission assessments before people move into the home. For example contemporaneous notes of assessments need to be retained. This will give more assurance that there is a rigorous pre admission process is in place, and that people moving into the home are assessed appropriately before admission is arranged. 01/06/2009 2 8 12 Record keeping regarding 01/07/2009 when people last saw a medical professional (e.g. dentist, chiropodist, optician) needs improvement. It should be possible to track when some one had an appointment with each professional. Care Homes for Older People Page 28 of 32 This should help to give people more assurance their medical needs are being monitored and they will receive frequent appointments from these services as required. 3 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. 4 21 23 There must be a satisfactory 01/09/2009 hot water supply available in bedrooms, toilets and bathrooms. The registered persons must confirm in writing when appropriate work has been completed. (Timescale of 01/09/08 not met 3rd Notification) This will ensure there is a satisfactory hot water supply to all areas in the home used by people who use the service 5 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 01/07/2009 Care Homes for Older People Page 29 of 32 6 29 19 Recruitment records for care 01/06/2009 staff employed from the date of this report must: (a) Have evidence on file to confirm the persons identity. (b) Have a statement by the person as to his/her mental and physical health (e.g. as part of their application form.) (Timescale of 01/06/08 not met. Second Notification) These measures will assist in providing appropriate evidence that individual staff are fit persons to work in a care setting. 7 38 13 1. Emergency lighting must be tested at intervals recommended by the fire authority. (Previous timescale of 01/09/08 not met-Fourth Notification) Immediate Requirement Notice issued. 2. Emergency call points on the fire system must be tested in line with the requirements of the fire authority. Immediate Requirement Notice issued. These measures will help to ensure that fire safety equipment works appropriately. People living in the home can then be more assured regarding action taken to protect their health and safety. 15/05/2009 Care Homes for Older People Page 30 of 32 8 38 13 The gas cooker must be serviced annually to ensure it is safe. A gas safety certificate should be obtained. This measure will help minimise health and safety risks to staff and people who use the service. 01/07/2009 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 16 Ensure information regarding social service department / health department complaint procedures are included in individualised service user guides. This will help to ensure people, funded by these authorities, are aware of their statutory rights to use these procedures if they have a concern or complaint. Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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