Inspection on 17/02/09 for Chyvarhas

This inspection was carried out on 17th February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chyvarhas 05/03/07

Chyvarhas 17/10/05

Chyvarhas 19/05/05

Chyvarhas 07/12/04

Chyvarhas 01/06/04

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chyvarhas 22 Saltash Road Callington Cornwall PL17 7EF     The quality rating for this care home is:   two star good 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: Michael Dennis     Date: 1 7 0 2 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 24 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Chyvarhas 22 Saltash Road Callington Cornwall PL17 7EF 01579383104 01579384373 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cornwall Care Ltd Name of registered manager (if applicable) Mrs Rachel Dooler Type of registration: Number of places registered: 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: Service users to include one named person only who has a learning disability and suffers from a dementia and is aged below the agreed age range. Service users to include up to 10 adults of old age (OP) Service users to include up to 30 adults aged over 65 with a mental illness (MD[E)) Service users to include up to 30 adults aged over 65 with dementia (DE[E)) Total number of service users not to exceed a maximum of 40 Date of last inspection 0 0 0 Over 65 30 30 10 care home 40 Care Homes for Older People Page 4 of 24 Brief description of the care home Chyvarhas is run by the organisation Cornwall Care Ltd., which is a registered charitable organisation, whose management team offer support regarding the running of the home. Members of the company visit regularly. Chyvarhas Care Home provides accommodation and care for older people in need of care due to dementia, mental disorder or old age. Accommodation and services are all located on the ground floor. The home consists of four wings, each with its own lounge area. Dining and further lounge areas are found centrally located. The home is a secure environment for the safety of service users. For those service users unable to get into Callington or who choose not to, services are provided within the home ie., hairdressing, dental and the services of the district nurses and G.Ps. Ample car parking is available. Care Homes for Older People Page 5 of 24 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 unannounced inspection took place on the 17th. February 2009 over a eight hour period. We met with the Registered Manager, administrator and a care coordinator. A selection of staff were spoken with and three service users. We also spoke with two relatives. Staff were observed to be tending to service user needs whilst respecting their dignity. Various records, policies and procedures were inspected. We visited all parts of the building and noted a satisfactory standard of hygiene and maintenance. Service users commented favourably on the overall service received, and acknowledged the improvements being made. Positive outcomes were noted Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 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 24 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. The Statement of Purpose is readily available to all.Service users are fully assessed prior to admission to the home.Prospective service users can visit the home to determine its suitability in meeting their needs. Evidence: The Statement of Purpose is in place and readilly available to all service users and their families. It was seen to be up to date and included all the relevant information as required. We were informed that this document is regularly reviewed and ammended as necessary to reflect any changes. Four service user files were case tracked, and all contained evidence of of pre- admission assessments conducted by senior members of the staff team. In addition there was evidence that health care assessments are completed by CPNs or hospital/GP personel. The information provided included :continence assessment, pain assessment, risk assessments and general details of daily care requirements, medication and health care requirements. Care Homes for Older People Page 10 of 24 Evidence: Each service user has a contract or statement of terms and conditions if privately funded. The present fee rate is from 357 to 465 pounds per week. Prospective service users and their families are encouraged to visit the home before making the decision to move in. Care Homes for Older People Page 11 of 24 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. The health care needs of service users are identified, planned for and met.Service users are treated with dignity and respect.Medication policies and procedures are followed Evidence: Four Individual Plans of Care were inspected. They were seen to contain full and relevant information, to include Risk Assessments, pertaining to the health, personal and social care needs of that individual. In addition information is gathered regarding the service users past life experiences and interests. This information will be used to promote an Active Care programme for that individual. Staff spoken with confirmed a knowledge of the care plans and care to be delivered on a day to day basis. Handovers are conducted at various times throughout the day when staff at all levels change shift or come on duty. All service users were mentioned and relevant information concerning their immediate care was relayed. Appropriate professionals from other disciplines frequently visit the home to provide for general health care, ie. G.Ps, Community Nurses, Opticians, Dentists etc. A community nurse visited the home on Care Homes for Older People Page 12 of 24 Evidence: the day of inspection. We observed staff treating service users with respect and dignity. Privacy issues were maintained. The medication round was observed and seen to be conducted according to policy and procedure guidelines. An audit of the controlled drugs was yundertaken and proved correct. Care Homes for Older People Page 13 of 24 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. Friends and family maintain contact with service users.Service users are given opportunities to maintain control over their lives.Food provided is varied and of a good standard. Evidence: A number of visitors were in the building throughout the inspection. The visitors book demonstrated that this is a regular occurrence. A policy of open visiting exists. Local community groups visit the home upon invitation. Service users are encouraged to exercise choice and where their capacity is limited friends and relatives can act as advocates. The majority of service users have brought personal possessions into the home. Access to personal records in accordance with the Data Protection Act is facilitated. Service users are free to rise and retire to their rooms at will and meal times may be staggered according to individual preference. During the morning a group of service users were making and painting various shapes and designs to produce a collarge, with assistance from staff. Others were engaged in various personal pursuits. A food cabinet is situated in the central lounge containing soft drinks, biscuits, crisps and various other snacks. Service users are free to help themselves. Service users spoken with commended the standard of food provided. Care Homes for Older People Page 14 of 24 Evidence: They also told us they were happy with the care provided and that the staff were very attentive. We observed visiting relatives spending quality time with their loved ones. Staff provided drinks and biscuits. We had quite a prolonged conversation with one relative, whose mother had been admitted to the home just before Christmas. He was full of praise for the home. He was particularly appreciative of the open visiting policy. Due to his variable work patterns this was important. He told us that he was always made welcome and looked after by the staff. He was impressed with the existing happy atmosphere of the home and commended the staff for the care delivered. Another member of the family had to travel some distance to visit. Because of this, the person would spend most of the day in the home. We were informed that staff would arrange private meals and facilitate all reasonable needs and requests to make the visit purposeful and worthwhile. During part of the day whilst we were working at a work station we observed good interaction between staff and service users. Staff were constantly in attention. Menus indicated that a wide range of choice is available. Care Homes for Older People Page 15 of 24 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. Service users legal rights are protected.Service users and their representatives are made aware of the complaints procedure. Evidence: Advocacy services are made available and in some cases have been taken up. Evidence was produced by way of written documents and talking to staff and visitors to indicate that all service users are given the opportunity to vote at elections. Complaints procedures are included in the statement of purpose and posted at certain points around the home. A complaints log is kept detailing any complaints made at the home. Information is included as to how these complaints were investigated and the outcome. Management are well aware of the procedure to follow should an allegation of abuse be made. Policies and procedures detail abuse procedures and many of the staff have received training. The complaints procedure contains the contact details of those to whom a complaint can be made. The address of the local office of the Department of Adult Social Care should be added. Care Homes for Older People Page 16 of 24 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. This inspection focussed on the accommodation, facilities and equipment provided. We consider that, overall, this home provides a good standard of accommodation. Bedrooms are on the small side but are individually decorated and suit service user needs. Good effort is made to present the home in a way most beneficial to service user need. Evidence: The home provides a safe and well-maintained environment for the service users. The registered manager discusses refurbishment and development issues with the company at the annual finance meeting. This results in a maintenance and improvement plan being implemented. The home employs a general assistant who deals with minor defects and maintains general standards within the home. The building complies with the requirements of the local fire authority and environmental health department. Communal areas consist of one central unit used for both a sitting and dining area, This area is divided into clusters of easy chairs and dining areas allowing service users to sit in groups for social interaction promoting an atmosphere of calm. In addition there are smaller areas adjacent to each wing where service users may also congregate. The overall impression is that of a well appointed home. Outside there is ample parking space, a sensory enclosed garden plus other walk areas with seating. Care Homes for Older People Page 17 of 24 Evidence: Heating, lighting and ventilation within the home meets required standards. Infection control is maintained through the companies policies and procedures and the provision of suitable sluicing and laundry facilities. Since the last inspection there has been a lot of redecoration and new carpets laid throughout. Each wing has been personalised around a specific theme with murals, street scenes etc. Overall the home is very pleasantly presented, clean and hygienic. Bedrooms are personalised to suit residents tastes. Bathing and wc facilities are plentiful and well equiped. We observed that radiators are protected and hot water outlets produce water within the required temperature limits. It was noted that two toilet areas on one wing did not have call bell cords fitted. This was pointed out to the manager who assured that the deficit would be dealt with. Care Homes for Older People Page 18 of 24 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. Robust recruitment policies and procedures are implemented. All staff are supported and Inducted through good training opportunities. A positive number of staff are on duty to meet the service users needs Evidence: The staff were observed interacting with service users throughout the day. They were continually in contact with the service users, assisting, encouraging and stimulating them whilst meeting their personal needs at the same time.. The staff were noted to be cheerful, friendly and committed. The staff rota demonstrated that there is normally 6 care staff on duty every morning, four staff on duty during the afternoon and evening with three waking night staff. This team is supported by the Manager, deputy manager, care coordinators, care practitioners, administrator, catering staff, domestic staff, laundry and general maintenance staff. Recruitment is undertaken according to the companies policies and procedures. Staff files indicated that application forms lead to interviews, references are obtained along with CRB and POVA checks. All new staff undergo in depth induction training followed up by company and external training. Approximately 84 per cent of the care staff have obtained NVQ awards at varying levels. The majority of staff have had Dementia care training. Care Homes for Older People Page 19 of 24 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 management of Chyvarhas House strive to maintain and improve a good quality of care and lifestyle for the service users and promote their health, safety and welfare. Evidence: Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge her responsibilities fully. The manager has successfully completed the registered managers award and has a post graduate certificate in management. The manager is able to demonstrate that she has undertaken periodic training i.e. the dementia care certificate in order to keep herself updated. The manager stated that her job description enables her to take responsibility to fulfil her duties. The records of the home demonstrated that all staff are supervised and subject to annual appraisals. Supervision of some staff is a little behind schedule. The health, safety and welfare of service users and staff is promoted and protected. The registered manager has a good awareness of the legislation regarding health and safety. Statutory checks are made by appropriate agencies as Care Homes for Older People Page 20 of 24 Evidence: evidenced from various service contract documents. Staff are trained in health and safety, manual handling, fire safety, first aid, food hygiene and infection control Fire records are up to date. On the day of inspection a member of the head office team was present to conduct an internal quality assurance assessment. We were told that this is completed on a monthly basis. Regulation 26 visits are completed monthly and documentation was available for inspection. Dementia mapping is also regularly undertaken and conducted at differing times of the day to include evenings. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 22 of 24 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 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 2 3 16 19 36 Include the contact details of the local Department of Social Care office in the complaints procedure. Ensure call bell cords are fitted to all bathrooms and toilet rooms. Maintain required level of staff supervision. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. Care Homes for Older People Page 24 of 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!