Inspection on 19/05/05 for Chyvarhas

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Chyvarhas 17/02/09

Chyvarhas 05/03/07

Chyvarhas 17/10/05

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Chyvarhas 2 Saltash Road Callington Cornwall PL17 7EF Lead Inspector Michael Dennis announced 19 May 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chyvarhas Address 22 Saltash Road, Callington, Cornwall, PL17 7EF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01579 383104 01579 384373 Cornwall Care Limited Rachel Dooler Care Home 40 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (10) Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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)) Service users to include up to 10 adults of old age (OP) 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. Total number of service users not to exceed a maximum of 40 Date of last inspection 07/12/04 Brief Description of the Service: Chyvarhas is run by the organisation Cornwall Care Ltd., which is a registered and 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 it’s own lounge area. Dining and further lounge areas are found centrally located. The home is a secure environment for the safety of the service users.For those service users who are unable to get into Callington or who choose not to, services are provided within the home i.e. hairdressing, opticians, dental, nursing care and medical services from the local general practitioners. Car parking for visitors to the home is available in the grounds. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 19th. May 2005 over a seven hour period. The inspector met with the Registered Manager and two assistant managers. A selection of staff from all departments were spoken with and five service users. During the course of the day the inspector observed groups of service users engaged in a number of activities. Staff were observed to be tending to service user needs whilst respecting their dignity. Various records, policies and procedures were inspected. The inspector 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 What the service does well: What has improved since the last inspection? Cornwall Care Ltd. endeavour to be innovative and have recently introduced “Appetite for Life”. This is a programme designed to promote meal times as a positive individual experience for each service user. Minimum Organisational Standards have been developed to improve all aspects of the meal time from kitchen preparation, choice and presentation to dining routines and client involvement. The inspector observed the implementation of this programme. It was seen to be working quite smoothly with staff in full attendance as needed. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 6 More in depth Occupational Profiles are now compiled enabling staff to promote interests and activities that are more personal to the individual service user concerned. The manager believes that there is better understanding and cohesion amongst the senior staff leading to stronger moral throughout the staff team. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 6 Prospective service users are provided with the information they require in order to make an informed decision about admission to the home. Each service user has a written contract/statement of terms and conditions. Service users are fully assessed prior to admission to the home. This home does not provide Intermediate care EVIDENCE: A comprehensive Statement of Purpose and Service User Guide is available. These documents are regularly reviewed. Service users informed the inspector that they had knowledge of these documents. Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. The information provided included :- continence assessment, pain assessment, risk assessments and general details of daily care requirements, medication and health care requirements. Service users files contained signed contracts/ terms and conditions of the home. The contracts include details of fees to be paid. Annual increases in fees are normally in line with the increase of inflation. Standard 6 is not applicable as the home does not provide intermediate care Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 The health care needs of service users are identified planned for and met. Comprehensive policies and procedures for dealing with medicines are followed Service users are treated with dignity and respect. 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. Appropriate professionals from other disciplines frequently visit the home to provide for general health care, ie. G.P’s, Community Nurses, Opticians, Dentists etc. The home’s medication policies are adhered to by all staff. The manager and assistant managers are the nominated persons who administer medication. The majority of the drugs are in blister packs. All medication including controlled drugs was recorded correctly as received, administered and disposed. . The controlled drugs were stored to comply with drug regulations Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The routines of daily living and activities made available are flexible and varied. Service users dietary needs are well catered for with a balanced and varied selection of food and drink available that meets tastes, and choices. EVIDENCE: The service users individual care plan has a detailed section regarding their interests and choice. Individual occupational profiles are undertaken and were evidenced during the inspection. As a result a number of service users have taken up activities previously lost to them. The home arranges and facilitates visiting entertainment and in-house activities. Staff were observed occupying service users, stimulating their interests and encouraging others to join in. Planned activities are displayed on a notice board. Service users are enabled to choose the time they get out of, and go to bed. Meal times are flexible. Emphasis is placed on individual requests and requirements. Daily planning occurs which is recorded highlighting the ‘outcomes’. This information is later analysed to further the understanding of the individual service users needs. Life story books are being compiled The home is introducing a new initiative named “Appetite for Life”. This programme is aimed at improving all aspects of mealtime experiences. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 11 Minimal Organisation Standards have been developed and cover 10 key areas. They are :- The Kitchen, The Dining Room, Presentation, Routines, Choice, Availability, Nutrition, Menu Planning and Client Involvement. The inspector spent some considerable time observing the midday meal with respect to the changes made. The service users were coping well with staff in attendance when required. The meal time was un-hurried, relaxed and orderly. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The registered persons ensure that service users are protected from all forms of abuse The complaints procedure is well publicised and used when required. with staff having knowledge through training of Adult Protection issues which helps to protect service users. EVIDENCE: A comprehensive complaints policy and procedure is kept within the home. This procedure includes timescales and who will deal with the complaint. The home also keeps a complaints log for ease of reference. Service users indicated that they were aware of the procedures. There have been a small number of complaints since the last inspection. These have been appropriately dealt with. The home has a comprehensive policy and procedure in place to protect service users from abuse. Policies are also available in regard to physical and / or verbal aggression from service users, physical intervention and restraint. Staff are made aware of these procedures during the induction period. The registered manager is also aware of the local social services procedure within “No Secrets” to investigate any complaints regarding the suspected abuse of any service user. CRB and POVA checks are undertaken, with Cornwall Care being the umbrella body to obtain these checks. Policy documents infer that restraint could be used in certain circumstances. The registered manager informed the inspector that restraint has not been used or considered. It is recommended that this policy is revisited. If the possibility of use of restraint is to remain then the parameters should be stated and staff given appropriate training Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live 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. A modernisation and redecoration programme is underway as observed by the inspector. The home is split into four wings of accommodation. Each wing is being developed to it’s own particular style incorporating a degree of experimentation. When completed one wing will resemble a street scene, others are colour coded. This variety of décor is designed to help the service Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 14 users identify their area of the home. Management continue to be pro-active in relating design issues to service user needs and wishes It was noted that, on inspection of the premises, all was found to be clean and tidy. Equipment was working correctly and in order. Policies and procedures for the control of infection were available and in order Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 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 user’s needs EVIDENCE: The staff team shows a positive regard for service users and appears very organised. Additional staff are on duty at peak times of activity during the day. In addition to care staff there are 2/3 domestics and 1 laundry staff member on duty each morning. The duty rota indicates that 6 care staff are on duty during the mornings, 4 throughout the afternoon and 3 on duty in the evenings. Waking night staff number 3. In addition managers, domestic and catering staff are on duty Staff recruitment is conducted in line with the home’s policies and procedures. Evidence obtained from staff files indicates that references, CRB and POVA checks are taken up prior to interview. All staff undertake Induction Training. . NVQ training is encouraged as demonstrated by the majority of staff, (90 ) having obtained awards at various levels. Individual training profiles for staff are kept up to date with accurate information of progress made. Staff are receiving supervision and an appraisal system is in place. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. 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 his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36 and 38 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 his or 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 appropriately supervised and subject to annual appraisals. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 17 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 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. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x 3 x 3 Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 18 . 5 Good Practice Recommendations It is recommended that the policy concerning the use of restraint is reviewed. Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall, PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chyvarhas DD52 D04 8995 Chyvarhas V216824 190505 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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