Inspection on 05/03/07 for Chyvarhas

This inspection was carried out on 5th March 2007.

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 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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Chyvarhas 22 Saltash Road Callington Cornwall PL17 7EF Lead Inspector Mike Dennis Unannounced Inspection 5th March 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 DS0000008995.V332207.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chyvarhas Address 22 Saltash Road Callington Cornwall PL17 7EF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 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 DS0000008995.V332207.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 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 17th October 2005 Brief Description of the Service: 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 it’s 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.P’s. Ample car parking is available. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 5th. March 2007 over a eight hour period. The inspector met with the Registered Manager and an assistant manager. A selection of staff were spoken with and three service users. 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? Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 6 The standards set in this home are being maintained. Training opportunities continue to be made available. The company is pro-active in looking at ways to enhance and improve standards of care. The manager is continuing the process of looking at ways to improve the visual aspect of the premises with some success. In particular the home has undergone redecoration in many areas and presents as appealing and homely. Staff remain positive and were noted to be very attentive to service users. 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. The summary of this inspection report can be made available in other formats on request. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3. Quality in this outcome area is good. This judgement has been made using available 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 will need updating when the new assistant managers join the home. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 9 Four service user files were case tracted, and all contained evidence of of preadmission assessments conducted by senior members of the staff team. In addition there was evidence health care assessments 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. Each service user has a contract or statement of terms and conditions if privately funded. The present fee rate is from £340.50 to £425 per week. Prospective service users and their families are encouraged to visit the home before making the decision to move in. This home does not provide Intermediate Care. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available 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. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 11 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.P’s, Community Nurses, Opticians, Dentists etc. CPN’s visited the home on the day of inspection. The inspector 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. It is required that hand written entries to the MAR sheets is signed by the person making the entry. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available 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. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 13 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 jam tartes 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. One service user said that she did not have to get out of bed at any particular time and that breakfast would still be provided. Another said that she enjoyed the opportunity to prepare bits and pieces for cooking, as an activity. We spoke with a visiting minister and two service users. All three commented favourably on facilities provided and the quality of care. They reported staff as being most helpful and caring. We spoke with another visitor who also commended the service provided. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available 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. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available 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: Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 16 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. 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, 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. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 17 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30. Quality in this outcome area is good. This judgement has been made using available 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 user’s needs EVIDENCE: The staff were observed interacting with service users throughout the morning. 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, one of which fulfills the role of Active care co-ordinator, four staff on duty during the afternoon and evening with three waking night staff. This team is supported by the Manager, assistant managers, 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. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 18 All new staff undergo in depth induction training followed up by company and external training. Approximately 75 of the care staff have obtained NVQ awards at varying levels. A further 18 of care staff are currently undertaking NVQ training. The majority of staff have had Dementia care training. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 19 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36,37,38 Quality in this outcome area is good. This judgement has been made using available 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. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 20 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 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 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. The last quality assurance survey was completed in May of last year. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 3 Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? none 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 OP9 Regulation 13 Requirement It is required that hand written entries to the MAR sheets is signed by the person making the entry. Timescale for action 01/04/07 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 OP36 Good Practice Recommendations Maintain required level of staff supervision. Chyvarhas DS0000008995.V332207.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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