Tregarne and Chy Koes Respite Service

Updated 11 January 2018

We carried out this comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Tregarne and Chy Koes is a ‘care home’. People in care homes receive accommodation and nursing care as single under one contractual agreement. CQC regulates both the premises and care provided. We looked at both during this inspection.

This inspection took place on 21 November 2017 and was announced. The inspection was undertaken by one adult social care inspector.

We gave the service 72 hours’ notice of the inspection visit because the service provides respite care which means there is not always staff and people using the service available during the day. We needed to be sure staff and people using the service would be available to support the inspection visit.

Tregarne and Chy Koes is situated close to the centre of the town of St Austell with all amenities being a walk or short drive away. The home provides single room accommodation for up to 15 adults living with a learning disability and or physical disability who need assistance with personal care. The service is a purpose built home with a range of aids and adaptations in place to support people with a range of disabilities which impact on their mobility and movement. Each person has their own room with adapted en-suite bathrooms. There are additional toilets located throughout the service.

Before the inspection we reviewed information we kept about the service and previous inspection reports. This included notifications of incidents. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern. We reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plan to make.

During the inspection we used a range of methods to help us make our judgements. This included talking with people using the service, interviewing staff, pathway tracking (reading people’s care plans, and other records kept about them), carrying out observations of care and reviewed other records about how the service was managed.

We spoke with the registered manager, team leader, three senior support workers and four support workers.

Following the inspection we contacted four relatives of people who used the service and two people who used the service to ask for their feedback. We also contacted four professionals who were external to the service.

We looked at a range of records including four care plans, records about the operation of the medicines system, two staff personnel files, and other records about the management of the service.

Updated 11 January 2018

This comprehensive inspection took place on 21 November 2017 and was announced.

Tregarne and Chy Koes is a residential home that provides respite personal care and support to younger adults and older people for up to 15 people. Tregarne and Chy Koes are two separate units. At the time of our inspection two people were receiving respite care at Chy Koes and five people were receiving respite care at Tregarne. People used the service for various short term periods to provide respite for them and their families who were their main carers.

Tregarne and Chy Koes is situated close to the centre of the town of St Austell with all amenities being a walk or short drive away. The service provides single room accommodation for up to 15 adults with a learning disability and or physical disability who need assistance with personal care. Up to ten people can be accommodated at Tregarne and up to five people at Chy Koes. Occupancy levels vary each week due to the nature of the service. The service is a purpose built home on one site but included two separate buildings. There are range of aids and adaptations in place to support people with a range of disabilities which impact on their mobility and movement. Each person has their own room which have en-suite facilities including bathing facilities. There are additional toilets located in both services.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service Like registered providers; they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Staffing levels were based around the needs of people using the service. Due to fluctuating occupancy levels, staffing the service needed to be flexible. Staff were responding to this and proposed changes in staffing shift patterns were currently in consultation with the provider and unions.

Staff had been recruited safely, received on-going training relevant to their role and supported by the registered manager and team leaders. They had the skills, knowledge and experience required to support people in their care. Staffing levels were sufficient to meet the needs of people who used the respite service.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

People’s rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Nobody we spoke with said they felt they had been subject to any discriminatory practice for example on the grounds of their gender, race, sexuality, disability or age. There was a strong focus on protecting people’s human rights.

Care records were generally organised, detailed, personalised and comprehensive care records were regularly updated and reviewed with involvement from people and their families. However, both units used their own recording system. The registered manager is working towards unifying both systems to ensure continuity. Care and support plans included person centred daily observation records that identified the care and support interventions that had been provided around care and support for the person being supported.

We observed positive exchanges between staff and people who used the respite service. There was a culture on promoting dignity, respect and independence for people. People told us staff treated them as individuals and delivered person centred care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Accidents and incidents were being recorded and reported and any lessons learned were shared with staff. The service learned by any mistakes and used this as an opportunity to raise standards. There was a culture of openness and honesty and staff felt able to raise concerns or suggestions.

People told us they had choices of meals and there were always alternatives if they didn’t want what was on offer. One person said, “Meals are OK but I sometimes like to go out and sometimes bring back things I like. It’s good to have the choice” A staff member told us, “We do a lot of themes like the recent Halloween and we do meals around that.”

There were a range of quality assurance arrangements at the service in order to raise standards and drive improvements. For example, audits to ensure quality in all areas of the service was checked, maintained, and where necessary improved. However people told us that the organisation did not always keep them informed of changes occurring in a timely way. We have made a recommendation about this.

The registered manager and team leaders engaged with all stakeholders of the service. Six monthly surveys were presented in a format that could easily be understood by people with learning disabilities. In addition to surveys people were asked for feedback after each visit. The results of the most recent survey had been positive.

There was a system in place for receiving and investigating complaints. People we spoke with had been given information on how to make a complaint and felt confident any concerns raised would be dealt with to their satisfaction.