Archived: Tregarne and Chy Koes Respite Service

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.

Care plans contained detailed information regarding peoples support needs. However, information was sometimes duplicated.

People were protected from the risks associated from the unsafe use and management of medicines because there were robust systems in place.

Staff had received training relevant to their roles. Management was supportive of staff.

Staffing levels were adequate to meet people's care needs.

One person told us Tregarne is 'a home from home', another person told us 'it's a very nice place'.

During our inspection we found, people's privacy, dignity and independence were respected and people experienced care, treatment and support that met their needs and protected their rights.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines and the provider had an effective system to regularly assess and monitor the quality of service that people receive.

We found there were enough qualified, skilled and experienced staff to meet people's needs. However, peoples training needs were not always updated and training undertaken by staff was not always in line with peoples associated care needs.