Archived: Chy Byghan Residential Home

Updated 8 February 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 10 November 2015 and was unannounced. The inspection was carried out by two inspectors.

The inspection was carried out to check if the service had met specific needs identified following the last inspection carried out on 26 May 2015, when the service was deemed to be inadequate and put into Special Measures.

In preparation for this inspection we looked at the inspection action plan provided by the service following the last inspection. We looked at notifications we had received from the service. A notification is information about important events, which the provider is required to tell us about by law.

During the inspection we spoke with twelve people who were able to express their views of living at the service, five staff members, the service manager and four relatives and two external professionals with experience of the service. We looked around the premises and observed care practices on the day of our visit. We looked at documentation relating to the care of individuals, three staff files, including training records, staff duty rosters, medicine records and other maintenance records relating to the running of the service.

Updated 8 February 2016

Chy Byghan Residential Home provides accommodation and personal care for up to 19 predominantly older people and had 14 people resident at the time of our inspection. The service currently does have a manager but they are not registered yet. . 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.

We carried out this unannounced inspection of Chy Byghan on 10 November 2015. At this visit we checked what action the provider had taken in relation to concerns raised during our last inspection in May 2015. At that time we found breaches of legal requirements related to unsafe staffing numbers and recruitment practices, unclean and not properly maintained premises, and risks

associated with unclear consent procedures in relation to the Mental Capacity Act (2005) and associated Deprivation of Liberty guidelines. There were also breaches concerning failures to meet people’s needs and a failure to provide an effective and accessible complaints system. In addition the provider’s systems designed to assess, monitor and improve the quality of care the service were ineffective.

The service achieved a rating of Inadequate and was put into Special Measures by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures are fully inspected again within six months.

During this inspection we found the service had made significant improvements in the quality of care provided. We found there were enough staff available to keep people safe and meet their needs. Since our pervious inspection, afternoon staffing levels had been increased to ensure peoples’ safety. This increase meant there were enough staff available to meet people’s care needs where they required support from two members of staff.

There was a cheerful, upbeat atmosphere at the service and people told us they were happy to be living at Chy Byghan. Staff were observed to be kind, patient and friendly towards the people they supported.

We found people were kept safe when being given their medicines because the service had introduced new procedures designed to ensure people received the correct medication when it was needed. Medicine recordings were kept accurately and an external pharmacy audit had found the service was following safe practices.

People’s care plans had been completely re-written in a clear and easy to understand way since our last inspection. We saw people had been involved in the development of their new care plans and had signed to formally record their consent to the planned care. There was historical information to aid staff in understanding the life and history of the person they cared for.

The service was providing staff with effective training, supervision and appraisal in line with its own

organisational policy. Staff told us they were now receiving regular supervision. Staff told us they felt ‘much better about the running of the home’.

People at the service had been assessed appropriately under the Mental Capacity Act (2005). Where people lacked capacity, decisions about their care and support needs had consistently been made in the persons best interests. Where people’s freedoms had been restricted to ensure their safety appropriate Deprivation of Liberty applications had been made.

The service had employed an activities co-ordinator and a range of stimulating

activities were now available at the service. People told us how much they enjoyed the new programme which included crafts and sing a-long sessions.

The service had a policy and procedure in place for dealing with complaints. This was followed

in practice and was made available to people and their families. People understood the service complaint procedure but told us they had not wished to make any complaints.

The provider was operating safe recruitment practices. Recruitment records showed all appropriate pre-employment checks had been completed before new members of staff started work at the service.

The registered provider had ensured maintenance of standards of hygiene at the service had improved since the last inspection.

Chy Byghan demonstrated improvements in operating an effective governance system, including assurance, and auditing systems and processes. The purpose of these systems is to assess, monitor and drive improvement in the quality and safety of the services provided, including the quality of the experience for people using the service. People and their families had been asked to give structured feedback about the quality of the service.

Staff told us they had experienced extensive positive changes in how the service was led since the last inspection. Staff told us they believed the service was now well led. The manager acknowledged the staff team had worked hard to improve the running of the service and was happy there was now a consistent, motivated staff team working at the service.