We carried out a review of the data available to us about HF Trust - Chy Keres on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about HF Trust - Chy Keres, you can give feedback on this service.
About the service
HF Trust – Chy Keres (Chy Keres) is a care home providing a respite service for up to six autistic people or people who have a learning disability. The service provides support to approximately 40 people through periods of planned respite throughout the year. At any one time the service can accommodate a maximum of 6 people. The service also supports people who need respite on an emergency basis. There were 4 people using the service at the time of the inspection visit, 3 of these were visiting the service for respite care and 1 person was on an emergency placement and was expected to live at the service for the next few weeks. The service is provided by HF Trust (Hft), a national charity with services throughout England.
People’s experience of using this service and what we found
Right Support
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
The environment was safe and clean and met people’s physical and sensory needs. There was plenty of outdoor space where people could spend their time. There were plans in place to further improve the garden.
Right Care
Medicines were safely managed by trained staff who administered people's medicines in line with the prescriber's instructions.
The service had enough appropriately skilled staff to meet people's needs and keep them safe.
Occasionally the service provided emergency support for people. Care was taken to help ensure staff were able to get a good understanding of people’s needs in a short time.
Right Culture
People received good quality care and support by trained staff that could meet their needs and wishes.
Staff knew and understood people well. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.
Chy Keres had a strong identity as a service committed to providing meaningful respite care for the benefit of people and their families.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 9 July 2018).
At our last inspection we made a recommendation about providing regular staff supervisions. At this inspection we found staff were receiving face to face supervisions and other informal support.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
This report only covers our findings in relation to the Key Questions safe, effective and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for HF Trust – Chy Keres on our website at www.cqc.org.uk.
Recommendations
We have made a recommendation in relation to health and safety audits in the report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Chy Keres is a respite service that provides care and support for up to six people who have a learning disability or autistic spectrum disorder. The number of people using the service fluctuates on a daily basis. There were six people using the service at the time of the inspection visit. The service is provided by HF Trust (Hft), a national charity with services throughout England.
Not everyone using Chy Keres receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection everyone staying at the service was receiving personal care.
Chy Keres has six en-suite bedrooms, two lounges, a sensory room and two kitchen/dining areas. All rooms are on the ground floor. One bedroom has a track hoist for people with more profound physical disabilities. Corridors and doorways are wide enough to accommodate access by people using wheelchairs. Private and enclosed garden areas surround the property.
The service requires a registered manager and there was one in post. 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.
Staff were skilled in supporting people safely and according to their needs and preferences. They had received training to enable them to deliver care and support according to people’s needs. They told us they were well supported and able to approach the registered manager or senior support worker for guidance at any time. Several staff had not had a formal supervision meeting for some time. We have made a recommendation about this in the report.
People were comfortable and happy when visiting the service. They had formed positive relationships with staff and other people. During the week people usually attended their normal day centre. In the evenings and at weekends there were opportunities for people to take part in activities both inside and outside of the service.
Some people had restrictive practices in place in order to keep them safe. Applications to authorise these restrictions had been made in line with the legal requirements. There were no records to show whether families had the legal authority to consent on behalf of people who lacked capacity to make specific decisions. This meant staff may not have been clear who was able to lawfully make decisions on people’s behalf. We have made a recommendation about this in the report.
The premises were purpose built and suited people’s diverse needs. People were able to choose to spend time socialising with their peers or staff as they preferred. Quieter areas were available for those people who disliked busy environments. Menus were planned in advance and were varied. Staff were aware of people’s preferences and any dietary requirements they might have.
Further information is in the detailed findings below.
Following the comprehensive inspection the registered provider wrote to us to say what they would do to meet the legal requirements in relation to the breach. As a result we undertook a focused inspection on 4 July 2017 to check they had followed their plan and to confirm they now met legal requirements.
This report only covers our findings in relation to the question ‘is the service effective?’ You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for HF Trust – Chy Keres on our website at www.cqc.org.uk
Chy Keres is a respite service that provides care and support for up to six people who have a learning disability or autistic spectrum disorder. The service can accommodate up to six people, although due to the nature of the service this fluctuates on a daily basis. There were four people using the service at the time of the inspection visit. The service is provided by HF Trust (Hft), a national charity with services throughout England.
Chy Keres has six bedrooms, one lounge and a sensory room. There are two open plan kitchen and dining areas although one is used only when cooking skills and craft workshops are held. Private and enclosed garden areas surround the service. All rooms are on the ground floor. All rooms have en-suite facilities and one room has a track hoist to support people with more profound disabilities. Rooms and lounge areas incorporate a range of seating and equipment to support people with physical disabilities.
Chy Keres is required to have a registered manager and there was one in post. 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 service had taken action to ensure appropriate referrals had been made to the specialist supervisory body when there was concern about people’s right to liberty being restricted. The registered manager told us the service had recently completed two new applications on behalf of people staying at Chy Keres; however, these had not been sent to the Deprivation of Liberty (DoLS) team. The supervisory body receiving applications had advised the service to put a hold on any additional applications. Following the inspection, we spoke with a representative from the DoLS team who confirmed there had been a county council change in policy regarding authorisation for restrictions for people using respite services. The service had acted correctly according to the advice provided by the DoLS team.
The service had completed mental capacity assessments on behalf of people who used the service and required this. These were documented. However, the assessments did not clearly identify decisions made around specific restrictions. For example, where Best Interest decisions had been taken on behalf of people who had specific restrictions, such as for the use of a stair gate at night for a person who was considered to be at risk of falls. The recording of this was not clear in its outcome. We have made a recommendation about how the service manage the requirements of the Mental Capacity Act, 2005.
The management team and staff understood the principles of the Mental Capacity Act and what their responsibilities were for assessment and referral, where restrictions were necessary for a person’s safety and well-being. Staff had undertaken training in this area and could clearly understand what restrictions meant and how these should be reviewed to ensure they were the least restrictive option.
At this focused inspection we found the registered provider had taken effective action to meet the requirements of the regulations and the breach had been met.
Chy Keres is a respite service that provides care and support for up to six people who have a learning disability or autistic spectrum disorder. The service can accommodate up to six people although due to the nature of the service this fluctuates on a daily basis. There were four people using the service following day support at the time of the inspection visit. The service is a national charity Home Farm Trust (HFT) with services throughout England.
Chy Keres has six bedrooms, two lounges, of which one is shortly to be made into a sensory room. There are two open plan kitchen and dining areas although one is used only when cooking skills and craft workshops are held. Private and enclosed garden areas surround the service. All rooms are on the ground floor. All rooms have en suite facilities and one room has a track hoist to support people with more profound disabilities. Rooms and lounge areas incorporated a range of seating and equipment to support people with physical disabilities.
The manager was currently going through the process of registration with the Care Quality Commission 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 service had considered the impact of restrictions for people that might need to be authorised under the Deprivation of Liberty Safeguards (DoLS). However there was no evidence other than the services own assessments that referrals had been made where people’s right to liberty was restricted.
Some people using the service had limited verbal communication. We therefore observed peoples activities when they arrived at the service. People were relaxed and engaged in their own choice of activities. There were enough staff to support people in what they chose to do. People were being supported by staff to settle in their rooms and plan their evening meal.
Staff were trained in a range of subjects which were relevant to the needs of the people they supported. New employees undertook a structured induction programme which prepared them well for their role.
The staff team were supported by the service manager through daily communication and regular supervision to support their personal learning and development needs.
Staff said the training was thorough and gave them confidence to carry out their role effectively. The staff team were supportive of each other and worked together to support people. They told us, “We are kept up to date with training, especially supporting guests with special needs” and “The organisation is really keen on training. I think I am up to date with everything”.
There were systems in place to ensure people who used the service were protected from the risk of harm and abuse and the staff we spoke with were knowledgeable of the action to take if they had concerns in this area.
There were suitable storage facilities to make sure medicines were stored safely. Medicines were signed in and out for each short stay at the service. Records were accurate and audited following each stay.
On the day of the inspection visit four people were booked to use the respite facilities and they began arriving later in the afternoon. Staff were on duty and ready to support people when they arrived. People were talking and interacting with staff in a relaxed way. Staff told us, “I love working here it has been the best job for me by far” and “We (staff) make sure we give guests a good quality of life whenever they come here
There were sufficient numbers of suitably qualified staff on duty to support peoples’ needs and engage in activities. The recruitment process took into account applicants had the appropriate skills and understood the needs of people using the service as well as having the necessary checks in place to make sure they were safe to work with people who may be vulnerable.
Care plans were being reviewed to include more person centred information. They were informative and contained guidance for staff. The plans included information about people’s routines, personal histories, preferences and any situations which might cause anxiety or stress. They described how staff could support people in these circumstances. In addition records included assessments and support plans from other health professionals. These were in easy read versions to aid communication.
People knew how to complain and we saw people had the opportunity to discuss how they felt about the service. Each person had a key-worker who checked regularly if people were happy with the service they received. One relative told us, “I have never had to make a complaint, but I am very confident if I was not happy with something the manager would listen to me and act on my concerns”.
Chy Keres was well-led and people told us they were kept informed about any changes in the service. They told us they felt their comments were listened to and acted upon. One relative told us they had needed some urgent support in the past and the service arranged it for them. They said, “It was a worrying time but I needn’t have worried about anything. It was a big relief for me”. The service had an open and positive culture with a clear focus on enabling and supporting people to reach their own personal goals.
We identified a breach of the regulations. You can see what action we have told the provider to take at the back of the full version of the report.
One person told us 'it is pretty good here, I am looked after OK. Usually people ask me the things I like; I am looked after quite adequate. I usually choose the things I like to eat. I like coming here, staff help you in the right way, they help you to do as much as you can'.
The staff we spoke with told us that they had received training in handling medications prior to having to do this and that the training was updated annually. We spoke with the parents of a person staying at Chy Keres and they told us that 'staff always checked the medication when it was brought in and they went through the medication list'.
We spoke with three support staff on the day of our inspection who told us they had adequate or good support. One support worker told us that 'seniors are always looking to see that staff are comfortable and confident in what they are doing and that they have a good understanding of the work and why they are doing it'.
We saw that care folders were stored in the office in a locked filing cabinet. The computer based care planning and assessment software was password protected and we saw that the computer was switched off when not in use.
People were fully involved in decisions about their support and staff members listened and acted in their best interests. We were told "They're very good here". We saw that people's needs were assessed and their support planned in detail. If there was an emergency admission sufficient information was always in place before the placement began, such as how to respond to a seizure.
Staff were skilled, knowledgeable and had good knowledge about people and their needs as they had received the training and support that they required. Staff said that the training was "excellent". Staff were available in sufficient numbers to provide individual care to people and they were supervised to ensure good practice. Staff understood how to safeguard people from abuse and uphold their rights and dignity. A person told us that they felt safe and we saw that people had chosen to spend time at Chy Keres.
Health care arrangements were made as necessary. One person told us how they enjoyed the bath and that they had one whenever they wished. People were informed how they could make a complaint . There were good arrangements to ensure that the service ran effectively and in people's best interest.