Inspection on 11/07/07 for Coplands Nursing Home

This inspection was carried out on 11th July 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

Coplands Nursing Home 16/05/06

Coplands Nursing Home 10/10/05

Coplands Nursing Home 11/08/05

Coplands Nursing Home 25/01/05

Coplands Nursing Home 11/05/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Coplands Nursing Home 1 Copland Avenue Wembley Middx HA0 2EN Lead Inspector Judith Brindle Key Unannounced Inspection 08:50 11 and 12th July 2007 th 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 Coplands Nursing Home DS0000022924.V340823.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. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coplands Nursing Home Address 1 Copland Avenue Wembley Middx HA0 2EN 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) 020 8733 0430 020 8733 0450 coplands@lifestylecare.co.uk Life Style Care (2005) Plc Lynne Marie Beckley Care Home 77 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (46), of places Physical disability (25) Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No more than 77 persons in need of nursing care may be accommodated at any one time. Categories of care are Elderly Mentally Ill, Elderly Frail and YPD Minimum staffing notice applies Temporary variation agreed for one named individual (Mr SS) aged 59 years for the duration of his stay No less than 37 places and up to 46 places for older people during the transition of Owl unit from older people to younger adults. 16th May 2006 Date of last inspection Brief Description of the Service: Coplands Nursing Home is a purpose built care home, which is owned by Southern Cross (LSC) Ltd, a national provider of care homes. It is situated at the junction of Coplands Avenue and the Harrow Road. The variety of shops, banks, and restaurants and other amenities of Wembley and Sudbury are located within a few minutes walk from the home. Public bus and train transport facilities are accessible close to the home. The home has a large car parking area at the back of the home. The front of the home is paved and has a small garden area with shrubs and bushes. There is also a back garden and patio area, which are accessible to people using the service. The home has accommodation for 77 people using the service in single bedrooms, which are ensuite. It caters for service users with a range of needs and is divided in to 5 units. Falcon unit is situated on the ground floor and has 16 beds for young physically frail service users. Owl unit also on the ground floor has 9 beds, which was accommodation for frail elderly residents; but the care home recently registered with the Commission for Social Care Inspection to increase the numbers of registered places (from 16-25 places) for adults with a physical disability. These residents are now accommodated in Owl unit, with four older persons who have chosen to remain living in the unit for the duration of their stay. Hawk unit is situated on the 1st floor and caters for the needs of frail elderly people using the service (20 beds). Eagle unit (15 beds) accommodates elderly service users with dementia care needs. Kestrel unit (17 beds) specialises in the care of frail elderly Asian service users. The fees range from £575-£1500, and additional charges are clearly recorded in the service user guide and the residents’ contract/terms and conditions. The Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 5 home provides people living in the home, and visitors with information about the care home, which is available in Gujarati. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place throughout two days in July 2007. There was one vacancy at the time of the inspection. On the first day of the inspection there was one inspector, a second inspector assisted the lead inspector for part of the second day of the inspection. The inspectors were pleased to meet and talk with the people living in the home, and with several staff on duty. The people living in the care home have varied needs. Some of whom (particularly those living in the dementia care unit) have limited vocal communication abilities and/or are unable to respond to questions other than to a limited degree. The lead inspector as part of the inspection process carried out SOFI (Short Observational Framework Inspection), which consisted of observing four residents continually for one and a half hours. The manner of interaction between people using the service and staff, and signs of residents ‘well being’ were noted as part of this observation. The inspection focussed on spending time talking with people living in the care home. Much of the two days was spent on the units talking to residents and staff. Documentation inspected included, resident’s care plans, residents’ financial records, risk assessments, staff training records, and some policies and procedures. An interpreter assisted the lead inspector in obtaining feedback from several residents in a unit within the care home, which provides care and support mainly for Asian residents. The lead inspector also spoke to several visitors during the inspection. Staff were very helpful during the inspection, and supplied all documentation, and information requested by the inspector. The registered manager and deputy manager were present during the inspection. The inspectors also completed tours and/or partial tours of all five units. Assessment as to whether the requirements from the previous inspection had been met also took place during the inspection. Staff and inspection of records confirmed that these had been met by the service. 24 National Minimum Standards for adults, including Key Standards, were inspected during this inspection. The inspectors thank all the people living in the care home, visitors, and the staff for their assistance in the inspection process. What the service does well: Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 7 Residents’ contact with relatives and others (as agreed by the residents) is fully supported and enabled by the care home. A caring, well trained, and competent staff team demonstrate knowledge, and understanding of the varied needs of people living in the care home. Staff have a good understanding of the religious and cultural needs of people living in the care home, and ensure that these needs are met. Several staff speak a variety of Asian languages, which are spoken by a significant number of people living in the care home. Residents spoke highly about the staff in the care home. A person living in the home said that “It’s like home, staff are very helpful, whatever I want people get it for me”. The Short Observational Framework for Inspection (SOFI) that was carried out during the inspection showed that there was generally significant positive staff interaction between residents and staff, and signs of ‘well being’ from people using the service. What has improved since the last inspection? What they could do better: Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 8 Some minor maintenance issues of improving the décor of bathrooms in the care home could be carried out. There could be some improvement in the recording of the monitoring of some specific clinical observations. Some recorded staff guidance to meet some particular needs of people using the service could be further developed in some care plans. 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. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 9 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 Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 10 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): Standards 1 and 3 (6 is not applicable) People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for prospective people using the service to have the information that they need to make an informed choice about where to live. Arrangements are in place to ensure that prospective resident’s needs are comprehensively assessed prior to their admission to the care home. EVIDENCE: The care home has up to date information about the service that it provides. This is included in the statement of purpose and service user guide (the main copies of this documentation are located in the reception area, and residents are provided with a service user guide on their admission). Some residents’ spoke of having received the service user guide and statement of purpose documentation, and copies were seen to be located in bedrooms inspected. The manager had confirmed during a previous inspection that summaries of Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 11 these documents could be provided in another language if people so wish. It is recommended that the registered person seek ways of improving the accessibility of the service user guide for those residents who have difficulty reading and/or other needs which lead to difficulties in accessing information from the written word. Fifteen care plans were inspected, including care plans of residents who had recently been admitted to the care home. These all included evidence that an initial assessment of the residents needs had been carried out prior to their admission to the care home. The assessment information confirmed that the registered manager generally carries out initial assessments. These assessments were judged to be comprehensive, and detailed and included health, social and cultural/religious needs. Several residents confirmed that they had been involved in the initial assessment of their needs. Some assessment information was signed by people using the service or their relative/significant others. It should be always recorded in the assessment documentation if prospective residents are unable to sign the assessment information. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 12 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): Standards 7,8,9, and 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that all people using the service have a plan of care, which sets out their health, personal and social care needs. Residents are treated with respect, and risks are managed positively to help people using the service to lead the life that they want. Medication is stored and administered safely. EVIDENCE: All residents have a plan of care 15 care plans were inspected by the two inspectors. These included a selection of care plans from each unit of people living in the home. These care plans included recorded residents’ identified needs, and staff guidance to support residents in meeting their assessed needs. Some recorded guidance (i.e. in care plans in Hawk unit) was particularly clear and comprehensive. It was evident that since the last key inspection in 2006, staff had worked hard to develop and improve the care plans and staff guidance to meet assessed needs. The nurses in charge of units within the care home spoke of their role in the development and the Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 13 review of the care plans. It was evident that care plans have been drawn up taking assessed needs into consideration. Individual disabilities are clearly explained and staff informed the inspectors that they have received specialist training to understand peoples needs better. The manager reported that there were monthly care plan meetings with staff to ensure that these documents were completed as required. Three care plans inspected by the lead inspector could have been further developed to include guidance to meet a resident’s diabetic needs, a resident’s depression needs, and in regard to meeting the needs of a resident who could not speak any English. The nurses working on the units concerned, confirmed that they would amend these care plans immediately. The care plans recorded evidence of being regularly reviewed. There was some evidence of residents being involved in the review of their care plan, (particularly the younger adults with physical disabilities), and that relatives/significant others are also involved in the reviews. Two reviews of care plans took place during the inspection. A relative spoke of the review meeting that she had attended as being ‘very helpful’. Some residents (particularly those living in Kestrel unit) who spoke with the lead inspector were unaware of their plan of care. Staff should continue to seek ways of ensuring that care plans are understood, and accessible to all residents, including those with multiple needs, and possibly look at putting in place a summary of the care plan in pictorial format and/or in the residents first language (if they are unable to speak English). Care plans inspected included moving and handling assessment, pressure sore assessment, and ‘nutrition screening assessment’. There is a prevention of pressure sores policy/procedure. The manager reported that there were no residents who have pressure sores. Care plans have a detailed falls assessment in place and if there is a moderate risks of fall clear guidelines are given to staff. The inspectors viewed a range of very good recording systems during this visit, but noted that files were lying around in the Owl unit and it is recommended to provide safe storage for these files. The use of bedrails has been risk assessed and people using the service have been involved in the risk assessments, which were signed by the person, General Practitioner and manager. A variety of healthcare risk assessments were recorded in the care plans inspected. It was evident from records, and from talking with people living in the care home, visitors, and staff that people living in the home have access to support, and treatment from healthcare professionals. These include the continence advisor, psychiatrist, optician, chiropodist, dentist, and specialist hospital appointments/clinics. A GP visited the care home during the inspection. Several people living in the care home have their fluid intake and output monitored. A previous requirement in regard to this was judged to have been met on Owl unit. Records inspected on Eagle unit had not been up dated Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 14 between 10am and 1600hours. The nurse in charge of the unit confirmed that these records would be completed. If fluid monitoring of residents, intake and output is required staff need to ensure that these records are maintained and up to date, or the need for this monitoring of fluids be reviewed. Residents’ weights are monitored. ‘Daily’ and night records are completed by staff in regard to the progress of each person living in the care home. Residents were very positive about the staff, and confirmed that their privacy was respected. Staff were observed to respect resident’s privacy during the inspection. The planned observation session (SOFI) that took place during the inspection on Eagle unit confirmed that staff interaction with people living in the home was positive and sensitive. Residents observed showed signs of ‘well being’ though one resident appeared to sleep for all but part of one five-minute observation session. It is recommended that staff review this resident’s needs particularly in regard to medication needs. This was discussed with the nurse in charge. People using the service informed both inspectors that staff are friendly and that they are treated with respect. Families are involved where applicable in peoples care. People have access to a telephone. Some people using the service were observed using their mobile phones. People informed us that they wear their own clothes and clothing was clean and appropriate for the time of the year. A visitor spoke of some past issues of sub standard laundering of clothes, and of clothing going missing, but the visitor reported that following reporting of the concerns this issue has improved. The registered manager spoke of the action taken to improve the laundering of clothes and that the laundering of residents clothes was closely monitored. The care home has a medication policy. The medication administration and storage systems were inspected, in four units. Medication is stored securely, and medication received from the pharmacist is checked and recorded by staff. Requirements made during previous inspections were judged to have been met. Medication Administration Sheets were of good standard and nursing staff generally demonstrated knowledge of common side effects. One staff member recently working on one unit was not clear about what some of a resident’s medication was for, but knew how to access a British National Formulary pharmaceutical book to look this information up. The nurse confirmed that he/she would be gaining knowledge of all the medications prescribed to the residents on this unit. Registered nurses administer medication to people using the service. The manager reported that unannounced monthly medication audits are carried out. Controlled Drugs are stored safely and appropriate procedures are followed. One of the assessed people is self administering their medication and appropriate guidelines are in place. Care plans have detailed risk assessments Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 15 in place. These are reviewed regularly and appropriate guidance for staff and people using the service is recorded. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 16 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): Standards 12,13,14 and 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the care home have the opportunity to take part in a variety of preferred activities. Arrangements are in place to enable people living in the care home to maintain contact with family/significant others, as they wish. People living in the care home have their rights and cultural/religious needs respected Arrangements are in place to ensure that people using the service choose meals, and are varied and wholesome, and meet the cultural and dietary needs of the residents. EVIDENCE: The care home employs four activity co-ordinators, one works full-time, and the other three are employed part-time. They complete individual social assessments of people living in the home, which are reviewed. Activity programmes were displayed in written English and Gujarati. Activities that took place during the inspection corresponded to the recorded activity programme. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 17 It was evident during the inspection that people living in the home had the opportunity to participate in some varied group and individual activities. During the planned observation session on Eagle unit the activity coordinator involved a resident in a 1-1 activity, other residents were given the opportunity to participate in varied leisure pursuits. Some residents joined in singing along to ‘old time’ songs, which were being played. A resident was observed during the lead inspector’s observation session to be encouraged and praised by staff for his singing. Other activities observed during the inspection were an Arts and Crafts session, a dominoes session, a religious/cultural session, and people using the service on Falcon and Owl unit were encouraged by an activity coordinator to participate in a Keep Fit Session, which was attended by people from both units during the second morning of this unannounced key inspection. One resident spoke of looking forward to a leisure session in the sensory room. Music was played in the communal areas at times during the inspection. It was positive to note that the television was not constantly switched on in Eagle unit, and that residents were asked their choice in music. Residents have access to television channels, including those, which show Asian programmes. People using the service informed us that they go on community outings. Records confirmed that some people living in the care home had participated in community events, including going to a local ‘funfair’, and had also helped collect money from the public for a registered charity. Risk assessments are in place when needed. Residents have the opportunity to have their spiritual needs met by visiting clergy and it was evident that the needs of those with other faiths were being met by the care home. Pictures of examples of art and craftwork completed by people living in the home are documented in the June 2007 Coplands newsletter. Photographs of people using the service participating in a variety of activities were displayed in the home. There were numerous visitors to the care home during the inspection. Several of whom spoke with the inspectors. Visitors spoke of visiting the care home at different times of the day, and spoke positively about the home, and the care provided by staff. One visitor informed the inspector that the staff were marvellous, and that her relative is well looked after. Residents spoke of receiving visitors in the home on a regular and flexible basis. A resident spoke of going out with family members particularly when there were significant family functions taking place. Staff were observed to offer residents choice during the inspection. Residents who kindly spoke with the inspector said that they were happy about the care and support that they received from staff, and spoke of being enabled to make choices. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 18 The menu was displayed on tables in the dining areas of the home, and recorded a variety of wholesome, and nutritious meals, which corresponded to the meals provided during the unannounced inspection. The format of the menus could be improved to include pictures to ensure that the information is more accessible for people using the service who have difficulty in reading. Choice was indicated on the menu. The inspectors observed lunch, and breakfast during the inspection. Meals were unhurried. It was noted that the presentation of meals had significantly improved since the previous key inspection in 2006. Records confirmed that residents are enabled to speak to the chefs personally about their food preferences. A resident was provided with a cooked breakfast of his choice during the inspection. Residents were offered choice during their meals. Food looked tasty and people using the service informed the inspectors that they liked the food, but that it could be a bit ‘bland’ at times. Asian residents have access to a separate Asian menu, and during the inspection received a lunch, which met their cultural needs, and spoke of enjoying the meal. Staff spoke of the action that they take to respond to concerns/complaints about the food, and of how they ensure that residents have the meals of their choice, and how they aim to meet the varied needs of the residents. Specific meals, which meet the needs of Afro-Caribbean residents, are provided on a weekly basis. Staff reported that rice is provided with most meals. An Afro-Caribbean resident was observed to be given rice with his lunch during the inspection. Residents were offered frequent drinks and snacks, including fruit during the inspection. Fresh fruit was accessible on the units in the care home. People living in the home were given assistance as and when required, with their meals. It is recommended that there is specific training, which includes risk of choking, in regard to giving assistance to residents with their meals. One of the people using the service receives their nutrition by a specialist method. An inspector noted that all boxes with equipment for the whole month was stored in his room, the inspector informed the home to find alternative storage for such equipment. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 19 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): Standards 16 and 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the care home can feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. EVIDENCE: The home has a complaints procedure. A summary of this is recorded within the statement of purpose documentation, and is attached to the service user guide. Residents who kindly spoke with the inspectors were aware of how to complain. A person using the service spoke of talking to staff or to her son if she had a ‘concern’ and/or a complaint. Other residents reported that the manager ‘deals’ with complaints. Visitors spoke of feeling able to complain if they so wished and that an appropriate response is taken by the home to resolve issues. Visitors reported that if they had a ‘concern’/complaint they would speak to the nurse in charge on the relevant unit. Complaints are recorded appropriately in accordance with the complaints procedure, and are monitored closely. Records confirmed that people using the service are confident to complain if they need to. The manager has recently displayed (on all the units) information about encouraging visitors and others to make comments about the service provided by the home, and to put completed comment slips in a post box located in the reception area. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 20 The care home has a protection of vulnerable adults procedure. Information received prior and during the inspection confirmed that staff had knowledge and understanding of the action to be taken in response to a suspicion or allegation of abuse. Records and staff confirmed that staff receive training in safeguarding adults/abuse awareness. Records confirmed that people living in the home had recently had a talk from the local community police about personal security and safety. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 21 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): Standards 19,23 and 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment of the home is safe, homely, clean and comfortable. The premises are suitable for the care home’s stated purpose. Residents’ bedrooms are individually personalised, and meet their individual needs. EVIDENCE: The care home is purpose built, and located within a few minutes walk from local shops, and bus public transport facilities. There is parking for several cars at the rear of the property. There is an accessible garden area, and a well maintained attractive forecourt area. The inspection included a partial tour of the premises. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 22 The care home is generally well maintained, homely, and clean. People using the service informed the inspector that new curtains have been purchased for the communal areas. The units viewed by the inspectors looked comfortable, and artwork completed by people using the service was displayed in the care home. The manager spoke of plans to replace several armchairs in the communal areas. There has been a significant improvement to some communal areas in regard to redecoration. Eagle unit is in the process of having the passageways painted, giving an outdoors effect with painted trees and walls. The manager reported that doors of resident’s bedroom are in the process of being painted in different colours, and will each have an individual look with particular door handles, pictures on the door and other individualised features. The manager spoke of plans to display items of different textures throughout the unit, which residents will be able touch and handle, and could help to meet the needs of those dementia care needs. People including visitors spoke positively of the improvement in décor. Previous maintenance inspection requirements have been met. The soap dispenser in the bathroom on Owl unit was missing. The door handle to the domestic room on the Owl unit is loose and must be repaired. There are areas of peeling paintwork in the bathrooms inspected that should be re painted. The manager reported that “lots” of maintenance was planned. This included the repainting of kitchenettes on the units, and the replacing of some carpets and chairs. Bedrooms inspected had some personal features, including photographs, and pictures. Residents spoke of being happy with their bedrooms. All bedrooms are single with ensuite facilities. Visitors spoke of their relative (a resident) recently having bought himself a comfortable armchair. The manager spoke of monitoring bedrooms, and of ensuring that improvements to the rooms are carried out as and when needed. Laundry facilities are located away from food storage, and food preparation areas. The home employs domestic staff, who were working during the inspection. Staff were observed to use protective disposable clothing such as gloves, and aprons. Records confirmed that staff had received infection control training. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 23 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): Standards 27,28,29 and 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff receive training to ensure that they are competent and skilled in regard to carrying out their roles and responsibilities. Arrangements are in place to ensure that people living in the home are supported and protected by the care home’s recruitment policy and procedures. EVIDENCE: The home employs registered nurses, care staff, activity co-ordinators, a physiotherapist, a receptionist, a maintenance staff member, and domestic staff. Staff rotas were available for inspection. The names of staff on duty were displayed on Eagle unit, and a notice board with pictures of staff was displayed on the ground floor. Visitors and staff confirmed that there were sufficient staff on duty. A visitor spoke of seeing familiar staff on the units more frequently recently, which they felt was positive in regards to consistency of care. In regards to a previous inspection requirement, the lead inspector was informed by the manager that the staffing levels on Hawk unit had been recently been reviewed in line with the assessed dependency levels of the Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 24 people living there, and that this would be monitored closely. The manager gave examples of staffing numbers having been increased when residents needs change. Residents, and visitors spoke positively about the staff. A resident spoke of staff “understanding her needs”. The manager and records confirmed that staff receive training in treating people living in the home, and others with respect, and to ensure that their right to privacy is understood, and valued. The planned timed observational session (SOFI) carried out by the lead inspector indicated that staff interacted positively and sensitively with residents, and that there were clear signs of well being in regards to the four residents that were observed. A previous requirement in regards to the attitude of some staff was judged to have been met. A nurse in charge of a unit spoke of the on going monitoring that was carried out to ensure that staff are skilled in their role, and provide quality care and support to people using the service. We were informed that staff now wear uniforms, which the manager said was working well that there had been positive feedback from residents, and from visitors. A staff member spoke of there being good staff teamwork on the unit that she works in. A resident spoke of there being several staff that understand the language that she speaks (Gujarati). The care home has a recruitment and selection procedure. Three staff personnel records were inspected. These confirmed that appropriate and required recruitment and selection procedures are carried out, including an enhanced Criminal Records Bureau check of each staff member. Records confirmed that staff receive a staff handbook and a job description. The manager confirmed that several staff had completed and were in the process of completing appropriate courses NVQ (National Vocational Qualification) in care. It was evident from talking with staff, inspection of records, and from observation that staff receive appropriate training including staff induction training, to ensure that they can carry out their roles appropriately. Staff training includes statutory training such as 1st Aid, food and hygiene training, and moving and handling training, and also specialist training including care plan training, managing challenging behaviour, nutrition training, and training in caring for people with specialist medical conditions. Much of the training is ‘in house’ training that is carried out by nursing staff. A staff member spoke of receiving “lots” of training. The manager supplied the lead inspector with an up to date training plan. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 25 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): Standards 31,33,35,36 and 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager is qualified, competent and experienced to run the care home, and staff are appropriately supervised. Arrangements are in place to ensure that effective quality assurance and quality monitoring systems are in place to monitor and improve the quality of the service provision by the care home. Arrangements are in place to ensure that so far as reasonably practicable the health, safety and welfare of people using the service and staff is promoted and protected. EVIDENCE: Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 26 The registered manager is qualified, and experienced to run the care home. She is a level 1 registered general nurse, and is in the process of completing the Registered Managers Award (RMA) qualification. During the inspection the manager’s assessor visited the care home to collect the manager’s portfolio of completed modules in regard to her management course. The registered manager has managed the care home for over two years. She confirmed that she undertakes regular training to update her skills and competence, and had recently attended a dementia care conference. It is evident that the registered manager is motivated, and that she has a clear understanding of the key principles and focus of the service, and works hard to continuously improve the service for the people living in the care home. She ensures that the staff team are well trained. Since the last key inspection in May 2006, she has worked hard to improve the service, and the outcomes for people who use the service. Residents and visitors spoke positively of the manager. A person living in the home said, “ the manager comes and asks how she is”. Visitors spoke of always being kept informed about any changes in their relative’s health and other needs. The manager has put in place a time during a weekday evening when she is available by appointment for talking to visitors and others. This information has been advertised in the Coplands newsletter. The inspectors were supplied with a copy of this newsletter which indicated involvement in it from people using the service. This is commendable. The home has a quality assurance policy/procedure. Arrangements are in place to ensure that the quality of the service is monitored. The provider has established arrangements for monitoring the performance and practice of the home, which includes gaining feedback from residents and from other stakeholders. The service has sound policies and procedures, which are regularly reviewed, and systems are in place to monitor staff adherence to policies and procedures during their practice. Staff meetings are held regularly, and recently the manager has organised the commencement of ‘Committee’ meetings. The first ‘Committee’ meeting was held this month and included six service users, the two chefs, several staff including the manager and an activities co-ordinator. Records confirmed that several issues in regard to the service were discussed, and goals were agreed to ensure that improvements to the service were carried out. Another meeting is planned to take place in August. This is positive, and indicates that the views of people using the service are valued and listened too. There should be ‘resident’ meetings held on each unit particularly in regard to those who are unable or do not wish to join the ‘Committee’ meeting. This was discussed with the manager who agreed that this could benefit people using the service. The care home has policies in regard to the management of service users monies. Care plans inspected included assessment information of resident’s Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 27 finances, and indicated that people living in the care home receive varying levels of support in regards to the management of their finances. Several residents’ relatives manage their monies, but all residents have access to some cash. Personal allowances are managed by from the Head Office. An administration staff member in the care home has the responsibility for ensuring that resident’s monetary transactions including all expenditure is recorded. People living in the care home have access to recorded statements of their monies including ingoing monies and expenditure, including a record of their benefits and allowances. Examples of expenditure included hairdressing appointments, and the purchase of newspapers. It was evident that it was a significant and constant role managing all the residents’ monies. It is recommended that the possible need for support in carrying out this role is kept under review. It was not clear from records inspected that people using the service receive entitled bank financial ‘interest’ on their financial accounts. Staff confirmed that they received regular 1-1 supervision, and feel supported. The care home has health and safety policies and procedures, including an accident reporting procedure. Accidents are recorded and monitored. Health and safety checks are carried out regularly in the home, and monitored by the organisation. These included wheelchair checks, and servicing of the passenger lifts and of moving and handling equipment. It was evident that staff receive training in health and safety. Records confirmed that a health and safety staff meeting took place in July 2007. Certificates of worthiness of the electrical and gas systems were available for inspection and up to date. A water chlorination check had been carried out recently. Hot and cold water temperatures are monitored. Required fire safety checks are carried out, and fire drills, and fire training take place regularly. The home has a fire risk assessment. Records confirmed that risk assessments in regard to safe working practices were in place and accessible. The employer’s liability insurance certificate was displayed and up to date. Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 28 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 ENVIRONMENT CHOICE OF HOME Standard No Score 1 2 3 4 5 6 Standard No 19 20 21 22 23 24 25 26 Score 3 X 3 X X 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 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? NO 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 OP7 Regulation 12(1), 14 (1)(2) Requirement Three care plans inspected by the lead inspector need to be further developed to include guidance to meet a resident’s diabetic needs, a resident’s depression needs, and a resident’s specific language needs. Staff need to ensure that records are maintained and are up to date for all people using the service who need their fluid intake and output monitored. Specialist feeding equipment must not be stored in residents’ rooms, more suitable storage facilities must be found. The home must replace the missing soap dispenser in the bathroom on Owl unit. There needs to be evidence that people using the service receive entitled bank financial ‘interest’ on their monetary accounts. Timescale for action 01/09/07 2 OP8 12(1) 17 01/09/07 3 OP15 23(2)(m 01/10/07 4 5 OP19 OP35 23(2) 12 (2) 13, 17 01/09/07 01/10/07 Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 30 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 OP1 Good Practice Recommendations The registered person should seek ways of improving the accessibility of the service user guide for those residents who have difficulty reading and/or other needs which lead to difficulties in accessing information from the written word. It should be always recorded in the assessment documentation if prospective residents are unable to sign the assessment information. • Staff should continue to seek ways of ensuring that care plans are understood and accessible to all residents, including those with multiple needs, and possibly look at putting in place a summary of the care plan in pictorial format and/or in the residents first language (if they are unable to speak English). • The registered manager should provide shelving or lockable space for the storage of files and other documentation relating to people using the service. It is recommended that staff review a resident’s ‘sleepiness’ particularly in regard to their medication needs. • The format of the menus could be improved to include pictures to ensure that it is more accessible for residents who have difficulty in reading. • It is recommended that there is specific staff training, which includes risk of choking, in regard to staff giving assistance to residents with their meals. There are areas of peeling paintwork in some of the bathrooms that should be re painted. There should be ‘resident’ meetings held on each unit particularly in regard to those people using the service who are unable or do not wish to join the ‘Committee’ meeting, but who have views of the service, and who also wish to receive up to date information about the care home. 2 3 OP3 OP7 4 5 OP9 OP15 6 7 OP19 OP33 Coplands Nursing Home DS0000022924.V340823.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Harrow Area Office 4th Floor, Aspect Gate 166 College Road Harrow London HA1 1BH 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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