Inspection on 11/05/07 for Copperbeech Care Home

This inspection was carried out on 11th May 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

Copperbeech Care Home 03/12/08

Copperbeech Care Home 01/08/08

Copperbeech Care Home 13/03/08

Copperbeech Care Home 13/02/07

Similar services:

Deepdene Care Centre

Ferndale Residential Care Home

David Gresham House

Elizabeth House

Elvy Court Nursing Home

Fontenay Nursing Home

Clairmont Residential Home

Cornford House

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

CARE HOMES FOR OLDER PEOPLE Copper Beech Care Home 154 Barnhorn Road Little Common Bexhill-on-Sea East Sussex TN39 4QL Lead Inspector Kathy Flynn Key Unannounced Inspection 11th May 2007 11:00 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 Copper Beech Care Home DS0000067146.V337171.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. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Copper Beech Care Home Address 154 Barnhorn Road Little Common Bexhill-on-Sea East Sussex TN39 4QL 01424 842770 01242 842770 copperbeachemi@btconnect.com 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) Meeraraj Limited Ms Clare Vilma Sobhanieh Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users should be aged sixty-five (65) years or over on admission. The maximum number of service users to be accommodated is twenty (20). Only service users with a dementia type illness to be accommodated. Date of last inspection 13th February 2007 Brief Description of the Service: Copper Beech Care Home is registered to provide personal care for up to 20 older people with a dementia type illness. It is situated in a residential area on the main road into Little Common, which is on the outskirts of Bexhill-on-Sea. The home provides single accommodation on two floors, and residents are encouraged to personalise their own bedrooms with small pieces of furniture and ornaments. The communal space on the ground floor offers residents comfortable and attractive rooms, with the lounge/dining room large enough to be used for group activities. A shaft lift enables residents to have access to all parts of the building safely, and hoists are available if required for staff to assist residents. There is an attractive garden to the front that residents can use safely when weather permits. Parking for a number of cars is provided to the side and rear of the home. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection that was carried out on the 11th May and took place over seven hours. The inspection included a tour of the home, a review of pre-admission assessments, care plans, accident records, staff records and training, medication records, activities, policies and procedures and menus. There were 11 residents at the home during the inspection and all of them were spoken with. The manager and the staff on duty discussed the care and support they provide at the home. The Annual Quality Assurance Assessment (AQAA) was sent to the home prior to the inspection, but the home did not receive this and the manager has downloaded it off the internet. It is a new assessment format and will take time to complete, therefore the manager will send it to the Commission when completed. The reader should aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 use the term service user to describe those living in care home settings. However for the purposes of this report those living at Copper Beech will be referred to as residents. What the service does well: What has improved since the last inspection? Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 6 The requirements listed on the previous inspection report have been addressed. Systems are in place to ensure medication is recorded appropriately. The kitchen floor has been replaced. The manager follows robust recruitment procedure and obtains two references prior to employing staff. Mandatory training is provided for all staff and appropriate dementia care training has been arranged. The hot water to residents rooms is checked regularly and is provided at approximately 43°c. A number of improvements have been made to the internal environment of the home, and the plan is to refurbish and redecorate of all the rooms. What they could do better: 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 Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 8 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 Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 9 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): 3. Standard 6 is not applicable. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Pre admission assessments are completed for all prospective residents to ensure the home can meet their needs. EVIDENCE: The manager confirmed that preadmission assessments are completed for all prospective residents before they are offered a room at the home. These are completed with the involvement of relatives and health professionals if appropriate. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 10 The format for the assessment has been reviewed and includes information about the prospective residents past medical and social history, health and support needs, mobility and interests. Six were viewed and found to include a range of information, which can be used as the basis for the care plans. Those completed after the introduction of the new assessment form were clearly more informative. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9 and 10. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care planning system provides basic information to enable staff to offer support and care, and residents are protected by staff following the homes policies regarding medication. EVIDENCE: The care planning system is currently being reviewed and the information recorded in the care plan is to be changed to enable a system of ‘person centred care planning’ to be introduced. This will enable staff to have a clear understanding of the individual needs of each of the residents, to ensure they are offered appropriate support, as well as opportunities to be involved in receiving the care they want. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 12 The manager is planning to develop this system from the information recorded in the residents life story, which will include details of their personal and work history, likes and dislikes, spiritual needs, as well as their health and support needs. Staff will be starting to complete these for new residents to the home in the next few weeks with information collected from as many sources as possible. The manager agrees that this is a large undertaking and additional staff training will be required to ensure both night and day staff understand this move towards individual based support. Until this process has been completed for all residents at the home the current care plans will be in use and these will need to be kept up to date and correct. Those examined on the day had varying levels of information and some assessments were not completed for the residents, including moving and handling. Records showed that residents are not weighed on a regular basis and there is no evidence that any action is taken if residents lose or gain weight or that nutritional assessments were completed in line with any changes. The manager advised that the scales may need calibrating and she will be organising this as a matter of urgency. Overall the care plans did not reflect all the support needs of residents. Residents are registered with GP’s and the home has good links with the District Nurse (DN) and the Diabetic nurse. The DN has provided appropriate pressure relieving mattresses to prevent pressure damage for those at risk and training for staff to enable them to give insulin for residents with diabetes. Referrals to allied health professionals, including the continence nurse, community psychiatric nurse and chiropodist, can be arranged if required. Policies and procedures for the receipt, storage and administration of medicines are in place. Training has been provided by a local pharmacist for staff and those spoken with have completed the training and are aware of their responsibilities. The Medicine Administration Record (MAR) charts were viewed and found to be appropriately completed. The manager confirmed that the requirements listed in the previous report concerning receipt of medicines to the home, and the administration of controlled drugs, have been addressed. Communication between residents and staff was friendly and first names were used. However the use of gloves and aprons when assisting residents to the toilet from the lounge or helping them sit up straighter in chairs when in the lounge was inappropriate. This does not follow the homes policies for the use of gloves and aprons and fails to treat residents equally and does not protect their dignity. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14 and 15. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Activities are provided for residents however they may not organised on the basis of the residents preferences and choices. The food is good at the home, offering residents choices and meeting special dietary needs. EVIDENCE: A programme of activities has been developed to offer a varied selection for residents on a daily basis. On the day of the inspection the staff who organise and provide the activities were on holiday, and the manager said the staff on duty cover for them at these times. The activity listed was a musical session and CDs were playing in the lounge/diner and residents were sitting around the room. However the music was modern, the residents were clearly not interested, and the staff were standing together chatting. The manager organised appropriate music for the residents who then joined in singing along and dancing to the tunes with staff. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 14 Afternoon tea and coffee was brought in with cakes for residents during this period. A number of residents were asked to sit at the table for this. One resident asked to remain in her armchair and was told by staff that there was no table to put her drink on so she should sit at the table. Staff did arrange a table when asked so that she could sit where she chose. The manager said there are difficulties at the moment, because the small tables purchased for residents to use for hot drinks are not safe because some residents have been sitting on them. This apparently is an ongoing problem, and the discussion identified that suitable tables should be purchased so that they are strong enough to support seated residents, and can also be used by other residents when they wish to sit in the armchair to have a drink. Visitors are welcome to the home at any time and the relative visiting at lunchtime said that the support provided is satisfactory, although the resident has only lived there for a short period. The manager and staff said that residents are able to make choices about all aspects of their day. But observations during the inspection noted that staff were directing residents rather than offering alternatives. The manager advised that additional training will be provided for all staff, linked to the person centred care planning that is being introduced. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 15 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): 16 and 18. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place for dealing with complaints, and training in protecting vulnerable adults is provided for staff to protect residents. EVIDENCE: The manager confirmed that policies and procedures for dealing with complaints are in place. They have been included in the Statement of Purpose and Service Users Guide, and details have been placed near the front door. There have been no complaints about the services provided at Copper Beech, to the home or to the Commission. The manager advised that there have been a number of positive comments about the improvements that have been made to the home since the new owners took over. Training in adult protection is provided for all staff at the home. Those spoken with said they had attended and were able to demonstrate an understanding of abuse and neglect and what action they should take if they have any concerns. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 16 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): 19 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A number of improvements have been made to the internal environment of Copper Beech and the home offers residents a comfortable and homely place to live. Training in infection control is provided for staff to protect residents, however staff were not following the homes policies regarding the use of gloves and aprons. EVIDENCE: There is sufficient communal space in the home, a lounge/dining room, a smaller lounge, and a separate dining room are available for residents to use. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 17 These have been refurbished and redecorated, with new carpets, curtains and furniture. The layout of the lounge/dining room enables residents to choose whether they want to sit in front of the TV or not, and the dining tables are available for use throughout the day. The room is large enough to be used for activities and a music session was provided during the inspection. Some of the residents rooms have also been refurbished and redecorated and residents are able to personalise them with their own possessions. It was noted in some rooms that the commodes were rusty and chipped, and bed tables were worn, with the veneer peeling. Therefore they are difficult to clean and residents would not be protected from infection. The manager said that these would be replaced as soon as possible. The manager advised that the improvement plan involves refurbishing the whole of the building, and a planning application has been put forward to extend the building to the rear. As part of the building process the rear garden will be improved, a patio area with a seating area will be provided for residents, and she hopes to arrange barbecues and outside entertainment when this has been completed. There is an ongoing maintenance program for the home and the maintenance person is available to carry out necessary repairs when they are identified. The manager confirmed that the hot water in residents rooms is checked on a regular basis, and is provided at 43°c to protect residents. Training in infection control is provided for all staff. Those spoken with were able to discuss the correct use of gloves and aprons, although they were observed using them incorrectly during the inspection. The manager advised that the training will be repeated and any subsequent problems will be discussed during supervision. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures protect residents, and staff training ensures they are aware of their roles and are able to provide the support and care the residents need. EVIDENCE: The home has robust recruitment procedures, which require completed application forms, two references and Protection of Vulnerable Adults (POVA) and Criminal Registration Bureau (CRB) checks. The four examined during the inspection had all the relevant information. A training programme has been developed for 2007. The deputy manager advised that all staff are required to attend mandatory training, which includes first aid, fire training, moving and handling and adult protection. Five staff have attended a training session on dementia and the manager is arranging further training for staff to have a better understanding of the needs of the residents at Copper Beech. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 19 All new staff are required to complete induction training, in line with Skills for Care. A number of staff are working towards National Vocational Qualifications (NVQ) and others will be starting the course when these have completed. Staff spoken with said the training opportunities at the home are good and they are well supported by the manager. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management style at the home is open and encourages residents and their relatives to be involved in developing the services offered, however some of the health and safety practices at the home may not protect residents. EVIDENCE: The management approach at the home is open and encourages residents, relatives and staff to be involved in developing the services offered. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 21 A quality assurance and monitoring system is being developed at the home and will include feedback from residents, relatives and health professionals, with the results published in the Statement of Purpose and available for visitors to the home to view. The home is not responsible for residents finances, support is provided by relatives or representatives, and extra payments including the chiropodist and the hairdresser are made by the home with costs added monthly to the fees. In addition to daily supervision, as part of the ongoing management of the home, formal supervision is being developed, some of the staff spoken with said this gives them an opportunity to discuss their work, any concerns they might have and opportunities for professional development. The staff said the management of the home is good, they feel they are well supported and are able to discuss any aspect of the care and support they provide for residents, as there is an open door policy at the home. The policies and procedures have been reviewed and updated, these are available for staff to refer to. Health and safety checks, including relevant risk assessments, are completed on a regular basis, and the manager confirmed that appropriate certificates are up to date, including electrical systems and fire safety. Staff training required by legislation is provided for staff, this includes moving and handling, fire training, first aid, food hygiene and infection control. However staff were not following the homes policies for the use of gloves and aprons for the control of infection, and staff used an inappropriate lift when assisting a resident to sit up in a chair. Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 22 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 CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 2 X 3 X X 2 Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 23 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 15(1)(2) Requirement Timescale for action 06/08/07 2 OP14 12(2) 3 OP38 OP26 13(3) 4 OP38 13(5) The care planning system is to include current information regarding the assessed needs of residents to enable staff to offer appropriate care and support. Staff are to provide support and 15/06/07 care for residents in such a way that they are encouraged to make choices about all aspects of their day to day lives. Training in infection control to be 15/06/07 reviewed to ensure staff protect residents by following the homes policies. Training in moving and handling 15/06/07 to be reviewed to ensure staff protect residents by following the homes policies. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 24 Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Copper Beech Care Home DS0000067146.V337171.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!