Inspection on 03/12/08 for Copperbeech Care Home

This inspection was carried out on 3rd December 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Copperbeech Care Home 01/08/08

Copperbeech Care Home 13/03/08

Copperbeech Care Home 11/05/07

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 29/01/2009.

CARE HOMES FOR OLDER PEOPLE Copper Beech Care Home 154 Barnhorn Road Little Common Bexhill-on-Sea East Sussex TN39 4QL Lead Inspector June Davies Unannounced Inspection 10:45 3 December 2008 rd 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.V373160.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.V373160.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 01424 843154 copperbeechemi@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 Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Copper Beech Care Home DS0000067146.V373160.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 1st August 2008 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. Parking for a number of cars is provided to the side and rear of the home. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This key unannounced inspection took place on the 3rd December 2008 over a period of 6 hours. During that time the inspector spoke with some of the residents and the manager, the deputy manager and three members of staff. A tour of the home took place and the inspector looked at all communal areas, and eight bedrooms. An audit of medication also took place. All documentation relating to the standards inspected were viewed and evidence recorded. The manager of the home has only been in post for four weeks, and through conversation it became evident that she is well aware of the many issues that need addressing to ensure that the home offers a good quality of care. Having only been employed in this home for such a short while, the manager has carried out some improvements, but has also given herself the time to assess where improvements need to be made. What the service does well: What has improved since the last inspection? A new manager has been employed in the home, and has only been in this position for four weeks. Nearly all the old staff team have left the home, and new staff, have been recruited. The inspector observed staff talking to the residents in a friendly and respectful way on the day of this inspection. The new manager has arranged for health care assessments from the multi disciplinary team to ensure that she and the staff are able to meet the residents’ needs in the home, and to provide further staff training if required. Many of the staff are now enrolled on an extended dementia care awareness training course, so that they have a better understanding of how to meet the residents’ needs. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 6 The cleanliness of the home has improved, and communal areas and residents bedrooms in the main are kept fresh and clean. The laundry area has improved beyond recognition and is now spotlessly clean, and laundress show great respect for the residents laundry. A maintenance man has been employed and health and safety checks in relation to the fire system, emergency lighting and hot water delivery are checked on a regular basis. Residents are offered a variety of choices at each mealtime. Many of the residents said that they enjoyed the food in the home. What they could do better: The new manager is aware of the issues that need addressing in the home, this includes pre-admission assessment, that must be detailed and contain information that will enable the manager in the first place to assess if the home can meet the prospective residents needs, and to be able to use the information gained at pre-admission assessment to form the basis of a care plan. Care plans needs to be simplified, to ensure that staff can easily obtain information as to how they are able to meet each individual resident’s needs. Daily reports should explain in detail all levels of care given to the residents. Medication in the home must improve to ensure that residents are not placed at risk. The manager still has to develop a quality assurance system, to ensure that she obtains the views of residents, relatives, friends, and professional visitors to the home as well as regularly monitoring systems used in the home. The monitoring of systems needs to be recorded, and this together with surveys should form the basis of an annual report as to the quality of care the home provides. When new staff are recruited into the home appropriate checks must be carried out to ensure that residents are not placed at risk of abuse. Further mandatory training needs to take place to ensure that all staff have received this training. There are still some health and safety issues that need to be addressed, in that the water system in the home must be checked for Legionella. Fire doors should have magnetic closures, to ensure that they automatically close when the fire alarm sounds. Please contact the provider for advice of actions taken in response to this Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 7 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. Copper Beech Care Home DS0000067146.V373160.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.V373160.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): Standards 3 and 6 People using this service experience adequate quality outcomes in this area. Pre-admission assessments must cover all areas of care to ensure that the needs of prospective residents can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last key inspection on 1st August 2008 there have been no new residents admitted to Copper Beech care home. From two care plans viewed at this inspection, the information contained within the pre-admission assessment was minimal and did not provide sufficient evidence on which to base a resident’s care plan. The format of the pre-admission assessment needs to be updated to ensure that all areas of personal, health and social care are covered, and that the manager is able to gain sufficient evidence to ensure Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 10 that the home can meet the residents needs. The format for this preadmission assessment needs to comply with 3.3 of the National Minimum Standards. Discussion took place between the new manager and inspector, and the manager agreed that a new pre-admission format would be produced to cover all areas of care. A recommendation has been made, that future preadmission assessments will comply with 3.3 of the National Minimum Standards. The home does not offer intermediate care. Copper Beech Care Home DS0000067146.V373160.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): Standards 7, 8, 9 and 10 People using this service experience adequate quality outcomes in this area. While there is care planning system in place at the present time it is very complicated and does not provide staff with good or immediate information as to how they can appropriately meet individual resident’s needs. The health care needs of residents have been re-assessed by external health care professionals to ensure that the home will be able to continue to meet residents’ individual needs. The systems for medication administration are poor and potentially place residents at risk. Personal care is offered in a way to protect residents’ privacy and dignity and promote independence. This judgement has been made using available evidence including a visit to this service. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 12 EVIDENCE: At the present time the residents care plans do not easily provide staff who work in the home, with the knowledge they need to provide individual care for each resident. The new manager was able to show the inspector one care plan which she envisaged using in the future for all residents, this provided detail information, in a much shorter format, and would be much more user friendly for care staff to use. There was evidence in each care plan that they had been reviewed on a regular basis. It was noted however that residents and or their relatives/representatives do not sign up to plans of care or to changes made at reviews. A recommendation is being made that all residents have plan of care produced that enables staff to use this plan of care as a working tool, and enable staff to provide individualised care for each resident. A requirement is being made that each resident and or their relative/representative sign up to the plan of care and to any review of this care plan in the future. Each care plan contains risk assessments in relation to mobility and tissue viability. It was noted however that while there were written permissions from relatives for two residents to have cot sides used on their beds, there were no permission signed by health care professionals. This was discussed with the manager who stated that she will produce a permissions letter with space for signatures from relatives, and relevant health care professionals. The new manager has been in post for four weeks and has had all residents assessed by their, General Practitioner, Mental Health Care Team, the continence nurse, chiropodist, optician and the dentist, evidence of these reviews are written up in residents daily notes. The manager is also in the process of contacting the ‘Falls Team,’ to ascertain what further help can be given to residents who fall on a regular basis. There is no evidence in daily notes as to what personal hygiene tasks care staff have assisted residents’ with, and therefore there is no record of when residents have had assistance with teeth or dentures, nails, hair washing, shaving etc. One resident in the home has developed a grade one-pressure area, which has been reported to the district nurse, who has provided the resident with pressure relieving equipment including an airflow mattress. Residents’ are now weighed on a regular basis to ensure their nutritional levels are maintained, and any concerns will be reported directly to the residents General Practitioner. There is no daily exercise programme for residents in the home at the present time, but ‘Motivation & Co.,’ an external company come into the home each fortnight to provide exercise and activities for the residents who wish to participate. The inspector carried out an audit of medication and found areas of concern, in regard to the receipt, recording, handling and administration of medication. While the manager stated that the pharmacy supplier would change for the coming month, the mistakes that had occurred over the period of Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 13 November/December 2008 were staff errors. The inspector noted that the Monthly Administration Records had ‘Tippex’ used on them, that they were not always initialled by staff when medication had be administered. In two instances, bubble packs containing medication had tablets removed ad hoc, and not on the day appropriate to the administration, in these two instances there were also too many tablets remaining in blister pack. When medication had been received into the home in many instances this had not been recorded onto the Monthly Administration Record. One bottle of eye drops was out of date from the day of opening, but it was noted that the opening date had been recorded on the box and not on the bottle. The medication policy and procedure has not been reviewed for some time, and there was no guidance for staff in relation to PRN (as required) medication. The medication policy and procedure was not easily available to staff. There was no list of medicationtrained staff, together with their signatures and initials. At the present time the home does not use controlled drugs. An Immediate Requirement was made in relation to medication, and a referral made for a pharmacy inspection to be carried out at Copper Beech Care Home. During the course of this inspection staff were observed promoting the privacy and dignity of the residents, and communicating with them in a friendly and respectful manner. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 14 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 using this service experience good quality outcomes in this area. A variety of activities are on offer to residents, both internally and from external professionals, to meet the residents’ social needs. Links with the community are good, and visitors are welcome into the home at any time. The meals in the home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are offered flexibility in the daily lives, and are able to get up and go to bed as and when they want to. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 15 On the day of the inspection the inspector observed staff sitting with residents playing games and communicating with residents on a one to one basis. There was evidence in the home that a variety of activities are on offer to the residents. The home employs an activities co-ordinator who works in this role on a part-time basis. The activities on offer are relevant to the social needs of the residents. Outside entertainers are also brought into the home, Motivation & Co, who provide activities to residents on a fortnightly basis, a Magic Show has been arranged for the 7th December 2008, a Private Theatre group is also visiting the home on the 5th December 2008 to present a pantomime to the residents. The local church choir is to visit the home nearer Christmas to sing to the residents. There was evidence within the daily reports that residents go for walks in the community accompanied by members of staff. Visitors are welcome to visit the residents at any time, and are welcomed by staff when they visit. None of the residents’ presently living in the home are able to manage their own personal finances, and have made arrangements for relatives or their representatives to act as powers of attorney on their behalf. During a tour of the home the inspector noted that residents are able to personalise their own bedrooms, with items of furniture, pictures, photographs and ornaments which they bring in from their own homes. Residents’ are able to have access to their own personal records as and when they wish to. As mentioned previously care plans as they are at present would be very difficult for residents to understand. The home has recently employed a new cook, who is in the process of ensuring that all meals offer an appealing and nutritious diet to the residents. The manager has on order a baine-marie that will have Perspex tops so that residents are able to choose what food they would like at the time of the meal. The manager is also considering introducing pictorial menus, which would be more relevant for residents suffering with dementia. Drinks are offered throughout the day with snacks available if required. The chef is able to cater for specialised diets as and when required. At the present time only diabetic diets are catered for. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 16 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 using this service experience adequate quality outcomes in this area. Residents and visitors know their complaint will be listened to and acted upon. Staff have good knowledge of Safeguarding Vulnerable Adults issues, which protects the residents’ from abuse, but further improvements need to be made in regard to employing new members of staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedure is up to date and displayed in the home. There have been no complaints to the home since the last inspection. From conversation with the new manager, it is evident that she is aware that all complaints must be recorded, that an investigation into the complaint takes place, and that all correspondence or verbal feedback to the complaint is recorded, and that this evidence is kept within the complaints file. There have been two separate safeguarding vulnerable adults alerts, in relation to the home since the last key inspection in August 2008. These occurred prior to the employment of the new manager, one alert is still open pending police action. All staff presently employed by the home have received Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 17 Safeguarding Vulnerable Adults training. While all new staff undergo the appropriate employment checks, there was evidence the Protection of Vulnerable Adults Register checks take place after the employee has taken up employment in the home. Staff do not deal with any of the residents financial affairs, and there are clear policies and procedures in place in regard to this. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 18 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 and 26 People using this service experience good quality outcomes in this area. The standard of the environment within the home is good, with some minor improvements that need to be made to ensure the residents have a safe place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Copper Beech Care Home offers comfortable, well-presented accommodation for its residents. During a tour of the building the inspector noted that all areas of the home were clean, and well maintained. The communal areas are bright and well furnished, with some leather sofas and higher fire side chairs. All furniture in the home is domestic in style. It was noted that in some of the Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 19 communal toilets handrails are not well positioned and would be of little assistance to residents trying to use them. Some of the call bell cords in ensuite facilities and in communal toilets are rather short and would not be within reach should a resident fall onto the floor. In some of the bedrooms the inspector noted that call bell cords had been placed behind the beds, and it is important that staff ensure that all call bells are available to residents at all times. At the present time there is clearance work taking place in the back garden of the home, where a new extension to the building is planned. Further work is also due to take place within the main home to refurbish some of the bedrooms, it would be wise for the registered provider to request an occupational health visit, to ensure that handrails are situated in an appropriate place and to ascertain what other mobility aids would be needed for frail elderly residents prior to this work taking place. At the present time residents do not have a secure usable outside garden area that they are able to use at will. The stair and hall carpet is in a poor state of repair and does need to be replaced to ensure that both residents and staff can use this area safely. The home is generally free from offensive odours. It was noted that in two bedrooms there was a slight offensive odour, and the manager is in the process of addressing this. She has arranged for those residents with continence problems to be assessed and is seeking advice from the continence nurse. The laundry room has improved out of recognition from the last key inspection. A new laundry assistant has been employed and she has completely blitzed the laundry area, which is now immaculately clean and well ordered. All linen in the laundry storeroom is arranged into neat piles. Residents clothing is well presented. There is a supply of liquid soap and paper hand towels in the laundry room and communal toilets. Communal bathroom have dispensers for plastic aprons and disposable gloves in place. Foul laundry is placed into red alginate bags and placed directly into the industrial washing machine. Clinical waste bins are situated in all the communal bathrooms, and there is evidence that these are emptied on a regular basis. The manager has applied to a training agency to carry out infection control training for all staff employed in the home. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 20 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 using this service experience adequate quality outcomes in this area. Staff morale in the home has improved resulting in an enthusiastic workforce that works positively with the residents. Staff are multi skilled ensuring a good quality of care and support. Recruitment policies have not been consistently followed resulting in residents receiving care from staff that have not been appropriately vetted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the present time there are eight residents residing in Copper Beech Care Home. There has been a high turnover of staff since the last manager left the home, but newly recruited staff are happy in their jobs. Staffing levels are good with three care staff on the daytime shift plus the manager or deputy manager and on the night shift there are two waking night staff, with either the manager or deputy manager on call. The deputy manager provides a managerial presence in the home at weekends. There are sufficient ancillary staff employed in the home, one domestic, one cook (with Deputy Manager Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 21 cooking at weekends), a maintenance person and a laundry assistant. All care staff with the exception of one has an NVQ qualification. All of the staff have undertaken a one-day Dementia Care training course. Ten staff have now been enrolled on National Further Certificate in Dementia Awareness, this is a longer course and will give staff more insight into working with dementia care residents. The inspector looked at two staff personnel files. These staff had been recently recruited to work in the home. It was noted that Protection of Vulnerable Adults Register checks had been applied for after the starting date, and while Criminal Records Bureau checks had been applied for prior to employment these had not been received until after the start of employment. In one file there were two references addressed ‘To Whom it may Concern’, and the manager had not followed these up, the same file did not have any form of identification. A requirement is being made that all staff employed by the home must have the relevant checks carried out prior to employment, this include Protection of Vulnerable Adults Register check, two current references addressed to the manager, and at least two forms of identification. There was evidence on file of previous current mandatory training. The manager has arranged mandatory training for some staff in the home and further mandatory training is due to take place to ensure that all staff employed in the home had undergone mandatory training or will be updating their mandatory training. It was noted that further training booked is Moving and Handling, Fire Safety, Food Hygiene and Infection Control. The manager and one carer are also booked onto the Moving and Handling diploma course. All staff receive the General Social Care Council code of conduct. Induction training at the present time is just a general induction to the practices and systems used in the home, and the manager is in the process of initiating ‘Skills for Care’ induction for all new care staff. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 22 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 using this service experience good quality outcomes in this area. The manager has a good understanding of the areas in which the home need to improve. A good quality assurance system needs to be put in place to ensure that residents are offered the best quality of care. Systems are in place to ensure that staff are regularly supervised, and that they have the knowledge and understanding of the homes policies and procedures and the National Minimum Standards, to provide a high quality of care to the residents’ living in the home. Some improvements still needs to be made in relation to health and safety in the home, to ensure that the residents live and staff work in a safe environment. This judgement has been made using available evidence including a visit to Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 23 this service. EVIDENCE: There is a new manager in post at Copper Beech Care Home, she has only been employed for four weeks in the home, and recognises that she has a lot of work to do to ensure that the home provides a good quality service in line with the National Minimum Standards. This new manager has a good range of qualifications, which include Level 2 Mental Health Nurse, NVQ level 4, Leadership and Management Level 3, and D32 and D33 assessor’s awards. At the present time she is in the process of studying for a Leadership and Management Certificate. The manager has 8 years experience at management level within a residential care and nursing home setting. On the day of the inspection the inspector noted that the manager is approachable by both residents and staff. The manager recognises that her workload at the present time is heavy, and she is in need of some administrative help to ensure that paperwork is filed correctly, and new paperwork formats are put into place and electronically stored. The new manager is in the process of applying to be registered by CSCI. At present the home does not have a full quality assurance system in place, and the new manager recognises the quality of care throughout the home does need to be monitored and an annual report produced in the relation to quality assurance of the home. The registered provider employs a consultant to carry out regulation 26 visits to the home on his behalf on a monthly basis. The inspector was able to view regulation 26 visit reports and found them to be comprehensive and written in detail. At present there is an outstanding requirement for an appropriate quality assurance system to be produced by the home, but the manager has only been in post for four weeks, and it is not appropriate that she should have produced a workable system at this point in time. There was lengthy discussion between the manager and inspector, and the inspector is satisfied, that while the requirement still stands that the manager has a good understanding of quality assurance documentation, in that she not only needs to carry out surveys, to include the residents, relatives, visitors and professional visitors to the home, but that she also needs to monitor and record the progress of systems used in the home. The home does not manager any of the residents’ personal allowances. Where a resident requests that he/she would like to make a purchase, this is done on their behalf by the home from their petty cash, and receipts are kept. At the Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 24 end of each month the resident’s next of kin is billed for the purchases that have been made and proof of purchase is enclosed. The manager has not as yet supervised any of the staff, but showed the inspector her plans to start carrying out supervision, starting this month. The inspector was able to evidence via the fire safety book that now regular weekly checks of the fire system and emergency lighting take place. At the time of the inspection the manager and deputy manager were not able to show evidence that hot water outlets in the home are regularly checked. During a tour of the building the inspector did note that the maintenance person was checking on hot water system in the home, and it is expected that at the next inspection a record of these checks will be available as evidence. There was no certificate available at the time of this inspection to show that a Legionella check had been carried out on the water systems in the home, and a requirement is being made that water systems must be checked for Legionella. All appliances used in the home have up to date maintenance certificates. The registered provider has ensured that Water Regulations are met, and an inspection has been carried out in relation to this. The home also has a pest control contract, and the company maintains bate boxes at regular intervals. The inspector did note that magnetic closing devices, to ensure that if the fire alarm did sound, that these doors would close automatically, are not in place on fire doors. The manager ensures that the accident book is kept up to date and she regularly monitors accident to residents. She has contacted the ‘Falls clinic’ to obtain advice as to how the occurrence of falls can be reduced in the home. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 25 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 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 2 3 X X 2 X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 2 Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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) (a)(c)(d) Requirement Timescale for action 28/01/09 2. OP9 13 (2) (4) (c) The registered manager must ensure that care plans and reviews are recorded in a style accessible to the resident. That the resident and or their relative/representative sign up to this plan of care. The registered person shall make 10/12/08 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person shall ensure that unnecessary risks to the health or safety of residents are identified and so far as possible eliminated. This is an IMMEDIATE Requirement. The registered person must 28/01/09 ensure that new employees are appropriately checked prior to taking up employment in the home. The registered person must receive – proof of identity, details of any criminal offences, two written references, with one reference relating to the person’s DS0000067146.V373160.R01.S.doc Version 5.2 3. OP29 19 (1)(a) (b)(c) (2)(3)(4) (5) Schedule 2 (1-9) Copper Beech Care Home Page 27 4. OP33 24 last period of employment. A full employment history together with a satisfactory written explanation of any gaps in employment. An effective quality assurance 04/02/09 and monitoring system to be developed and introduce to assess the efficacy of services provided for residents. The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety and that unnecessary risk to the health and safety of residents are identified and so far as possible eliminated. This applies to the risk of Legionella, and fire doors closing when the fire alarm sounds. 28/01/09 5. OP38 13 (4) (a)(c) 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 OP3 Good Practice Recommendations The manager to produce a new format for pre-admission assessments to ensure that all the personal, health and social care needs are covered as required by National Minimum Standards 3.3. This is to ensure that all care needs are assessed prior to admission for the manager to ascertain if the staff have the knowledge and skills to meet the prospective residents needs. The care plan should be produced in a user friendly format to ensure that care staff are able to provide individualised care for each resident. All aspects of personal hygiene should be recorded. Guidance states: Daily records are a good source of DS0000067146.V373160.R01.S.doc Version 5.2 Page 28 2. 3. OP7 OP8 Copper Beech Care Home 4. 5. OP19 OP22 6. 7. OP30 OP38 evidence to show that care is being provided, as detailed in the care plan, however the term ‘All care given’ is not helpful or adequate. Daily records when well written, help ensure a consistent approach and good quality of care for residents. Detailed daily records will help the manager to audit the care being provided to residents, and ensure that staff are following the guidelines in the care plans. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review. The registered provider must consider renewing the corridor and stair carpet to ensure that residents and staff are not put at risk of trips or falls. All call bells should be accessible to the resident in the home this includes bedrooms, communal toilets and ensuite facilities. It would be useful to the registered provider to obtain an occupational health assessment of the aids available within the home to ensure that there are sufficient usable aids available for frail elderly residents to use. The manager must ensure that all staff employed in the home receive mandatory training in Moving and Handling, Fire Safety, Food Hygiene, First Aid and Infection Control. It would be good practice to ask for a Fire Safety Officer visit to the home to give guidance on fire safety to ensure the health and safety of the residents. Copper Beech Care Home DS0000067146.V373160.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone 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.V373160.R01.S.doc Version 5.2 Page 30 - 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. 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