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Inspection on 13/12/05 for Copper Beeches Nursing Home

Also see our care home review for Copper Beeches Nursing Home for more information

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Many residents were spoken to and all who were able to do so confirmed that the staff are very caring and kind to them at all times. The inspector noted that staff spoke to the residents in a respectful and courteous manner. Evidence gathered during the inspection process confirmed that the service user has the benefit of living in a home which is suitable for his needs and provides a homely environment.

What has improved since the last inspection?

In respect of the standards inspected no improvement was noted.

What the care home could do better:

The following areas have been identified as needing to be addressed. Statutory Requirements were included within the report to address shortfalls with regard to training, medication and lack of a Registered Manager.

CARE HOMES FOR OLDER PEOPLE Copper Beeches Nursing Home 5 Sylewood Close Cookham Wood Rochester Kent ME1 3LL Lead Inspector Robert Pettiford Announced Inspection 13th December 2005 09:30 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 Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 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 Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Copper Beeches Nursing Home Address 5 Sylewood Close Cookham Wood Rochester Kent ME1 3LL 01634 817858 01634 817855 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) Southern Cross Healthcare (SE) Limited Care Home 42 Category(ies) of Dementia - over 65 years of age (31), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12) Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May not admit patients detained under Sections of the Mental Health Act 22nd August 2005 Date of last inspection Brief Description of the Service: Copper Beeches is managed on a day-to-day basis by Southern Cross Healthcare (SE) Limited. The home is currently registered for people who have Dementia and have been assessed as having additional nursing care needs. The home is situated on the outskirts of Rochester close to local amenities and public transport. The building is a modern detached property which has amply parking Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection at Copper Beeches took place on 13th December 2005 at 9:30AM The Inspector agreed and explained the inspection process with the Manager. Documentation and records were read. A tour of premises was also undertaken. The focus of the inspection was to assess Copper Beeches in accordance to the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? 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 contacting your local CSCI office. Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 6 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 Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. EVIDENCE: Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Service users benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Service users also benefit from being treated with respect and their dignity and their independence is promoted. Health needs are met and residents benefit from having full access to all professional health care services as required. The service users’ welfare is not always protected from harm by the home’s policy and procedures with regard to the administration and dispensing of medication. EVIDENCE: Several care plans were read and found to be comprehensive and contain good detail. The home has recently changed it system of care planning. Therefore it was acknowledged that further updating was required. Care plans contained a full client profile along with admissions assessments and contact details for relatives along with physical and social assessments. The home has in place very detailed systems of assessment and screening tools which include Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 9 pressure areas, dependency, moving and handling, nutritional, malnutrition, continence, falls risk review and client reviews. The home was requested to review the daily notes contained in the care plans and eliminate the use of abbreviations to ensure that all staff fully understand what is written. It was clear from the records that the service users were all registered with a local GP and their care needs were being fully met. Access to other health professional such as Chiropodist, Opticians and District Nurses were well documented. In the medication room there was two locked mobile drugs cabinet (anchored to the wall when not I use), a small lockable fridge, and four locked purpose built cupboards for medication. A locked steel cupboard for storage of schedule 1 drugs was located within one of the locked cupboards. Controlled drugs have a separate record of numbers dispensed/remaining. Service users are not treated in the medication room the individual’s bedroom is used. The Home uses a Monitored Dosage System. The inspector viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets. Evidence was not available that service users medication is reviewed to ensure that medication given is not given unnecessarily. Shortfalls were noted with regard to ensuring that agreed lists of homely remedies are regularly reviewed along with the service users general medication. It was also not apparent at time of inspection that the medication room contained a copy of The Royal Pharmaceutical Society guidelines for the administration of medication. The manager was requested to include within the home’s action plan steps taken to ensure that the shortfalls identified are addressed. The majority of the service users were spoken with and it was very clear they all felt well cared for and were happy to live at the home. Good interaction was seen between staff and the residents and staff were seen to respect the service users dignity and privacy and used the preferred term of address for individuals. Personal care is given in a way that clients prefer allowing for preferences were possible. Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. EVIDENCE: Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Service users know that their concerns and complaints are taken seriously and that appropriate policies and procedures are in place. Service users are not fully protected from the risk of abuse due to the lack of training for some of the staff with regard to Adult protection. EVIDENCE: The inspector viewed a copy of the home’s complaints procedures. The procedure included details of how to complain, timescales for response and information for referring a complaint to the Commission for Social Care Inspection. A copy of the complaints procedure has been provided and explained to service users where possible. The inspector viewed and discussed copies of the home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training however in abuse has not been provided to the majority of staff. The inspector requested that priority be given to ensure that all staff have received Adult Protection training to protect service users from abuse. Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. EVIDENCE: Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Whist sufficient staff were seen on duty during time of inspection, service users care, social and emotional needs are not fully promoted by the employment of suitably trained staff. Service users cannot feel confident that care staff have received the basic training they need to meet their needs. Service users are protected from potential abuse by the home’s robust staff recruitment procedures. EVIDENCE: The home has a mix of management personnel, care staff, chef and kitchen assistants, laundry assistant, maintenance specialist, and housekeeping staff. A copy of the staffing roster seen indicates that rotas have been prepared for the following month. The home provides seven AM carers with 2 qualified staff and six PM carers with 2 qualified. The home has three carers and 2 qualified working nights. The rota and observations during the inspection reflected sufficient staff to support residents to participate in activities and to meet their personal needs. The manager stated that staffing levels are regularly reviewed taking account of the changing needs of residents. Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 14 Currently only 33 of care staff have an NVQ Level II in Care or above. The CSCI requirement was for 50 by the end of 2005. The manager was requested to include within the home’s action plan on how the home would achieve 50 . Staff training within Copper Beeches on evidence seen did not meet with the required standards. Shortfalls were noted with regard to basic training in the following areas. These areas include adult Protection /Abuse, Health and Safety and Dementia Care, Infection Control. The manager was requested to include training needs as a priority within the homes action plan. The home has a development programmed which the manager stated meets National Training Organisation (NTO) workforce training targets. The inspector viewed details of the home’s recruitment procedure and a number of records relating to staff members recruited. The home undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. The manager reported all staff had received statements of terms and conditions of employment, evidence of which was seen in the file. Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35,38 Whilst the quality of care offered to the service users overall is sound, it will be better promoted once a Registered Manager is appointed to run the home. Service users’ financial interests are protected by sound financial procedures with regard to their personal monies kept within the home. Service users on the whole can feel confident that their health and safety is protected. EVIDENCE: The home currently does not have a Registered Manager. The management of the home is supported by a manager who was previously the deputy manager at the home. The provider intends to put forward the manager for registration to ensure that the home meets with the Care Home Regulations 2001. Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 16 The inspector viewed several records relating to personal monies held at the home. In the records seen small amounts of money were accounted for separately. It is used by the service users for purchase of hairdressing and other small items. The home ensures that access is restricted and that it is appropriately stored in a safe. The inspector viewed records relating to Health and Safety Procedures, maintenance and servicing, and risk assessments. The inspector viewed the Fire Log book, which was up-to-date, reflecting that checks and servicing of fire safety equipment had been undertaken at the required frequency. Procedures are available for the reporting of accidents and incidents (Regulation 37). Action has been taken to minimise identified risks to service users including regulation of hot water temperatures. Some shortfalls were noted however with regard to staff training. Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 17 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 x x x x x x x x STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x 3 x x 2 Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 18 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 9 Regulation OP9 Requirement Timescale for action 31/03/06 2 18 3 28/30 13.—(2) The registered person shall make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. Regulation 17(1)(a) Schedule 3 (k) a record of all medicines kept in the care home for the service user, and the date on which they were administered to the service user; OP18 13.—(6) The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. OP30OP28 18.— (1) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users— (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate DS0000026158.V274652.R01.S.doc 31/03/06 13/06/06 Copper Beeches Nursing Home Version 5.1 Page 19 4 31 OP31 5 38 OP38 for the health and welfare of service users; (c) ensure that the persons employed by the registered person to work at the care home receive— (i) training appropriate to the work they are to perform; 9.—(1) A person shall not manage a care home unless he is fit to do so. (2) A person is not fit to manage a care home unless— (b) having regard to the size of the care home, the statement of purpose, and the number and needs of the service users— (i) he has the qualifications, skills and experience necessary for managing the care home; 12.—(1) The registered person shall ensure that the care home is conducted so as— (a) to promote and make proper provision for the health and welfare of service users; 12.—(1) The registered person shall ensure that the care home is conducted so as— (a) to promote and make proper provision for the health and welfare of service users; 12.—(1) The registered person shall ensure that the care home is conducted so as— (a) to promote and make proper provision for the health and welfare of service users; 06/03/06 06/03/06 Copper Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 20 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 Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 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 Beeches Nursing Home DS0000026158.V274652.R01.S.doc Version 5.1 Page 22 - 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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