Inspection on 13/06/07 for Copper Beeches Nursing Home

This inspection was carried out on 13th June 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

Copper Beeches Nursing Home 19/04/06

Copper Beeches Nursing Home 20/01/06

Similar services:

21 High Street

Vale House

Chestnut Walk

Dunwood Manor Nursing Home

The Old Vicarage

Excelsior

Cherwood House Care Centre

Durban House Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Copper Beeches Nursing Home Rake Liss Hants GU33 7PG Lead Inspector Marilyn Lewis Unannounced Inspection 13th June 2007 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 DS0000065931.V338737.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 Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Copper Beeches Nursing Home Address Rake Liss Hants GU33 7PG 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) (01730) 892889 01730 894435 www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Lizette Krause Care Home 40 Category(ies) of Dementia (40), Dementia - over 65 years of age registration, with number (40), Mental disorder, excluding learning of places disability or dementia (40), Mental Disorder, excluding learning disability or dementia - over 65 years of age (40) Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 55 years of age. Date of last inspection 19th April 2006 Brief Description of the Service: Copper Beeches is a care home, providing nursing care for forty service users over the age of 55 years. It is registered to accommodate service users who have a mental disorder or dementia. Copper Beeches is situated on a site with two other homes, Silver Birches and Heathmount. The home is owned by Southern Cross, a healthcare provider since 1996. The twenty-two single bedrooms, nine shared bedrooms and four communal spaces are accommodated over two floors. There is a shaft lift and a stair lift to provide access to the first floor. The home has large grounds with a secure garden area that is accessible to service users, and a large car park is available for visitors to the three homes. Copper Beeches is located in a rural area near local amenities in Liss. At the time of the visit the fees for the home ranged from £328.36 to 811.92 depending on level of care needs. . Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit to the home took place on the 13th June 2007. The inspector toured the home and talked with staff, relatives and the operations manager for the organisation. Care plans were sampled and records seen included those for medication, complaints, staff training and recruitment and fire safety checks. The registered manager was not on duty at the time of the visit and the inspector was assisted by a trained nurse and the operations manager. Information received from the registered manager and that obtained from relatives and a care manager prior to the visit, plus previous reports, was taken into account when writing this report. What the service does well: The care needs of all potential residents are assessed before admission to ensure the home can meet their care needs. Relatives are encouraged to visit to see the home and meet with staff before making a decision about a relative taking a place there. Relatives said that they had received good information about the home and felt welcome there. Care plans provide staff with good information regarding the care needs of the residents and the actions required to fully meet those needs. Advice is sought from GPs and other health professionals such as physiotherapists and occupational therapists, ensuring the health care needs of the residents are met. Relatives said that they thought the nursing care at the home was excellent. Staff treat residents with respect and talk with them in a caring and friendly manner. Residents appeared to enjoy the well- presented meals offered at lunch. Staff supported residents who needed assistance with their meals in a caring and sensitive manner. The operational manager was addressing the issue of one staff member who stood while assisting a resident with their meal. The home looked clean and welcoming. Residents have access to two lounges, an activities room and a separate dining room. Corridors in the room have been decorated to look like streets such as Market Street where small replica market stalls are fitted in the corridor. Pictures that have ‘tactile’ surfaces provide stimulation for residents are hung along the corridor walls. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 6 Residents rooms looked homely and contained many personal items such as small pieces of furniture, photographs and ornaments. Relatives said that they thought any complaints would be taken seriously and investigated quickly. The homes’ procedures for the protection of vulnerable adults were readily accessible to staff and staff had received training in the prevention of abuse. Staffing levels were sufficient to meet the needs of the residents and relatives said that staff were ‘very good’, ‘very caring’ and ‘excellent’. The registered manager is a qualified nurse who is studying for the National Vocational Qualification (NVQ) level 4 in Management. Staff and relatives said that they received good support from the registered manager. What has improved since the last inspection? What they could do better: Recording of the participation of residents in activities was not good and records seen had not been completed since April or beginning of May so it was not possible to identify whether residents had been involved in any activities. This could result in staff not being aware of the activities residents had been involved with during the day and could mean that their social and recreational needs were not being met. Records for a new staff member did not contain all the information required including confirmation that a Criminal Records Bureau (CRB) and registration with the Nursing and Midwifery Council checks had been completed. The operational manager was able to confirm with the organisations’ Human Resources department that the checks had been completed but the home could not demonstrate this at the time. Following the inspection confirmation of the checks was forwarded to the commission. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 7 During the visit a door to a room where cleaning materials were kept was left unlocked and this could have put the safety of residents who walked around the home at risk. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Copper Beeches Nursing Home DS0000065931.V338737.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 Beeches Nursing Home DS0000065931.V338737.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): 1, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential residents and their relatives are provided with good information about life at the home and are able to visit before making a decision about taking a place there. No one is admitted to the home without a care needs assessment to ensure the home can meet their care needs. The home does not provide intermediate care. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place that provide good information about life at the home including the qualifications and experience of the registered manager, the admission process and systems for obtaining information on the quality of care provided at the home. However, the documents stated that staff held NVQ level 2 or 3 in care and this suggested that all staff had obtained the qualifications. Although the home Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 10 had a high percentage of staff with the qualification not all held it and this needs to be made clear in the documents. The documents were provided for each resident and their relatives and were also available in the home. The registered manager or senior nurse visit potential residents at their homes or place of residence such as another care home, before a place at the home is confirmed. During the visit a care needs assessment is undertaken to ensure the home can meet the persons’ care needs. The assessment is in the form of a draft care plan and information obtained from relatives, doctors and other health professionals such as physiotherapists and community psychiatric nurses is included in the report. Assessments seen for four residents who had been admitted since the last inspection gave clear information about the care needs of the resident and the actions required by staff to meet those needs. A nurse said that usually it was not appropriate for potential residents to visit the home prior to admission as it could cause confusion and upset. However relatives were encouraged to visit and relatives spoken with said that they had done so. The home does not provide intermediate care and therefore standard 6 is not applicable. Copper Beeches Nursing Home DS0000065931.V338737.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information is provided in the care plans and the residents health and personal care needs are fully met. Staff treat residents with respect and protect them by adhering to the homes’ clear procedures for the safe handling of medication. EVIDENCE: Care plans were seen for four residents. The plans provided good information on the care needs of the residents including personal care, nutrition, mobility communication and behaviour. The plans had been reviewed regularly to ensure information was up to date. Detailed guidance was given for staff including how to deal with challenging behaviour. One plan stated that if the resident was showing signs of aggression staff could alleviate the situation by asking if the resident would like to take a shower or change their clothes, which were tasks they liked doing. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 12 The care plans reminded staff to encourage residents to make decisions for themselves and to support them to remain as independent as possible such as assisting people with meals when needed but allowing and encouraging them to participate perhaps with a small spoon. During the visit staff were observed asking residents what they would like such as which lounge they would like to sit in or which flavour drink would they like. Risk assessments were included in the care plans including those for moving and handling, falls, nutrition and pressure areas. Dementia assessments had also been completed for each person. Health care records seen indicated that GPs visited residents frequently and visits were also made by physiotherapist, dietician, occupational therapist and speech therapist. The inspector was shown documents completed by the tissue viability nurse who had been visiting to provide advice on the care needed for one resident, who had been admitted to the home with pressure area wounds. The tissue viability nurse had noted that the care provided had been good and the wounds were healing well. Information in the form of a survey completed by one of relatives for the commission stated that the nursing care at the home was of a very high standard with the GP readily at hand. Another relative said that wound care at the home was excellent. A nurse on duty at the time of the visit went through the homes’ medication procedures with the inspector. The home has systems in place to record and monitor medication entering the home and medicines for disposal. Individual medication records seen had been completed appropriately and medicines were stored safely. Up to date information on the medication in use at the home was readily available to staff. Only the trained nurses administered medication. Medicines kept in the fridge, such as eye drops, had been dated when opened to ensure they were discarded on the correct date. The temperature of the fridge was being monitored and recorded to ensure medication was being stored at the appropriate temperature. Controlled medicines were stored in a locked cupboard in a locked cupboard. The outer cupboard was made of wood and may not comply with the requirements for storage of controlled medicines. The nurse said that she would discuss this with the registered manager and check that it did comply with the requirements for medication cupboards in care homes. Records seen confirmed that two staff members signed when medication was administered or disposed of as unneeded. Records seen for one resident matched the amount held. Staff checked the amount of controlled medication held for each resident at each staff hand over of shift. The nurse said that she had received training in the safe handling of medicines. At the time of the visit none of the residents were self administering their medication. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 13 During the visit staff were observed to close room doors when assisting a resident with personal care and knocked on doors before entering rooms. Staff spoke to residents and visitors in a caring and friendly manner. Relatives said that staff were polite, very caring and treated the residents with respect at all times. Copper Beeches Nursing Home DS0000065931.V338737.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): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported to exercise choice over their lives and enjoy meals that are well presented. Improved recording of the residents’ participation in activities is needed, to enable staff to ensure their social and recreational care needs are being met. EVIDENCE: Information on the life history of the residents such as their family and work life, is contained in their care plans. A care manager said that staff had worked hard to find the information for her client as very little was known when the person entered the home. The home employs an activities co-ordinator who has responsibility for the activities programme provided for residents. The co-ordinator was not on duty on the day of the visit and activities arranged for residents were listening to music and watching videos. One resident sitting in the lounge asked a staff member if she would turn the television on for her. The staff member asked what channel the resident would like to watch and put it on for her. Some residents were sitting in the small Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 15 lounge listening to music. One resident wanted to sit on the floor and look at magazines and staff had put a drink within reach for her. Drinks were available for all residents and staff were encouraging them to drink, to minimise the risk of them becoming dehydrated, throughout the day. Music was playing in the room of one resident who was asleep in bed that was ‘rap’ style music and did not appear appropriate. When this was brought to the attention of a staff member she said that she did not think the resident would like the music and attempted to change the channel but was unable to do so and turned the music off. The activities programme indicated that group and one to one sessions took place. Entertainers such as musicians visited the home and a fashion show had recently been held. Notices in the home advertised a garden fete later in the summer. The home has links with local churches and services are held regularly for those who wish to attend. Visits from PAT dogs also take place regularly. A hairdresser visits the home on a weekly basis and a room has been provided for hairdressing that looks like a hair salon. Artwork was displayed around the home that provided ‘tactile’ interest for the residents. A member of staff said that most of the work had been completed by the activities co-ordinator for the residents. Records seen of the residents’ participation in activities had not been completed since March or April. Prior to this participation in activities appeared to be infrequent with gaps of weeks between activities recorded. The records were kept in a folder that was locked in a cupboard in the activities room and the information was not recorded in care plans or daily records. This meant that staff on duty later in the day could be unaware of what activities the resident had been involved with during the day. It was also not possible to confirm that the residents had participated in any activities and if they had, whether they had enjoyed the activities they had been involved in. Two relatives spoken with said that they were able to visit at any time and that staff were always welcoming. Meals are prepared in the kitchens of one of the other homes situated close by and transported to Copper Beeches by heated trolley. The meals are then served from the small kitchen in the home. The meals served were well presented and residents appeared to enjoy them. Staff supporting residents in the dining room did so in a sensitive manner, asking if they would like to try a little to see if they liked the food offered. Another staff member patiently assisted a resident who wished to eat their meal when walking up and down the corridor. Residents appeared to enjoy their meals. However, one staff member stood to assist a resident in one of the lounges and did look in a hurry for the resident to finish their meal. This was brought to the attention of the operations manager who said that this went against the Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 16 policies of the home and went to discuss this with the staff member. The operations manager said that the issue would be followed up during the staff member’s supervision sessions. Residents were offered a choice of meals for lunch that were Toad in the hole or beef casserole with new or mashed potatoes, carrots and beans, followed by fruit crumble, yoghurt or cheese and biscuits. Menus for the day were placed on the tables in the dining room but they did not provide the correct information as they stated that chicken chasseur was one of the options and not beef. Staff said that they had put out the menu for the following Wednesday in error. Information received from relatives prior to the inspection suggested that more snack food be available in the kitchen of the home so that staff could provide a light meal for residents, particularly if they had not eaten well at the main meals. This was being addressed by the registered manager who had stated in information received by the commission that more snacks would be made available between meals including a range of fruit smoothies, which the residents, if they wished, help prepare. The operations manager said that fruit and ‘finger type’ foods were also being provided during the day. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Relatives feel that any complaints will be investigated and acted upon quickly. Residents are protected by staff awareness for the protection of vulnerable adults. EVIDENCE: The home has a complaints policy which indicates who will investigate the complaint and timescales for the process. Relatives spoken with said that they thought any complaints would be taken seriously by staff and acted upon quickly. Three complaints had been recorded in the log seen. The complaints had all been dealt with quickly and feedback had been given to the complainants. The records indicated that the log was audited regularly to identify any common causes of complaint and actions were taken to address the issue. Staff had access to the homes’ procedures for the prevention of abuse including whistle blowing. Staff have received training in the protection of vulnerable adults. The registered manager has also made training in dementia awareness in the form of a course called Yesterday, Today and Tomorrow, mandatory for all staff, to ensure they are aware of the needs of the residents. Records seen indicated that the majority of staff had already attended the sessions and dates had been arranged for those still required to attend. A staff Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 18 member who had received the training said that she had found it very useful. The registered manager stated in the information received prior to the visit, that she was going to offer the training to relatives when the training for staff had been completed. There have been no adult protection investigations since the last inspection visit in April 2006. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean and homely environment for those who live, work and visit there. EVIDENCE: The home is a detached property situated in a rural location in Rake, Liss. Two other homes owned by the same organisation are located close by. Accommodation is provided over two floors with a passenger lift, a stair lift and stairs giving access to each floor. The top floor of the home is used for staff, with a training room and a rest room. The home looked clean and welcoming. Residents are accommodated in twenty-two single rooms and nine shared rooms. Nine of the single rooms and six of the double rooms are fitted with en-suite facilities. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 20 A resident spoken with said that they liked their room. Rooms seen looked homely and contained many personal items including small pieces of furniture, photographs and ornaments. A screen was provided in shared rooms to allow for privacy as wished by the residents. Residents are able to use the two lounges, an activities room and the separate dining room. A small sensory room was located alongside the activities room. Corridors in the home are given street names with items such as small market stalls placed alongside the wall of Market Street and a large mural of flowers in Tulip Street. Items to support stimulation for the residents such as tactile boards and clocks are also displayed in the home. Doors to rooms have been painted to assist residents to recognise rooms such as toilets, bathrooms and bedrooms. There are sufficient bathroom and toilet facilities for the residents and those seen looked clean and in good order. The meals for residents are prepared in one of the other homes and transported to the home by heated trolley. The kitchen in the home is used for serving the meals and for preparing snacks. Laundry from the home is taken to one of the other homes and there are no laundry facilities at Copper Beeches. The home has large well-maintained gardens that are enclosed and are accessible to residents including those who use wheelchairs. Parking is available in the car park that is shared with the other two homes situated in the same location. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 21 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 39 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient number and receive the training they require to meet the needs of the residents. Records need to confirm that all the information required for the recruitment of staff has been obtained. EVIDENCE: Comments received from relatives through surveys and during the visit indicated that they felt staff were very good. Comments included ‘the staff are marvellous’ and ‘however busy staff are they always find time for us’. At the time of the visit the home was employing the registered manager, six qualified nurses, four senior carers, seventeen carers and an activities coordinator. Separate staff were employed for administration, catering, domestic and maintenance duties. Thirty-five residents were accommodated on the day of the visit and staffing levels were two nurses and six care staff from 8am until 8pm and one nurse and three care staff at night. A staff member said that when the number of residents rose to thirty-seven and additional carer was on duty. Staff spoken with said that there were sufficient staff on duty for each shift. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 22 Eight of the care staff had obtained NVQ level 2 or above in care and three were currently studying for the qualification that provides them with the knowledge and skills required to fully support the residents. The home has procedures in place for the recruitment of staff. Staff records seen for a staff member who had been employed since the last inspection contained a completed application form and two written references. A Protection of Vulnerable Adult (POVA) check had been completed before the person started work but there was no confirmation in the file that a Criminal Records Bureau (CRB) check had been received. The operations manager contacted the organisations Human Resources department to confirm that the check had been completed and arranged for confirmation to be put in the records. A photocopy of the staff members’ personal identification number with the Nursing and Midwifery Council was in the file but there was no confirmation that the registration had been confirmed with the council and was still valid. The operation manager said that the records indicated that this had been done and she did not know why it was not in the file. Following the visit, the inspector received confirmation of the staff members CRB check and registration with the Nursing and Midwifery Council. Written confirmation of the CRB check and registration with the Nursing and Midwifery Council should be held at the home or be available for inspection. New staff were required to complete an induction course that was in line with Skills for Care requirements. The training included the principles of care and equal opportunities. Staff said that they were encouraged to attend training sessions and notices were on display in the home regarding training courses available and those that were mandatory. Training records indicated that staff had received training in moving and handling, food hygiene, infection control, protection of vulnerable adults and challenging behaviour. As previously stated some staff had attended training in dementia awareness and arrangements had been made for those who still required the training to attend sessions. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 23 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, 32, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents but their safety could be put at risk by the lack of safe working practice such as the insecure storage of hazardous substances. EVIDENCE: The registered manager was not on duty at the time of the visit. Information from the registered manager, Lizette Krause, received by the commission prior to the visit stated that she was undertaking NVQ level 4 training in management. Lizette is a qualified nurse with a BSc in Nursing who registered with the commission as manager of the home in June 2006. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 24 Staff at the home said that they received good support from the registered manager and information received from relatives and a care manager indicated that they too felt the level of support was good. Records seen indicated that meetings were held for residents and their relatives on a monthly basis where all aspects of life at the home were discussed. Staff meetings were held on alternate months with additional meetings held for nursing staff. Relatives are asked by the home, to complete a satisfaction survey annually and information obtained is audited at the organisations’ headquarters. Feedback is given to people involved in the surveys at group meetings or one to one basis. The registered manager also writes a newsletter to relatives to keep them informed of any social events or changes taking place at the home. The home holds small amounts of money for residents in a ‘pooled’ bank account and when residents require some money such as for hairdressing, money is taken out of the account to pay for it. Individual records are kept for each resident. The account is a type that does not incur charges and no interest is paid. Information on the handling of residents’ money is clearly given in the homes’ Statement of Purpose’. The operations manager said that individual bank accounts were being set up for residents. Two staff members said that they did not have the opportunity for one to one supervision although both felt that they could speak with the registered manager if they had any concerns. Supervision records were not available for some of the other staff members. One to one meetings for supervision need to be arranged for staff to receive feedback on their performance and to give time for discussion on their development needs such as training requirements. Following the visit the registered manager provided the inspector with dates where supervision had taken place, which indicated that staff were receiving supervision, some of which took place as group sessions. Staff spoken with did not seem to be aware that the meetings they attended were supervision sessions. Health and safety policies and procedures were available to staff and health and safety notices were displayed around the home. However, as noted in standard 25, during the tour of the home the door to the sluice room, where soiled linen was stored until it was taken to the laundry and also where hazardous substances such as cleaning fluids were kept, was not locked. This was of concern as some residents at the home wander from room to room and there was nothing stopping them entering a room that could put their safety at risk. The door remained unlocked even though it was brought to the attention of staff and the operations manager. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 25 Staff had received training in health and safety including infection control during induction. Protective clothing such as disposable aprons and gloves were available and staff were seen using the clothing as necessary. At the time of the visit a terry towel and not paper towels was provided in the staff toilet. The operations manager said that there were usually paper towels in the toilet. However there was not a paper towel holder fitted in the room. The domestic placed paper towels on the windowsill in the room when asked to do so by the operations manager. It is recommended that paper towels are always available to minimise the risk of cross infection and also a bin for disposal of the towels that can be opened by a foot lever rather than having to lift the lid by hand. The home employs a maintenance man for the day- to- day maintenance of the home. Records seen indicated that checks were carried out regularly for fire safety equipment and fire alarm tests. The lift and specialist equipment such as hoists were serviced regularly and more frequently as needed. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 26 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 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 3 x 2 Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 27 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 OP29 Regulation 17(3)(b) Requirement Timescale for action 31/08/07 1. OP38 13 (4) (a) (e) Records relating to the recruitment of staff including confirmation of CRB and POVA checks and confirmation of current registration with professional organisations such as the Nursing and Midwifery Council should be available for inspection. The door to the sluice room 14/06/07 where hazardous substances are stored should be kept locked to minimise the risk to any residents who may wander in the corridors and walk into the room when it is unattended. 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 OP26 Good Practice Recommendations It is recommended that terry towels in the staff toilet room DS0000065931.V338737.R01.S.doc Version 5.2 Page 28 Copper Beeches Nursing Home be replaced with disposable paper towels and the disposal bin be of a type that can be opened by a foot lever, to minimise the risk of cross infection. Copper Beeches Nursing Home DS0000065931.V338737.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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