Inspection on 19/04/06 for Copper Beeches Nursing Home

This inspection was carried out on 19th April 2006.

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

Other inspections for this house

Copper Beeches Nursing Home 13/06/07

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 Craig Willis Unannounced Inspection 19th April 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Copper Beeches Nursing Home DS0000065931.V289529.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 DS0000065931.V289529.R01.S.doc Version 5.1 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 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.V289529.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 55 years of age. Date of last inspection 20th January 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. Ownership of the homes has changed since the last inspection and the Southern Cross group of homes now owns them. 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. The home has a service users’ guide, which is provided to prospective service users and their relatives. This document details the services that are provided at the home. The acting manager reported that the range of fees for April 2006 was from £368.89 to £937.00 per week. The registered manager is currently on a period of leave and the provider has appointed an acting manager. The acting manager said she expected the registered manager to return to work. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) following the last inspection and a site visit to the home on 19th April 2006. During the site visit the inspector spoke with residents, visiting relatives, care staff and the manager. A tour of the building was made and the inspector observed the care that staff were providing to residents. Documents relating to the running of the home were inspected during the visit. What the service does well: What has improved since the last inspection? Support provided to residents to dress appropriately and to take care of their appearance has improved. Changes in working practices and the deployment of domestic staff have resulted in a home that is clean, pleasant and hygienic. The home’s refurbishment and redecoration programme is ensuring that the quality of the environment is improving. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 6 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 DS0000065931.V289529.R01.S.doc Version 5.1 Page 7 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.V289529.R01.S.doc Version 5.1 Page 8 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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of residents before they move into the home, which assures residents that their needs can be met. EVIDENCE: Prior to admission to the home the acting manager or senior nurse completes a full assessment of prospective residents to ensure that their needs can be met. This covers both physical and psychological needs. Information is obtained from the resident’s family and other health professionals including doctors, community nurses and community psychiatric nurses. One resident’s relative that was spoken with confirmed that a thorough assessment was undertaken and that information about the service that would be provided was given to them. Following the assessment, the acting manager decides whether or not the home can meet the needs of that prospective resident. The needs identified during this assessment form the basis for the care plans that are written after the resident has moved into the home. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 9 The assessments were seen in residents’ care files for the four residents whose care was tracked. The home does not provide intermediate care. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 10 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The details recorded in care plans, support to access health services and the way staff support residents ensures that they are treated with dignity and respect and their needs are met. EVIDENCE: The care plans of four service users were viewed during the visit. These documents set out how the assessed needs of service users should be met and were reviewed monthly, or sooner if needs changed significantly. The acting manager has completed an audit of all the care plans and made amendments where necessary. The acting manager also completes a monthly audit of pressure sores to ensure that action is taken to consult with the GP and tissue viability specialist where necessary. The acting manager reported that she was in the process of transferring all of the care plans into a new format that has been introduced by the new provider. It was anticipated that this would be completed by the end of April 2006. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 11 All residents are registered with a GP practice, which has links with the home or have remained registered with their existing GP. The GP visits the home each week and additional calls are made where necessary. One relative spoken with said that their mother was able to access all of the medical services that she needed. Medication was securely stored and administration records had been fully completed. The acting manager reported that since the last inspection she had set up a new contract for the disposal of unwanted medication. It was also reported that the home was awaiting the implementation of a new medication procedure, which is being issued by the new provider, Southern Cross. Concerns were raised at the last inspection that not all staff were speaking to residents in a respectful manner and residents had not been supported to dress in a manner that respected their dignity. The acting manager reported that all staff had received training and instruction in the standards that are expected of them. During the visit, the inspector noted that all residents had been supported to dress appropriately and to take care of their appearance. Staff were observed speaking with residents in a respectful manner and providing support, for example to go to the toilet, in a manner that maintained residents’ dignity. Residents spoken with said that staff treated them well. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 12 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): 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 take part in a good range of activities, although improvements are needed to ensure the cultural needs of all residents are met. The quality food provided to residents is variable, although changes planned by the home will ensure the preferences of residents are met. EVIDENCE: Residents were observed taking part in various activities, including reading, knitting, listening to music and watching television. The acting manager reported that the activities co-ordinator is currently off on a period of leave and other staff are covering her duties. Residents’ interests are recorded as part of their initial assessment before moving in to the home. During the afternoon the inspector noted that some residents were sat in the lounge with the television and the CD player both on at the same time, which meant residents could not concentrate on either of the activities. The acting manager said she would address this issue with staff. Relatives spoken with said they were able to visit at any time and were made to feel welcome. The home maintains links with local churches and a service is held every month for the residents. Relatives also confirmed that meetings Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 13 had been held for them about the changes to the service following the new provider taking over. The acting manager reported that one resident did not speak English as a first language and was able speak with an agency worker who spoke the same language. This agency worker was only occasionally used and the inspector recommended that greater efforts should be made to support this resident, as they are no longer able to speak English. During the visit the inspector observed a mealtime. Staff were observed providing appropriate support to residents to eat the meal, in a sensitive and dignified manner. The acting manager reported that there had been some concerns raised by a relative about the meals not being suitable for residents, for example tough meat and insufficient portions. As a result of these concerns a decision has been made to take the planning of menus and purchasing of food “in-house”, giving catering staff greater flexibility to meet the needs of residents. Residents spoken with said that the food was generally good. One relative spoken with said the staff had made a lot of effort to meet her mother’s dietary needs and provide alternatives. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 14 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home has good systems to investigate complaints and make referrals under adult protection procedures. This gives residents and their representatives confidence that their concerns will be taken seriously and acted upon. EVIDENCE: The home’s complaints procedure is supplied to residents and their relatives with the service users’ guide. Relatives spoken with said that they were aware of the home’s complaints procedure and were confident that any complaints would be taken seriously and responded to appropriately. The provider has taken disciplinary action against two members of nursing staff following a complaint made by a visiting health professional. The complainant was concerned that these two staff members were not providing appropriate care for service users. The manager reported that as a result of this disciplinary action two members of staff have been dismissed from the home. Since the last inspection, three allegations have been made that have been investigated under Hampshire County Council’s adult protection procedures. One investigation has been completed and was unresolved as it could not be determined how a resident sustained bruising to their wrists. The provider has taken action to remind all staff that they must follow the moving and handling guidelines for all residents and all staff have received moving and handling training. The two other allegations about care practice are currently being investigated by Hampshire County Council. The inspector spoke with the Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 15 officer from Hampshire County Council who is co-ordinating the investigations, who said she would be making contact with the home to get more information. The acting manager expressed her intention to co-operate with the investigations and take any action that is required as a result of the findings. The home has copies of the local authority adult protection procedures and the acting manager reported that they were waiting for the new adult protection and prevention of abuse procedure to be supplied by the new provider, Southern Cross. The home has made referrals under the adult protection procedures where necessary. Staff have received training in adult protection issues. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Changes to the working practices and deployment of domestic staff have resulted in a home that is clean, pleasant and hygienic for residents. The home’s refurbishment programme is ensuring that the quality of the environment is improving for residents. EVIDENCE: Since the last inspection the provider has started a programme of refurbishment and replacement of furniture. New carpet has been laid in the downstairs hallways and new chairs have been bought for the lounge. Some areas of the downstairs have been re-painted and the acting manager reported that it was planned to re-decorate all of the communal areas of the home. Bedrooms are being re-decorated before new service users move in. The acting manager reported that a recent environmental health inspection had resulted in requirements to repair flaking paint, improve ventilation and replace the fridge. A new fridge has been bought and the acting manager Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 17 reported that she has made an urgent request for the outstanding work to be completed. Since the last inspection the home has recruited additional cleaning staff and the acting manager has ensured that all staff are aware of their responsibilities for keeping the home clean and safe. During the visit the inspector made a tour of the building and found it to be clean and free of offensive odours. The manager confirmed that the home has suitable facilities for washing soiled items of clothing, although this was not viewed during the visit. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home’s recruitment procedures are not sufficiently robust and do not protect service users. The home employs staff in sufficient numbers, although additional training for staff would give them a greater understanding of how to meet residents’ needs. EVIDENCE: Residents and their relatives spoken with said that there were sufficient staff to meet their needs. The home has a rota that indicates which staff are covering which shifts. The acting manager reported that she was currently recruiting to vacant staff posts and was covering shifts with bank and agency staff who know the home. Of the twenty-one care staff, eleven currently have the National Vocational Qualification (NVQ) level 2 or above, or an overseas qualification which means they are employed as a senior carer. Two of the care staff are waiting to start the NVQ level 2. The acting manager reported that she had the assessor’s qualification for NVQ. The records of four staff members were checked during the visit. Three of these files contained all of the required information, such as an enhanced disclosure from the Criminal Records Bureau (CRB), two written references and a completed application form, including a medical declaration form. The file for one cleaner did not contain a disclosure from the CRB. The acting manager Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 19 reported that she had been advised by Southern Cross that they did not need a disclosure for this staff member as they were 16 years old, although she would now obtain one. The acting manager confirmed that the staff member was not providing any personal care to residents and was not left alone with residents unsupervised at any time. Staff received training in moving and handling, health and safety, food hygiene, infection control, protection from abuse, fire safety. It was noted that staff had not received specific training in care of people with dementia or in responding to residents who may be aggressive. The acting manager reported that specialist dementia training was being planned for all staff and that she would look into courses on responding to aggression. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The provider has good systems to keep residents and staff safe and monitor the performance of the home, which are used to plan future improvements to the service. EVIDENCE: The home currently has an acting manager whilst the registered manager is on a period of leave. The acting manager anticipated that the registered manager would return to work in the home. The Commission for Social Care Inspection has been informed of the personal details of the acting manager and received confirmation that suitable employment checks have been completed. The acting manager said that she had received good support from her manager during a recent disciplinary investigation she carried out, although she was not able to provide any evidence of formal supervision meetings with her manager. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 21 A senior manager of Southern Cross makes monthly visits to the home and a monthly audit of the quality of the service provided at the home is completed. These monthly audits are used to produce an action plan for improvement, which contains time-scales and a named person responsible for completing each task. Relatives spoken with confirmed that the home had held meetings to keep them informed of developments following the take over by Southern Cross. The acting manager reported that the home does not hold money or operate accounts for any residents. Residents or their appointees are invoiced for any additional services that they use, for example hairdressing. Since the last inspection the acting manager has ensured that all staff are aware of the location of fire training and maintenance records. These records demonstrated that the fire safety equipment was being regularly checked and serviced and that staff have received fire safety training. Hazardous chemicals were suitably stored, in locked cupboards. The lift, hoists and emergency call systems have all been serviced regularly. Radiators are covered to prevent burns and hot water outlets are controlled to prevent scalds. Records of all accidents and incidents are kept and the manager audits these monthly to identify any patterns. Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 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 X X X X X X 3 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 3 X 3 X X 3 Copper Beeches Nursing Home DS0000065931.V289529.R01.S.doc Version 5.1 Page 23 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 OP29 Regulation 7 (Schedule 2) Requirement New staff may only be employed following completion of satisfactory Criminal Records Bureau disclosures. This requirement is repeated as the previous time-scale of 01/03/06 was not met. Timescale for action 19/04/06 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 DS0000065931.V289529.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000065931.V289529.R01.S.doc Version 5.1 Page 25 - 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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