Inspection on 30/11/05 for Copper Hill Nursing Home

This inspection was carried out on 30th November 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.

Other inspections for this house

Copper Hill Nursing Home 18/09/07

Copper Hill Nursing Home 25/10/06

Copper Hill Nursing Home 03/08/05

Copper Hill Nursing Home 01/03/05

Copper Hill Nursing Home 22/07/04

Copper Hill Nursing Home 28/01/04

Similar services:

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Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Copper Hill Nursing Home Church Street Leeds Yorkshire LS10 2AY Lead Inspector Hebrew Rawlins Unannounced Inspection 30th November 2005 10:00 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 Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 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 Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Copper Hill Nursing Home Address Church Street Leeds Yorkshire LS10 2AY 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) 0113 2771042 0113 2719324 BUPA Care Homes (CFH Care) Limited No. 2741070 Mr Charles David Hitch Care Home 180 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (150), Physical disability (8), Terminally ill over 65 years of age (10) Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That no person under the age of 65 with a physical disability be placed on the dementia unit. 3rd August 2005 Date of last inspection Brief Description of the Service: Copper Hill is owned by BUPA Care Homes and is located in the Hunslet area of Leeds. It is designed to care for residents with all levels of confusion, mainly with a diagnosis of dementia related conditions and nursing requirements.The Home is comprised of six bungalows providing care for a total of 180 residents. Each bungalow contains its own lounge facilities and kitchenette. The bedrooms are fully furnished, with en-suite facilities. Service users are encouraged to bring personal effects such as ornaments, pictures and small items of furniture. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections a year; these may be announced or unannounced. The last inspection was unannounced and took place on the 3rd August 2005. There have been no further visits until this unannounced inspection. This inspection was carried out between the hours of 10.00am and 5.30pm by three inspectors. The people who live in the home prefer the term resident therefore this is the term that will be used throughout this report. During the inspection, we looked at records, saw care staff carrying out their work, made a tour of some parts of the building and spoke with residents, staff, visitors and the manager and operational manager. Comment cards/questionnaires are left for residents, visitors and other professionals at each inspection. These provide an opportunity for people to share their views of the home with the Commission for Social Care Inspection (CSCI). We discuss any comments received with the manager, without revealing the identity of those completing them. Copies of previous inspection reports are available via the Internet at www.csci.org.uk. What the service does well: What has improved since the last inspection? Some senior staff have attended external training on the multi agency approach to adult protection. They are planning to cascade to all staff by the end of March 2006. The manager confirmed that the pressure area care policy is based on NICE guidelines and said the home has good links with the tissue viability nurse specialist. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 6 The patio doors in residents’ bedrooms have a ventilation grid on top panel and residents have keys. The food is improving, the cook is going out to meet residents and discuss food preferences on monthly basis. He is looking at introducing second choice on lunchtime menu, probably in the New Year he is also looking at making better range of food available for supper menu. 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 Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 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 Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 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): 1,2,3 and 5. The home makes sure it can meet the needs of future residents, and preadmission visits are offered. EVIDENCE: A resident recently admitted to the home said that they had been visited in hospital by staff from the home and that family members had visited the home prior to admission. Another resident and his family said that a social worker had given them a choice of three homes; they had chosen Copper Hill because they had heard good reports about it and it was convenient for some family members. The Service User Guide and Statement of Purpose have been reviewed. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 9 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. Care plans do not give detailed and precise information on how care should be delivered and this creates the opportunity for care needs to be overlooked. Nutritional assessments are not carried out in sufficient detail to inform future care. In some cases the safety and wellbeing of residents is being compromised by the incorrect use of moving and handling procedures. To ensure the safety of residents the medication policy must reflect current practices in the home. EVIDENCE: The home is in the process of adopting new care plans based on the Minimum Data Set (MDS) model of assessment. Other formats for care records are being piloted in other homes within the company. (The company is looking at a 2 years timescale for the implementation of new standardised care records format). Where a need is identified a care plan sheet will be devised indicating Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 10 the response required to meet the identified problem or issues. Staff confirmed that training had taken place on the new documentation but some clarification is needed to guide staff on retention of current documentation. Two new care plans were inspected both were incomplete. The documentation does not have space to record residents preferred names, food likes and dislikes, preferences in relation to activities, and/or wishes in relation to death and dying. The religion of residents is not identified nor is there space to record how religion may or may not affect care. Abilities of residents are not recorded and this information should not be lost. Overall the care plans in the previous format were good, setting out personal health and social care needs would be met. They were detailed with clear identification of needs and action required to address identified needs. Nutritional risk assessments are not done for all residents at the time of admission, there are only done for those residents where nutrition has been identified as a concern, it is recommended that this be done for all residents at the time of admission. Weights were recorded monthly. Two residents were observed being moved in a hoist from their chairs in the lounge to the bathroom, which does not comply with the home’s policy or good practice. In both cases there was little or no communication with the residents throughout the process. In another part of the home two staff using a new hoist said they had been trained and this had included being supervised until competent. They said they had moving and handling training annually. There are two moving and handling co-ordinators on site. There was no moving and handling training recorded in the training files. The home has recently adopted a blister pack monitored dosage system for medicines, provided by a local pharmacist. Staff confirmed that they had received training on the new system. However the medication policy kept on file in Kitson was dated December 2001 and did not reflect current practice. There was evidence of involvement by GP and other health and social care professionals. There had been an outbreak of diarrhoea but is now clear. The Environmental Health Officer (EHO) has been back to take swabs, no concerns identified. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 11 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. Stimulating opportunities are not provided for all residents. Not all residents are given the opportunity to take part social and leisure activities that meet their needs and expectations. More could be done to make residents meals more enjoyable. EVIDENCE: The home employs two activities co-ordinators to meet the needs of 180 residents. A programme of one-off events such as clothes sale was seen on Churchill unit. No information about activities was seen on Kitson, some evidence was seen of past activities such as card making, glass painting and karaoke were seen on Churchill. Traditional activities such as bingo have been adapted by using a whiteboard to write down the numbers to allow more residents to join in, which is good practice. Residents commented positively about a trip to see the Christmas lights and a fish and chips meal. The activities co-ordinators do not receive supervision and need clarification on the resources available to them. More work needs to be done to ensure all residents needs are considered. There are no residents meetings, which could be used to discuss matters that affect residents’ daily lives such as the planned redecoration. Residents confirmed that the chef had consulted them about Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 12 preferences. Two residents said that they were pleased to see that their separate requests for kippers and croissants had been accommodated. Comments about the food were mixed, all residents spoken to say that they understood that it was difficult to satisfy the requirements of all the residents. Specific comments included “ boiled eggs are like bullets, fried eggs are rubbery, Yorkshire puddings are poor and the vegetables are too wet and overcooked”. On one of the units a resident’s meal was left on the table. It was two hours after the meal had been served and staff said the resident was a slow eater and had been asleep. The meal was not covered or reheated. Several residents on Churchill unit are diabetics; tea is served at approx 5pm and last snack of the day is 8.30pm. Breakfast is not served until after 9am. Lunch times meal were fairly well organised, it consisted of shepherds pie, green beans, broccoli, mashed and roast potatoes, there was no evidence of choice of main course. There was rice pudding or sponge and custard for pudding, two residents asked for ice cream but these requests were refused. Staff did not offer to go to the main kitchen to get it, (the fridges on the units do not have freezer compartments). Soft meals were well presented. Residents were given aprons if needed but no napkins. Residents were given appropriate help as needed. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 13 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): 16,17 and 18. The home responds appropriately to complaints and in order to make sure that residents are protected from abuse is organising training for all staff on Adult Protection EVIDENCE: The home has a policy for dealing with complaints. Some senior staff have attended external training on adult protection and the multi agency approach to the protection of vulnerable adults. The plan is to cascade to all staff by the end of March 2006. The manager said he felt all staff were aware of what constituted abuse and would know they must report to senior staff, they would not necessarily be aware of multi agency approach. The manager said the home gets good support from Leeds Adult Protection co-ordinator. One of the senior nurses said all residents are registered for postal voting. She was aware of how to access advocacy services and gave an example of a situation where advocacy services had been involved with a resident. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 14 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, 20, 22, 23,24,25 and 26. Some working practices create a potential risk of cross infection. Overall residents live in a clean, comfortable and safe environment and a programme of refurbishment was scheduled to commence in December 2005. EVIDENCE: A number of the units were looked at. On Fenton several bedside cabinets looked the worse for wear. In 2 bedrooms and in the kitchen the vinyl floor covering was split. There were soap dispensers but no paper towels in bedrooms and staff said they put paper towels in when residents have MRSA. Door locks are fitted to all bedroom doors, however the nurse in charge said residents did not have keys, she was not aware residents should be offered keys and said keys were not on the unit, although the manager later said they were. Some bedrooms have carpets fitted and looked much more homely. A visiting GP commented on the absence of bedroom carpets and said how much cosier the rooms would be with a carpet. In many of the rooms residents have their personal belongings Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 15 around them. The corridor carpet was showing signs of wear and tear and is starting to split between fire doors. The lounge carpet was badly stained in several areas, most noticeably outside the kitchen door and there were numerous cigarette burns on the carpet in the residents smoking area. Overall the unit was clean but is in need of refurbishment. Kitson, Murray and Churchill are due for refurbishment and this was scheduled to start in December 2005. The refurbishments will include new corridor carpets, decoration of corridors, new dining room furniture for one unit and new bedroom chairs and commodes for some units. In the main kitchen the cook said the Environmental Health Officer had visited a few weeks before and made some requirements, which had been addressed. However the inspector noted that the walls tiles, the floor and trolleys for transporting foods to the units were in need of deep cleaning and the cook was made aware of this. At the time of the inspection deep cleaning was taking place in the laundry. Residents and relatives spoken with said the laundry staff were very helpful and that clothing comes back quickly, some mentioned problems with socks and hankies but seemed to feel this was inevitable because of the size of the home. Relatives on one unit said were very pleased with the new hoist but felt there should be another one as residents sometimes had to wait for it to be available. The taps in bedrooms and communal bathrooms have a push down lever mechanism with the water only flowing whilst the lever is pressed down. This means that washing both hands together is very difficult as the water does not flow long enough for hands to be washed properly, thereby creating a potential cross infection risk. The operational manager stated this is under discussion by BUPA senior management as the implications are company wide. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 16 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): 28 and 30. Care staff are making good progress towards National Vocational Qualifications (NVQ). All staff must have training in the fire procedures and training records must be fully maintained. EVIDENCE: A new member of staff gave a good account of induction training, which included time to observe before working in the numbers, moving and handling training which included a demonstration of how to use hoist and being moved in the hoist, and training on respecting the privacy and dignity of residents. She said she had an induction book that she was working through and would be discussing with unit manager. She was not aware of the fire procedures and did not know what to do in event of fire alarm going off. This was later discussed with the training manager who said this had not been done during the induction because she (trainer) had been on leave. Training records were looked and were not fully maintained. The training manager stated she is in the process of updating them. The records showed 32 care staff have done National Vocational Qualifications (NVQ) level 2 or above training and 12 are in the program. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 17 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, 34 and 36 The registered manager holds all the required qualifications. Residents finances are handled properly. Formal supervision for all staff is still not fully in place. EVIDENCE: The manager meets all the requirements of a registered manager. Regular formal staff supervision of nurses and care workers has not consistently taken place. Yearly appraisals of nurses have taken place, but actions agreed at appraisals are not always followed through. The finances of existing residents were sampled and found to be in order. There are records of all transactions, and receipts relating to withdrawals are kept. Quality assurance questionnaires are sent out between 6 monthly and annually. Residents spoken with are not sure what happens to the results. Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 18 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 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 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 3 18 2 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x 3 x 2 x x Copper Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Nutritional assessments must be carried out in sufficient detail to inform future care (raised at last inspection). Care plans do not give detailed and precise information on how care should be delivered and this creates the opportunity for care needs to be overlooked. In some cases the safety and wellbeing of residents is being compromised by the incorrect use of moving and handling procedures. The medication policy must reflect current practices in the home. All residents must be given the opportunity to take part social and leisure activities that meet their needs and expectations. To ensure that residents are protected from abuse all staff must have Adult Protection training (raised at last inspection). DS0000001333.V264934.R01.S.doc Timescale for action 03/10/05 2 OP8 15 20/02/06 3 OP8 12 30/11/05 4 OP9 13 20/02/06 5 OP12 16 20/02/06 6 OP18 13 20/11/05 Copper Hill Nursing Home Version 5.0 Page 20 7 OP19 23 & 13 8 OP30OP28 18 & 12 Programme of refurbishment was scheduled to commence in December 2005. The taps in the home create the opportunity for potential cross infection throughout the home (raised at last inspection). All staff must have training in the fire procedures and training records must be fully maintained. Regular formal staff supervision of nurses and care workers must consistently take place (raised at last inspection). 20/11/05 20/02/06 9 OP36 18 03/10/05 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 Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Hill Nursing Home DS0000001333.V264934.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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