CARE HOME ADULTS 18-65
Copperbeech Copperbeech 75-76 Penkett Road Wallasey Wirral CH45 7QG Lead Inspector
Inger Moynihan Unannounced Inspection 27th February 2006 10:30 Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 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 Copperbeech DS0000062442.V285019.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 Adults 18-65. 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. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Copperbeech Address Copperbeech 75-76 Penkett Road Wallasey Wirral CH45 7QG 0151 639 1405 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) Mannacom Ltd Mr Peter David Neil Murphy Care Home 25 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (25) of places Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2 named service users over 65 years of age (MD/E) within the overall total of 25 15th September 2005 Date of last inspection Brief Description of the Service: Copperbeech is a large three storey detached property that was registered in February 1991 for the care of people with mental health problems. It is situated in an urban location within easy reach of Liscard and New Brighton town centres which both have a selection of shops, banks and community facilities. The area in which the home is situated contains many other residential homes providing care for other vulnerable groups of people. The home is situated in its own grounds with parking space for about six cars. There is a large garden at the back of the home with a patio. Accommodation is provided in 14 single and 3 shared bedrooms all with en-suite facilities. Three flats in the basement provide more independent accommodation. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 4.5 hours and is the second statutory unannounced inspections for 2005/2006. A partial tour of the premises took place and service users records were inspected. Four staff and five service users were spoken to during this inspection. What the service does well:
An assessment of service users care needs is completed to ensure staff can provide an appropriate package of care and meet service users changing needs. Prospective service users have an opportunity to visit and test drive the home before making a decision on whether to move in on a permanent basis. Service users are involved in the development of their care package and are encouraged to make decisions about their own lives. Staff demonstrated an understanding of the importance of ensuring service users confidentiality. Staff support service users in their personal development. Service users are supported and encourage to participate in the local community in accordance with their particular care requirements. The routines in the home are flexible which means family and friends are welcome to visit at any time and service users can go about their day as they choose. Service users praised the staff team for their kind and caring nature and confirmed they were always available for support and advice. The service users health care needs are well met with evidence of good multidisciplinary working taking place. The home has a comprehensive complaints procedure to ensure service users views are listened to and acted upon. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 6 Systems are in place to ensure service users are safeguarded from abuse and harm. Further redecoration work has been carried out which further improves the condition of the home. Staff are aware of their role and responsibilities with regard to the care of the service users. The staff have the competencies and qualities required to meet service users care needs. There are sufficient staff to care for the number of service users living at the home. The home has a training and development plan in place to ensure qualified and competent staff are employed to care for the service users. Staff receive the support and supervision they need to enable them to fulfil their responsibilities with regard to the care of the service users. The Acting Manager is competent and experienced to run the home for its stated purpose, aims and objectives. The management approach in the home is open and inclusive of all staff members. The health, safety and welfare of the service users is well promoted throughout the home. What has improved since the last inspection? What they could do better:
A documented plan of care is in place for each of the service users which provides staff with the information they need on how to meet service users needs. More detailed information needs to be recorded during the review Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 7 process to ensure the care plans are an accurate reflection of service users current care requirements. Improvements need to be made to the standard of the food provided as during the inspection a number of service users said they were not entirely happy with all of the meals provided. Systems for the administration of medication are good and ensure service users safety and good health. However, further documentation needs to be recorded in relation to when medication should be given on the basis of as and when required. The standard of the decor is satisfactory and further improvements have taken place since the last inspection to ensure the service users are provided with a comfortable and homely environment. The Registered Persons are committed to improving the standard of the facilities. 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. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 An assessment of service users care needs is completed to ensure staff can provide an appropriate package of care and meet service users changing needs. Prospective service users have an opportunity to visit and test drive the home before making a decision on whether to move in on a permanent basis. EVIDENCE: An assessment of service users care needs is carried out to ensure the staff are able to support the service users in accordance with their particular needs. The service users spoken to said their individual care needs are fully met and confirmed the staff team are very supportive and caring. Service users have access to a range of health care professionals to ensure their good physical and mental well-being. There is evidence of multidisciplinary working to ensure all aspects of service users care needs are addressed and met. A record of this information is kept to help staff monitor service users’ general welfare. Prospective service users are given an opportunity to visit the home on an introductory basis before making a decision to move in permanently. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 10 Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 10 A documented plan of care is in place for each of the service users which provides staff with the information they need on how to meet service users needs. More detailed information needs to be recorded during the review process to ensure the care plans are an accurate reflection of service users current care requirements. Service users are fully involved in the development of their care package and are encouraged to make decisions about their own lives. Staff demonstrated an understanding of the importance of ensuring service users confidentiality. EVIDENCE: A documented care plan is in place for each service user. The care plans cover a range of issues relating to service users’ care needs. This information gives staff guidance on how to understand the service users often complex health needs and how to carry out the necessary care. The service users are involved in the care planning process and encouraged to make decisions about their own development and plans for the future. They are also encouraged to
Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 12 take responsible risks as part of living an independent lifestyle. Documented risk assessments are compiled to ensure service users safety. The care plans are reviewed on a regular basis although more detailed information does need to be recorded in the review process to demonstrate the basis of any decision making. Information held in relation to service users care needs is stored securely and staff respect service users confidentiality in relation to this aspect of care provision. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 16 and 17 Staff support service users in their personal development. Service users are supported and encourage to participate in the local community in accordance with their particular care requirements. The routines in the home are flexible which means family and friends are welcome to visit at any time and service users can go about their day as they choose. A varied and balanced diet is provided to ensure service users health and interest. A number of service users spoken to the during inspection said they were not entirely happy with all of the meals provided. EVIDENCE: The Acting Manager demonstrated how she addresses service users personal development. A number of development programmes have been set up to address service users individual care requirements. A multi-disciplinary approach is sometimes taken with this aspect of care provision to ensure all
Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 14 relevant stakeholders are involved in the development of the care package. All of this is in line with good practice and ensures service users confidence and independent living skills are developed. At present none of the service users are involved in paid employment although this aspect of care provision has been looked at in the past. One service user is involved in voluntary work with the Merseyside Fire Service. The Acting Manager acknowledged the positive impact this voluntary work had on the service users confidence and personal development. The service users confirmed they make use of community facilities for their leisure and health care needs. A range of activities are provided both inside and outside the home. Staff work with the service users on a one-to-one basis or in small groups. Activities provided include bowling, pub lunch, and the cinema etc. Staff have also purchased leisure passes for a number of service users. An activities organiser is employed at the home on a part time basis. This is a positive aspect of the home as this provides a stimulating and interesting environment for the service users to live. The service users spoken to during the inspection said they enjoyed the activities although they did confirm that staff respected their wishes if they did not wish to join in. Service users confirmed the routines in the home are flexible and they can come and go as they wish. This flexibility is an important aspect of care as this ensures service users independence and rights are respected. A varied and nutritious diet is provided to ensure service users interest and health; service users medical needs are included in the menu planning. The service users spoken to said they always had enough to eat and drink and confirmed a choice is available. A number of service users said they did not particularly like some of the meals provided. This issue was discussed with the Acting Manager who agreed to look into the matter straight away. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users praised the staff team for their kind and caring nature and confirmed they were always available for support and advice. The service users health care needs are well met with evidence of good multidisciplinary working taking place. Systems for the administration of medication are good and ensure service users safety and good health. Further documentation needs to be recorded in relation to when medication should be given on the basis of as and when required. EVIDENCE: Service users said the staff supported them in they way they wanted and confirmed they were always courteous and polite. Regular contact is made with a range of health care professionals who give advice and support as required. A record of service users general welfare is in place along with the outcome of any health care appointments being recorded. All of this is in line with good practice and ensures service users physical and mental health is monitored and maintained.
Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 16 The systems in place for the administration of medication are good with all the required documentation and storage facilities being in place. All staff have completed training in relation to the administration of service users medication and the testing of blood for service users who have diabetes. This training is supported by relevant nursing health care professionals to ensure staff are upto-date on any changes in practice. The medication administration record sheets indicate that two signatures had not always been obtained when handwritten entries were made. Also there was no guidance in place for when medication is given on the basis of as and when required. To ensure service users medical care needs are met appropriately, the Registered Persons are required to address these issues. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a comprehensive complaint procedure is in place to ensure service users views are listened to and acted upon. Systems are in place to ensure service users are safeguarded from abuse and harm. EVIDENCE: The CSCI has not received any complaints about the standard of care provided at Copperbeech and no complaints have been made directly to the home. The service users spoken to during the inspection said they were happy with the standard of care they received and had no complaints to make. The complaint procedure is displayed in the hallway to ensure service users know who to contact if they are unhappy about any aspect of the service provided. Staff spoken to were aware of the action they should take in the event of them suspecting an incident of abuse had taken place and supporting documentation was available for their reference. All staff have completed training in relation to the protection of vulnerable adults from abuse. This aspect of care provision is also included in induction training when staff are first employed at the home. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The standard of the decor is satisfactory and further improvements have taken place since the last inspection to ensure the service users are provided with a comfortable and homely environment. EVIDENCE: Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 19 There is a programme of ongoing refurbishment to further improve the condition of the building in order to provide a pleasant and comfortable place for service users to live. The home is currently maintained to a satisfactory standard. Further improvements have been made to the home since the last inspection including the redecoration and re-carpeting of service users bedrooms. The Acting Manager acknowledged that further work still needs to be carried out for the purpose of maintaining this standard. The Registered Providers are committed to improving the overall standard of the building and continue to work with the CSCI on this aspect of care provision. The standard of hygiene throughout the building is good. The domestic staff spoken to during the inspection confirmed she has sufficient equipment and materials to carry out their work. The standard of cleanliness in the kitchen is good although improvements do need to be made to the kitchen store room. The Acting Manager confirmed this had already been identified and will be completed within the forthcoming year. Although improvements have been made to the garden area, further worked still needs to be carried out and arrangements are in place for this to take place during the summer. The laundry floor needs to be made impermeable. The Acting Manager stated that arrangements are in place for this to be addressed later in the year. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 33, 35 and 36 Staff are aware of their role and responsibilities with regard to the care of the service users. The staff have the competencies and qualities required to meet service users care needs. There are sufficient staff to care for the number of service users Living at the home. The home has a training and development plan in place to ensure fully qualified and competent staff are employed to care for vulnerable adults. Staff receive the support and supervision they need to enable them to fulfil their responsibilities with regard to the care of the service users. EVIDENCE: The staff spoken to during the inspection had a positive attitude towards their work and demonstrated a clear understanding of their role and responsibilities with regard to the care and support of the service users. Staff spoken to confirmed they have completed a range of appropriate training. Arrangements are in place for staff to complete further training throughout the
Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 21 year. This is a positive aspect of the home and ensures the service users are being cared for in accordance with good practice. The staff rota indicated staff are evenly deployed across the week and that the required staffing levels are provided. This ensures service users are provided with good levels of support and that their individual care needs are met. There has been one new member of staff employed at home since last inspection. This is a positive aspect of the home and ensures consistency in the care of the service users. Since the last inspection a further four care staff have completed training to the National Vocational Qualification standards. All but two of the care staff have now completed this training and arrangements are being made for them to start this training within the next couple of months. The staff spoken to confirmed they receive regular supervision to enable them to develop within their role. Regular staff meetings take place which give staff an opportunity to put forward their views and ideas on the running of the home and the care of the service users. The staff spoken to said they felt well supported within their role and confirmed they enjoyed their work. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 42 The Acting Manager is competent and experienced to run the home for its stated purpose, aims and objectives. The management approach in the home is open and inclusive of all staff members. The health, safety and welfare of the service users is well promoted throughout the home. EVIDENCE: There are clear lines of management and accountability within the home which is run for service users best interest. Mrs Karen Scregg is currently acting as manager of Copperbeech. Her application to become registered manager of the service is currently being processed by the CSCI. She is in the process of completing National Vocational Qualification level 4 which is the recognised qualification for managers of residential care services. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 23 All of the staff spoke highly of the Acting Manager and Registered Persons and confirmed they are always available for advice and support when necessary. This is a positive aspect of the home and ensures staff are supported within their role. All of the service users spoken to during inspection praised the Acting Manager for her kind and caring approach and said she was always available for support when necessary. The health, safety and welfare of service users and care staff is promoted and protected through the homes policies and procedures. Staff are further supported in this area of care through regular training. Documentation is in place to demonstrate the Acting Manager has kept up to date with health and safety issues by way of the Medical Devices Agency Website. Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x x 3 LIFESTYLES Standard No Score 11 3 12 x 13 3 14 x 15 x 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 x x x x 3 Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 25 yes Are there any outstanding requirements from the last inspection? 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 YA6 Regulation 15 Requirement The Registered Persons are required to ensure all aspects of the service users care plans are reviewed and that detailed records are kept of this review process. The Registered Persons are required to review the menus currently in place. The Registered Persons are required to ensure two signatures are recorded on the medication administration record sheets where hand written entries are made. The Registered Persons are required to ensure guidance is in place in relation to when medication is given on the basis of as and when required. The Registered Persons are required to ensure all parts of the building are maintained to a satisfactory standard. Timescale for action 01/04/06 2 3 YA17 YA20 16 13 01/04/06 01/04/06 4 YA20 13 01/04/06 5 YA24 23 01/12/06 Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 26 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 Copperbeech DS0000062442.V285019.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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