CARE HOME ADULTS 18-65
Copperfield 94 Liscard Road Liscard Wallasey CH44 8AB Lead Inspector
Inger Moynihan Unannounced Thursday, 1st September 2005 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 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 Stationary 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. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Copperfield Address 94 Liscard road, Liscard, Wallasey, Wirral, CH44 8AB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 639 0438 Mannacom Ltd Mrs Helen Elizabeth Rogers PC Care HOme only 14 Category(ies) of MD Mental Disorder - 14 registration, with number of places Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One named service user over 65 years of age (MD/E) within the overall total of 14 MD 2. One named male service user over 65 years of age (MD/E) within the overall total of 14 MD Date of last inspection 10 and 11 March 2005 Brief Description of the Service: Copperfield is a large three storey detached house providing care for fourteen adults and one older person, with mental health problems. The home is near to local shops and is within walking distance of Wallasey town centre. It is on a main road which is well served by public transport. The service users live in three double and eight single bedrooms all of which have en-suite facilities. There are two communal lounges, one of which is a conservatory where service users can smoke. The dining room is linked in open plan style to the main lounge. Car parking facilities are available at the front of the home. Copperfield also has a small garden and patio at the back of the house. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 3. 5 hours and was the statutory unannounced inspection for 2005/2006. A tour of the premises took place, documentation was examined and service users and staff were spoken to. What the service does well:
A comprehensive assessment of service users care needs has been completed which ensures staff can provide the appropriate package of care. A plan of the care provided to each service user had also been drawn up to support staff in their care of the service users. Service users are encouraged to take risks in order to maintain their independence, although at the same time systems are in place to ensure their safety and welfare. Service users are supported to participate in the local community through the use of healthcare and leisure facilities. The routines within 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 wish. Varied and balanced meals are provided to ensure service users health and interest. 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 which ensures service users safety and good health. The home has a comprehensive complaints procedure 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. The standard of the decor is mixed with some parts of the home being maintained to a good standard and other parts being in need of redecoration and refurbishment. The home does not therefore, present as a homely and comfortable environment throughout. There are robust procedures for the recruitment of staff which safeguards the protection of service users living at the home. Staff have undertaken a range of training to enable them to care for the service users in line with their particular requirements. Staff are evenly deployed throughout the week and in numbers sufficient to meet service users needs and the requirements of the registering authority. There are clear lines of management and accountability within the home which is run for the best interest of service users. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 8 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 standard(s) 2 and 3 A comprehensive assessment of service users care needs had been completed which ensures staff can provide the appropriate package of care to each of the service users. EVIDENCE: Documentation examined indicated that a comprehensive assessment of service users care needs has been carried out to ensure the staff at the home are able to support the service users in accordance with their particular needs. All of this documentation was well organised although the registered manager must identify the level of risk following completion of any risk assessment. Service users have access to a range of health care professionals when necessary to ensure their physical and mental health needs are met. A record of this information was kept to help staff monitor service users’ general welfare. This is further supported by a system whereby staff spend time each day discussing any issues or concerns that have arisen over the past 24 hours. Through discussion, the registered manager and staff team demonstrated they met the service users’ physical and mental health needs in a variety of ways such as staff being provided with a range of appropriate training; a range of social activities being provided and staff being available for support when necessary Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 6, 7 and 9 A documented plan of the was in place for each of the service users which provides staff with the information they need on how to meet service users needs. Service users are encouraged to take risks in order to maintain their independence, although at the same time systems are in place to ensure their safety and welfare. EVIDENCE: Documented care plans were in place for each service users. The care plans covered a range of issues relating to the service users’ care needs and gave staff guidance on how to understand the service users often complex mental health needs and how to look after the service users in accordance with their individual requirements. The service users are encouraged to be a part of the care planning process and make decisions about their own development and plans for the future. They are also encouraged to take responsible risks as part of living an independent lifestyle although documented risk assessments had been compiled to ensure their safety. Discussion took place with the registered manager around the care plan for one particular service user and it was agreed that a more concise missing person procedure would be developed. The registered person agreed to ensure this was completed by the end of the day of the inspection.
Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 10 Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 14, 16 and 17 Service users are supported to participate in the local community through the use of healthcare and leisure facilities. The routines within 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 wish. Varied and balanced meals are provided to ensure service users health and interest. EVIDENCE: Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 12 Service users are encouraged and supported to pursue their own interests and hobbies outside of the home and activities are also provided within the home. Service users social care needs have been assessed and the registered manager has carried out a great deal of work to develop this side of the service, some of which had been done in consultation with healthcare professionals. A range of board games etc have been purchased for the home and links have been set up with the activity organiser employed at the sister home Copperbeech. The activities are provided on an individual and group basis and include an outing every Thursday and Friday, art, craft and cookery sessions and a film night with a fish and chip supper. A flexible weekly plan has been compiled with a member of staff being allocated each day to this aspect of service users care. Developing this side of the service is a very positive aspect of the care provided at Copperfield and ensures a stimulating and interesting environment is provided and addresses service users development. The service users spoken to during the inspection confirmed the activities take place and they were free to join in if they wished. A service user meeting is held on a regular basis to ensure the activities are in line with their particular needs and interests. The service users spoken to confirmed the routines in the home were flexible and they could come and go as they wished. This flexibility is an important aspect of care for people with mental health problems and ensures their independence and rights. The service users spoken to during the inspection said they enjoyed the food provided and always had plenty to eat and drink. Special diets were provided when necessary. Mealtimes are flexible and in accordance with service users’ needs. Service users may ask for an alternative meal if they do not like what is offered. One of the service users spoken to said they did not always like the meals provided; this issue was raised with the registered manager who agreed to address the matter straightaway. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19 and 20 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. EVIDENCE: Regular contact is made with a range of health care professionals who give advice and support as and when required; a record of service users general welfare is in place along with the outcome of any health care appointments. All of this is in line with good practice and ensures service users physical and mental health is monitored and maintained. The systems in place for the administration of medication are good with all the required documentation being in place. Appropriate training has been provided to those staff who take responsibility for administering medication. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22 and 23 The home has a comprehensive complaints procedure to ensure service users views are listened to and acted upon. Systems are in place to ensure service users safeguarded from abuse and harm. EVIDENCE: The CSCI has not received any complaints about standard of care provided at Copperfield, nor have any complaints 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. One of the service users confirmed she knew who to contact if she wished to make a complaint. Documentation was also in place on the protection of vulnerable adults from abuse and the registered manager demonstrated she was aware of the Wirral adult protection procedures which had also been discussed with the staff team. Although the staff have already completed training on protecting vulnerable adults from abuse, the registered manager was in the process of arranging a refresher training course on this aspect of care. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24 and 30 The standard of the decor is mixed with some parts of the home being maintained to a good standard and other parts being in need of redecoration and refurbishment . The home does not therefore, present as a homely and comfortable environment throughout. EVIDENCE: Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 16 The standard of the decoration throughout the home is mixed with some areas being decorated in a way that provides a homely environment and other parts, primarily the bedroom en suites and bathrooms, being in need of refurbishment and decoration. Plans have been made for all bedrooms and to be redecorated and refurbished by the end of the year. New furniture has been provided in the lounge and the furniture in the conservatory had been reupholstered which provides a much improved appearance. The registered owners of Copperfield have been in place now for just under one year and have demonstrated a commitment to ensure the standard of the facilities are improved in order to ensure a much improved and comfortable environment is provided for the service users. A couple of the service users spoken to during inspection commented their bedrooms were too hot and the inspector noticed the radiator in one bedroom was switched on and for health and safety reasons, this bedroom did not have an opening window. These issues were discussed with the registered manager who agreed to deal with them straight away. The standard of hygiene throughout the home is good. The domestic staff spoken to during inspection confirmed they had sufficient equipment and cleaning materials to carry out their work. The current laundry facilities are adequate and systems are in place to prevent the spread of infection. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 35 There are robust procedures for the recruitment of staff which safeguards and protects service users living at the home. Staff have undertaken a range of training which enables them to care for the service users in line with their particular requirements. Staff are evenly deployed throughout the week and in numbers sufficient to meet the service users needs. EVIDENCE: Staff records are up to date and thorough recruitment procedures are in place to ensure the staff at the home are suitably qualified and safe to work with vulnerable adults. Staff are evenly deployed throughout the week and in numbers sufficient to meet the service users needs and the requirements of the registering authority. A Criminal Records Bureau police check has been carried out prior to any member of staff being employed at the home. The staff group is stable which is a positive aspect of the home as this provides consistency in the care provided and enables positive working relationships to develop. Staff spoken to stated a range of training was provided to support them within their role of caring for service users with sometimes complex mental health needs. Nine of the thirteen care staff are qualified to a minimum of NVQ level 2 and two of the domestic staff were qualified to NVQ level 2 in housekeeping. Arrangements are being made for other staff to commence NVQ training this month. The staff spoken to said they enjoyed their work and felt they worked well as a team. It is clear the registered manager is committed to ensuring the staff are well qualified and have an
Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 18 opportunity to develop within their role as care providers. The registered manager has a training plan for the forthcoming year and a staff appraisal system is in place to further support staff development. Again this is a very positive aspect of the home as it ensures high standards of care are provided and maintained. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 There are clear lines of management and accountability within the home which is run for the best interest of service users. EVIDENCE: Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 20 The registered manager who has been in place since October 2004 has clearly worked very hard to continue with the development of the service provided at Copperfield. Through discussion she demonstrated her commitment to supporting and developing the staff within their role and demonstrated an open and positive style of management. The staff spoke highly of the registered manager with comments being made such as the registered manager has introduced much more structure to the home and she has a hands-on approach and the registered manager is excellent and extremely supportive, she is always available for advice when we need it. The registered manager also spoke highly of the staff team and outlined how supportive they have been particularly during the period of change. The health, safety and welfare of the service users is well promoted throughout the home. Fire safety checks are carried out on a regular basis and checks on water temperatures had been made. All small equipment had been tested for electrical safety although the registered person is required to check the radiator in the conservatory as no record was in place to show it had been tested and it appeared very old. Steps had been taken to ensure the prevention of Legionella. Staff have undertaken fire safety training this year although the registered person must ensure training briefings are also provided every six months the day staff and every three months for night staff which is in accordance with the Fire Department regulations. Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Copperfield Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 2 x F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 22 No 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 24 Regulation 23 Requirement The registered person is required to ensure the premises are kept in a good state of repair, in this instance that the bedrooms, ensuite facilities and bathrooms are redecorated and refurbish. The registered person is required to address the issue of the heating identified in two bedrooms. The registered person is required to ensure staff receive regular fire safety briefings, in this instance every three months for night staff and every six months for day staff. The registered person is required to ensure the radiator in the conservatory is checked for it electrical safety. Timescale for action 31/12/05 2. 24 23 31/11/05 3. 42 23 1/11/05 4. 42 23 1/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1.
Copperfield Refer to Standard Good Practice Recommendations There are no recommendations resulting from this
F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 23 inspection Copperfield F52 F02 S62434 Copperfield V245530 300805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Liverpool Area Office 3rd Floor, 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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