Inspection on 24/05/06 for Copperfields Residential Home

This inspection was carried out on 24th May 2006.

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

Copperfields Residential Home 22/08/08

Copperfields Residential Home 04/09/07

Copperfields Residential Home 07/09/06

Copperfields Residential Home 18/10/05

Copperfields Residential Home 24/05/05

Copperfields Residential Home 18/01/05

Copperfields Residential Home 22/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Copperfields Residential Home Copperfields Residential Home 42 Villa Road Higham Kent ME3 7BX Lead Inspector Jo Griffiths Unannounced Inspection 24th May 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 Copperfields Residential Home DS0000023919.V294539.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. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Copperfields Residential Home Address Copperfields Residential Home 42 Villa Road Higham Kent ME3 7BX 01474 824122 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) Larchwood Court Limited Miss Janet Irene Aldridge Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Care for older people with dementia is restricted to 2 older people whose dates of birth are 12/03/17 and 10/08/15. Care of one older person with a learning disability is restricted to one person whose date of birth is 17/03/37. Date of last inspection Brief Description of the Service: Copperfields is set in a residential area in the village of Higham near Gravesend. Shops and amenities are located within a short walking distance. The home is registered to provide residential care and support to 20 older people and has a range of single and double bedrooms and a number of communal lounges and dining areas. There is a garden to the rear of the property. The home is not ideal for wheelchair users. The fees charged for this service range from £301 - £485 per week. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and was carried out by Jo Griffiths and Marion Weller on 24th May 2006 between 09.00 and 17.00. A number of residents were spoken with and some relatives were spoken with both at the home and on the telephone. Records were inspected and the inspectors were shown around the building. There had been some improvements made since the last inspection but a number of issues of serious concern about the home still remain. What the service does well: What has improved since the last inspection? What they could do better: The home must not take people outside of the category of registration and they must be sure they can meet all residents needs before offering them a place. The Statement of Purpose must reflect the category of registration. Residents should be involved in their assessments and care plans and these should cover all areas of need including activities. Staff must improve the recording of the activities that residents are enjoying to be able to monitor that they are being offered the things they wish to do. The activity and menu board should be made clear for older people. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 6 Staff must receive training in how to support people with dementia and any involvement of specialist professionals must be clearly recorded in the care plan. The cook must be provided with all information about residents dietary needs. Staff must ensure that residents are supported to drink sufficient fluids. There must be proper arrangements made for leading and supervising staff on a daily basis. The Manager must carry out regular audits of areas of the service to ensure it is meeting the needs of the residents. The complaints procedure must be clearly displayed for residents and relatives to see. The Manager must make safe arrangements for administering medication. This should include a competence assessment for staff in giving medications. All staff must have a recorded induction and all new staff must register to do an NVQ. Sufficient numbers of staff must be employed and staff must not work long hours as this puts residents at risk. The residents sharing a bedroom should be offered a single room. They have been unable to make a positive choice to share and records show they are not getting the privacy they should have. Where protective sheeting is needed on beds this must be comfortable and not present risks of pressure areas. Safe procedures must be followed for dealing with laundry and all cleaning products need to be kept locked away to protect residents. It would benefit residents if the worn armchairs in the lounge were replaced. It is recommended that the Manager continue to review the risk assessments for the home and the fire officer should be contacted about the toilet door that blocks a bedroom. 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. Copperfields Residential Home DS0000023919.V294539.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 Copperfields Residential Home DS0000023919.V294539.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): 1, 3, 4 Residents are not provided with accurate information about the types of needs it can support. Residents do have their needs assessed before moving to the home, but these needs are not being met for all residents. The overall outcome in this area is poor. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The home has a Statement of Purpose and Service User Guide. Both these documents required minor amendment, as they do not accurately reflect the category of residents the home is registered for. The Manager stated that residents are given a copy of both documents when they express an interest in the home. Each resident had an assessment of their needs although it is recommended that these be dated. It was good to see that one resident had signed to agree their assessment and it is recommended that all residents be involved in their assessments where possible. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 9 There were a number of residents with very specialist needs in the home. In 2005 the home was granted a variation to their registration to continue to care for 2 specific people who have developed Dementia since being in the home. However, the inspectors found that an additional 2 people with a diagnosis of Dementia had been admitted to the home outside of the registered category. This means that the home may have admitted residents for whom they cannot meet their needs. One of the residents who had dementia was clearly very confused and the records in the care plan evidenced that her needs were not being fully met. The Manager said that she would contact the care Manager of this person regarding an appropriate placement. Staff spoken with demonstrated little understanding of the specific needs of the residents with Dementia and how to support them to lead stimulating and interesting lives. Some staff have undertaken training in this but it is recommended that all care staff do training in supporting people with Dementia. Copperfields Residential Home DS0000023919.V294539.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, 10 Residents’ care plans do not meet all their needs. Residents’ health needs are partially met. Residents are not protected by the home’s procedures for administering medication. Residents feel they are treated with respect but not all residents right to privacy was being upheld. The overall outcome in this area is poor. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Residents have a care plan that details the support they need in terms of their personal care and this was clear for staff to follow. The care plans do not cover residents specific needs particularly those with Dementia. There was no evidence of residents choices within the plan and not all residents had been involved in developing their plan. The care plans did not clearly state how residents social needs would be met on a daily basis. All of the care plans viewed had been kept under review. Residents said their health needs were met and they could see a doctor or other health professional when they wished to. Residents had their nutritional Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 11 needs assessed by the staff in the home. However, where problems were identified there was no evidence that professional help had been sought. For example, one residents assessment said that they required a low calorie diet. There was no evidence of any advice from a dietician or GP with respect to this. It was difficult to ascertain if someone qualified to do so had made this decision. Medication practice had improved in some areas. A new trolley has been purchased and medication is now stored safely. A new pharmacy is being used and the procedures for returning unused medication are clear and safe. There are no residents administering their own medication. Training updates in medication have been arranged for staff. It was discussed with the Manager the benefits of monitoring the competence of staff giving medication at regular intervals. The Manager was advised this could be done as part of the recommended 6 staff supervision sessions per year. There are still no clear guidelines for staff on when to give PRN medicines and the dose to be used. The reason for giving paracetamol for one service user had not been recorded and some medications that had been refused regularly had not been reviewed with the GP. This was raised at the last inspection and had not been addressed. Some relatives had brought in medicines such as cough mixture and these were left out in residents bedrooms. The Manager must ensure that relatives know to inform staff of any homely medicines they bring in so that staff can check it will not affect any other medication they are taking and that it can be stored safely. There were no handwritten entries on the MAR sheet. Some residents were becoming very agitated because they had to wait a long time after breakfast for their medication. Morning medication is due to be given at 09.00 but was not started until 09.45 with some residents not receiving their medication until 10.15. One residents medication is to be given ½ hour before food but this was not given until after breakfast. Residents’ privacy is not always respected. Two residents have to share a bedroom and also require the use of a commode at night. This is not very private. Residents said they felt they were treated with respect most of the time but found it frustrating when they had to wait for staff to be available to support them. Copperfields Residential Home DS0000023919.V294539.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, 15 Residents would benefit from more activities and more opportunities to go out of the home. They are supported to maintain contact with relatives and friends. Residents have lots of choice of meals but would benefit from more choice of activities. Residents enjoy a varied and balanced diet. The overall outcome in this area is adequate . This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: There was a weekly programme of activities in place but there was no evidence of consultation with residents when designing this. Residents said that they did sometimes get bored in the home and they have little or no opportunity to go out of the home for activities. At the time of the inspection visit staff were doing their best to entertain and interact with residents and the relationships staff have built with residents are very positive. However, there are concerns about the numbers of staff on duty and this makes it difficult for staff to consistently provide activities. Residents use records did not clearly show activities that they had been involved in each day or if they had chosen not to. It is recommended that clear records be kept to show how people are offered appropriate activities on a Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 13 daily basis. The activities that were available at the time of the visit were knitting and massage. These were written on a blackboard in the hall but were not very clear for residents with visual difficulties to see. The activities that were actually provided did not reflect what was on the board. Residents said they could receive visitors when they wish and feedback from relatives supported this. There is a new chef employed at the home who works 5 days per week. A part time chef works on the other days. The chef was able to evidence that he has completed the training he needed to do and he had a good understanding of nutrition and food hygiene. There was a communication problem identified between the chef and care staff, as information about a resident’s diabetes had not been passed to the chef. A new menu was in place offering 3 choices at each mealtime. Residents were seen to have different meals at lunchtime evidencing that their choices had been respected. A dietician has approved the menu and residents say they enjoy the meals. The new menu is a great improvement for the home. The options are displayed on a blackboard in the hall each day but this is not very clear for all residents, as the blackboard was very busy with lots of information in small writing. It may be more appropriate to enlarge the writing or use pictures. Mealtimes were seen to be a relaxed a pleasant experience for residents. Some residents are at risk from not drinking enough fluids. Staff encourage them to have regular drinks but are not always following up to ensure that they had drunk them. For example, one lady was seen to be provided with 4 drinks throughout the morning but did not drink these. Staff were quick to support her when this was pointed out but had not followed this up as part of their routine. Residents who need support or encouragement to drink may be at risk of dehydration if left unattended with drinks. Copperfields Residential Home DS0000023919.V294539.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, 18 Residents know that they can complain if they need to, but would benefit from an accessible complaints procedure. They are not fully protected against abuse in the home due to some unsafe procedures. The overall outcome in this area is poor. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: There is a complaints procedure for the home but the Manager needs to ensure this is displayed where residents and relatives can easily access it. There have been no recent complaints received at the home. There has been one complaint received by CSCI in respect of the home since the last inspection. This raised concerns about a broken lift and insufficient numbers of staff. This complaint was upheld and requirements were made on 15/03/06. Residents are given the opportunity to raise any concerns they may have at their monthly care plan review meeting. There have been 2 adult protection alerts raised about the home since the last inspection in relation to the safe management of residents’ medication and these are currently open and being investigated through the Kent adult protection procedures. Most staff have received training in the Protection of Vulnerable Adults and all staff are appropriately vetted before they are employed. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 15 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, 21, 22, 23, 24, 25, 26 Residents live in a comfortable and clean home. Generally residents’ benefit from a safe environment, but one issue of fire safety needs to be resolved. Residents have access to sufficient facilities and most residents’ bedrooms meet their needs. Residents have the specialist equipment they need. The overall outcome in this area is adequate. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The home was clean and homely at the visit. There were no unpleasant odours or dirty areas of residents’ accommodation. The cleanliness of the home had improved since the last inspection and the garden was no longer cluttered with equipment. The home was warm and well lit. Most residents said they were happy with their bedrooms. Two of the residents are currently sharing a bedroom. They have not been able to make a positive choice to do this. Their care plans showed that both residents have very high Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 16 levels of personal care needs and records indicate that they do disturb each other in the night. One of the residents in the shared room has a diagnosis of dementia. Residents should only share a room where their consent to do so can be obtained. As this has not been possible the residents should be provided with single bedrooms to ensure their privacy. The lounge and dining areas were very pleasant for residents with comfortable chairs, although several of the chairs are becoming rather worn. Residents’ bedrooms are personalised with their belongings. Some residents had protective sheeting on their beds, but this was very loose fitting and did not look very comfortable. The loose fitting plastic sheets could cause problems for older people who have delicate skin. The bathrooms are fitted with equipment that meets the needs of the residents and has been regularly serviced. The recommended frames around the toilets have been fitted. The laundry machines have a sluice programme, but the laundry assistant needs to be clear about safe procedures for managing soiled laundry. Some cleaning products were stored on a shelf in the kitchen. Cleaning products must be stored away safely. One downstairs bedroom is next to a toilet that has the door opening across the bedroom doorway. This could block the exit of the person in the bedroom in the event of a fire. It also makes it difficult for the person in that bedroom to access the toilet. The Manager was not sure when the last fire risk assessment was completed but is in the process of reviewing all risk assessments. It is recommended that the Manager check this issue with the local fire officer. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 17 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, 30 Residents are not supported by sufficient numbers of qualified staff to meet their needs. They are protected by a robust recruitment procedure. The overall outcome in this area is poor. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Rotas evidenced that there are still insufficient numbers of staff on duty to meet the needs of the residents. As reported under standard 4 there are some residents who have been placed in the home out of category and there are insufficient numbers of staff to meet their needs. Staff were clearly unable to carry out all the duties required of them on the day of the visit. This was evident when the medication was due and staff were busy supporting residents with their personal care. Staff said that they found it difficult to meet all the needs of the residents when they are short staffed and especially if there is not cook on duty. On some days there were only 2 staff on the rota to support 18 residents. Feedback from relatives confirmed that they are also concerned about the low numbers of staff on duty in the home. Staff are working very long hours without a break. In some cases staff were rostered to work a 14-hour day for 3 days in a row. This is not safe as staff will become tired and this puts residents at risk. The Manager said she was not Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 18 aware that the rotas had been written in that way and would immediately change this. The Manager was asked to ensure all staff are included on the rota. This was done at the time of the visit. Staff surnames must also be included on the rota. Staff would benefit from more leadership on each shift. There are no systems for monitoring what is happening downstairs in the home as the Manager is based upstairs in the office. Examples of where monitoring and leadership would have been beneficial are the safe allocation of staff and the administration of medication. Staff are very enthusiastic about their roles but are not being supported on a daily basis by the Manager. As the Manager remains registered for two homes daily supervision and guidance for staff has not been consistent. 3 care staff, the manager and the assistant Manager have achieved the appropriate qualifications. It is planned that the new staff will begin their NVQ this year to bring the ratio of qualified staff up to the recommended 50 . Some work is required to ensure all staff have a full induction and that this is recorded in their training file. Recruitment procedures are robust. All staff have been employed after the appropriate checks have been made. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 19 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, 32, 33, 35, 36, 37, 38 Residents do not benefit from a well run home. They are at risk as staff are not supported and supervised. Residents have been consulted on their views of the home and their financial interests are safeguarded. Residents health and safety in the environment are protected, with the exception of one fire issue. Their health and welfare is not protected in other areas as described in above. The overall outcome in this area is poor. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The Manager is still the registered Manager for 2 homes. Action is now being taken by CSCI in relation to this requirement. Staff are not being offered the support they need to carry out their roles safely and they are not being supervised regularly. Where staff supervision has occurred this has not always been recorded to evidence this. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 20 The Manager has completed a quality survey for the home to gather the views of all residents. It was discussed with the Manager that other methods of quality assurance need to be adopted in the home. These should include monitoring medication procedures, supervision staff, reviewing records for residents, spot-checking the management of residents finances and monitoring accidents and incidents. There have been no recent quality audits submitted for the home. The registered provider under Regulation 26 of the Care Home Regulations must complete these monthly. Residents money was stored safely and any transactions made were recorded accurately. The Manager stated that all risk assessments for the home were currently under review. Some examples of good risk assessment were seen for residents and staff who complete risk assessments have been trained. All policies and procedures for the home are under review. The Manager stated half of these had been completed and evidence was seen that these had been done in April 2005. As reported under standard 19 the Manager must ensure that the toilet door that is blocking a bedroom doorway is not a fire risk. All equipment in the home had been recently serviced. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 21 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 2 X 2 1 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 2 3 3 1 2 3 2 STAFFING Standard No Score 27 1 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 2 X 3 1 3 2 Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 22 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 OP1 Regulation 4 and 5 Requirement The registered person shall compile in relation to the care home a written statement which shall consist of— (a) a statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and (c) a statement as to the matters listed in Schedule 1 In that, this should clearly state the categories of registration. The Service User Guide should also reflect this. 2. OP4 14(1)(a) The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so, the needs of the service user have been assessed by a suitably qualified or suitably trained person. DS0000023919.V294539.R01.S.doc Timescale for action 30/06/06 31/05/06 Copperfields Residential Home Version 5.1 Page 23 In that, service users must not be offered a place at the home where the home cannot meet their needs or where the home is not registered to provide care to a person with those needs. 3. OP9 13(2) The registered person shall 30/07/06 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. In that, a) Clear and accurate records of residents medication must be maintained. b) The GP must be contacted with regard to any resident who is regulary refusing their medication. c) Clear guidance must be in place for when staff should administer as required medications. d) Homely remedies must be stored safely and checked by an appropriately trained person to ensure they do not interact with any regular medication. e) The Manager should carry out regular assessments of staff competence to administer medication. f) Medications must be given at the prescribed time and following the instructions on the presription. Parts of this requirement were not met following the last inspection. Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 24 4. OP12 16(2n) The registered person shall 30/07/06 having regard to the size of the care home and the number and needs of service users consult service users about the programme of activities arranged by or on behalf of the care home, and provide facilities for recreation including, having regard to the needs of service users, activities in relation to recreation, fitness and training. In that, evidence of consultation and how service users social needs will be met should be included in the care plan. Clear records of all activities service users participate in should be kept. 5. OP15 12(1a) The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users. In that, information about service users dietary requirements must be communicated to the chef. 31/05/06 6. OP22 16(2)(c) The registered person shall having regard to the size of the care home and the number and needs of service users provide in rooms occupied by service users adequate furniture, bedding and other furnishings, including curtains and floor coverings, and equipment suitable to the needs of service users and screens where necessary. In that, any protective bedding used must be comfortable and suitable for the needs of older 30/06/06 Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 25 people. Consideration should be given to people at risk of pressure areas. 7. OP27 18(1)(a) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. In that, sufficient staff must be employed to meet the needs of service users and the Manager must ensure compliance with the Working Time Regulations with regard to the number of hours staff work. This requirement was not met following the inspection on 15.03.05 The registered person shall make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users; In that, service users must be offered single bedrooms unless they can make a clear positive choice to share and this can be evidenced in their care plan. 9. OP30 18(1c)(iii) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that the persons employed by the registered person to work at DS0000023919.V294539.R01.S.doc 31/05/06 8. OP10 12(4a) 30/06/06 30/07/06 Copperfields Residential Home Version 5.1 Page 26 the care home receive training appropriate to the work they are to perform including structured induction training; In that, all staff should complete training in POVA, Dementia and a full induction programme. 10. OP31 8(1)(b)(iii ) The registered provider shall appoint an individual to manage the care home where the registered person is not, or does not intend to be, in full time day to day charge of the home. In that, The Manager must not be registered for more than one establishment. This requirement has not been met since first made in 2002.Action is now being taken by CSCI with regard to this requirement. 11. OP33 24(2) 26 The registered person shall supply to the Commission a report in respect of any quality review conducted by him and make a copy of the report available to service users. In that, the Manager must ensure that systems are in place for regularly monitoring the quality of care in the home. The registered provider must make monthly quality audits of the home and provide a copy of the report to CSCI. 12. OP36 18(2) The registered person shall ensure that persons working at the home are appropriately supervised. 30/06/06 30/06/06 31/05/06 Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 27 13. OP38 13(4a) The registered person shall ensure that all parts of the home to which service users have access are, so far as reasonably practicable, free from hazards to their safety. In that, Cleaning products are to be stored safely. The fire officer should be consulted regarding the bathroom door that blocks a bedroom. 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is strongly recommended that care plans include details of any input by other professionals. It is recommeded that service users be involved in their initial assessment and their care plan and sign to agree these. It is recommended that advice be sought with regard to the suitability of the environment for the 2 people with Dementia. It is strongly recommended that at least 50 of staff have an NVQ level 2 or above. It is recommended that the Manager reviews the arrangements for supervising and leading staff on duty on a daily basis to provide them with more guidance. It is recommended that the board to display menus and activities be clearer for service users to read, using DS0000023919.V294539.R01.S.doc Version 5.1 Page 28 2 OP22 3. 4. OP28 OP32 5. OP14 Copperfields Residential Home 6. 7. OP8 OP16 pictures if necessary. This will allow them to make more choices. It is recommeded that staff monitor service users fluid intake where they are at rsik of not drinking enough fluids. It is recommended that the complaints procedure be displayed in a more prominent position for service users to access. It is recommended that a programme of replacement of the armchairs in the lounge be introduced as some are beginning to look worn. It is recommeded that the Manager review the procedures for handling soiled laundry with the laundry assistant. It is recommeded that the Manager continues to review the risk assessments for the enivornment as planned. 8. OP20 9. 10. OP26 OP38 Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Copperfields Residential Home DS0000023919.V294539.R01.S.doc Version 5.1 Page 30 - 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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